SEQUENCE OF SYMPTOM CHANGE DURING AUD OR PTSD TREATMENT FOR COMORBID PTSD/AUD

合并 PTSD/AUD 的 AUD 或 PTSD 治疗期间症状变化的顺序

基本信息

批准号：
8423703
负责人：
DEBRA L KAYSEN
金额：
$ 53.4万
依托单位：
UNIVERSITY OF WASHINGTON
依托单位国家：
美国
项目类别：
财政年份：
2012
资助国家：
美国
起止时间：
2012-02-10 至 2017-01-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8423703
关键词：
Address Affect Aftercare Alcohol abuse Alcohol consumption Alcohol dependence Alcohol or Other Drugs use Alcohols Cognitive Combined Modality Therapy Communities Comorbidity Complex Cues Data Dependence Disease Funding Individual Mediating Mediator of activation protein Methodology Modeling Monitor Neurobehavioral Manifestations Outcome Participant Patients Phase Population Post-Traumatic Stress Disorders Process Randomized Recruitment Activity Relapse Relative (related person)Research Self Efficacy Self Medication Severities Specific qualifier value Symptoms System Telephone Testing Trauma Treatment outcome Voice Waiting Lists Work alcohol craving alcohol use disorder clinical practice coping craving disorder later incidence prevention distress tolerance drinking effective therapy improved innovation interactive therapy meetings reduced substance use response social theories treatment response

项目摘要

DESCRIPTION (provided by applicant): The broad, long-term objective of the current research is to improve treatment outcomes for individuals with comorbid PTSD and alcohol abuse and dependence (AUD). Prior research has established that PTSD and AUD are frequently comorbid. Although combined treatments have been developed, they are complex and lengthy with mixed results as to their efficacy. Excellent treatments exist for PTSD or AUD alone, however, it has not been adequately addressed to what extent these treatments are effective in treating comorbid symptom presentations. To address this research gap, we will evaluate two widely accepted treatments for each respective disorder; Cognitive Processing Therapy (CPT) an effective PTSD treatment and Relapse Prevention (RP), a widely used effective AUD treatment. The purpose of the present application is to evaluate changes in both PTSD symptoms and alcohol use and cravings associated with CPT or RP treatment in individuals with PTSD/AUD, along with mediators and moderators of outcomes. We will build on our prior work using a daily telephone Interactive Voice Response (IVR) system to test models of self-medication and the sequence of symptom change for both primary and secondary symptom targets associated with each therapy with. The study will randomize 235 PTSD/AUD participants recruited from the VA and from the community to CPT, RP, or IVR assessment only (AO). Those in the AO condition will be re-randomized after the treatment phase to either RP or CPT. Individuals will be assessed pretreatment, immediately post-treatment, 3-, 6-, 9-, and 12-months post-treatment and will monitor symptoms daily throughout treatment. Creating a more comprehensive model of symptom change in PTSD and alcohol use with widely used selective treatments is critical in testing theories of PTSD/AUD, evaluating these treatments for use with PTSD/AUD, and implementing these therapies with PTSD/AUD patients in standard clinical practice.

描述（由申请人提供）：当前研究的广泛长期目标是改善合并症患者，酗酒和依赖（AUD）的患者的治疗结果。先前的研究表明，PTSD和AUD经常是合并的。尽管已经开发了合并的处理，但它们的功效既复杂又冗长，结果混合了。仅对PTSD或AUD存在出色的治疗方法，但是，这些治疗方法在何种程度上可以有效地治疗合并症症状表现。为了解决这一研究差距，我们将评估每种疾病的两种广泛接受的治疗方法。认知加工疗法（CPT）有效的PTSD治疗和预防复发（RP），这是一种广泛使用的有效AUD治疗。本应用的目的是评估PTSD症状和饮酒的变化以及与PTSD/AUD患者中与CPT或RP治疗相关的渴望，以及结果的介体和调解人。我们将使用每天的电话交互式语音响应（IVR）系统以先前的工作为基础，以测试自我药物的模型以及与每种疗法相关的初级和次要症状靶标的症状变化顺序。这项研究将仅随机从VA招募的235名PTSD/AUD参与者，仅从社区到CPT，RP或IVR评估（AO）。治疗阶段后，AO条件下的患者将重新转换为RP或CPT。在治疗后，将对个人进行预处理，治疗后立即进行治疗，3-，6-，9-和12个月，并每天在整个治疗过程中监测症状。创建更全面的PTSD症状变化模型和使用广泛使用的选择性治疗的饮酒模型对于测试PTSD/AUD的理论至关重要，评估这些治疗方法与PTSD/AUD一起使用，并在标准临床实践中使用PTSD/AUD患者实施这些疗法。