Testing a Comorbid PTSD & Substance/Alcohol Use Intervention in Delinquent Girls

测试合并症 PTSD

基本信息

批准号：
8714018
负责人：
AMY E LANSING
金额：
$ 45.87万
依托单位：
UNIVERSITY OF CALIFORNIA, SAN DIEGO
依托单位国家：
美国
项目类别：
财政年份：
2010
资助国家：
美国
起止时间：
2010-08-20 至 2017-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8714018
关键词：
18 year old Address Admission activity Adolescent Advocacy Affect Aftercare Age Alcohol consumption Alcohol or Other Drugs use Alcoholics Anonymous Anger Attention Behavior California Caring Child Abuse and Neglect Child Welfare Chronic Clinic Clinical Clinical Trials Design Cognitive Communities Comprehension Continuity of Patient Care Coping Skills County Data Development Drug usage Environment Evidence based intervention Evidence based treatment Exposure to Feedback Female Fostering Frequencies Funding Future Genetic Research Goals Harm Reduction Health Services Needs Image Impaired cognition Imprisonment Intervention Justice Learning Liquid substance Maintenance Mental Health Mental Health Services Mental disorders Modeling Modification Narcotics Nature Neurocognitive Outcome Outcome Measure Participant Pattern Population Positioning Attribute Post-Traumatic Stress Disorders Problem Solving Prostitution Psychiatric therapeutic procedure Psychopathology Randomized Randomized Clinical Trials Randomized Controlled Trials Recording of previous events Recruitment Activity Regulation Rehabilitation therapy Research Research Training Resources Risk Safety Sample Size Sampling Self-Injurious Behavior Services Severities Social support Societies Stream Subgroup Suicide Symptoms Testing Training Translational Research Trauma Treatment Protocols Treatment outcome Ursidae Family Violence Work Youth addiction adjudicate adolescent substance use alcohol use disorder base community based service community organizations cost court design drinking executive function follow-up functional disability girls health disparity high risk improved juvenile delinquent juvenile justice system maltreatment policy implication post intervention probation programs psychoeducation public health relevance recidivism self help severe mental illness sexual assault skills social therapy design treatment adherence treatment as usual treatment duration ward

项目摘要

DESCRIPTION (provided by applicant): Many youth with the most serious mental health problems resulting from violence exposure and maltreatment never receive mental health services [MHS].8,11 These youth are disproportionately found in juvenile delinquent populations where 67% - 75% have impairing psychiatric disorders, 20% have severe mental disorders and more than 1/3 need ongoing clinical MHS care- a figure twice the rate of the general adolescent population.7-10-12 Girls are the most vulnerable, understudied and underserved but fastest growing delinquent subgroup, with data strongly suggesting they have the most serious MHS needs: 75-95% have histories of child maltreatment, 95-100% have poly-trauma histories of violence exposure, sexual assault and child maltreatment, up to 50% have current Post Traumatic Stress Disorder [PTSD] and substance and alcohol use disorders [SAUD] and they have higher rates of PTSD and suicidality than delinquent boys.7,10,12,26-28 However there are few, if any, rigorously tested interventions available in the juvenile justice system [JJS] for youth with these comorbid problems. Our primary aim in this proposed study is to evaluate the efficacy of Seeking Safety [SS], an intervention for concurrently treating comorbid PTSD and SAUD that also addresses self harm and negative affect regulation, for female delinquents. This study lays the groundwork for developing a model for importing evidence based treatment [EBT] to high-risk youth who gain the attention of the JJS. We will recruit 250 female delinquents, 13 to 18 years old, with comorbid PTSD and SAUD through the San Diego Probation Department's Girls' Rehabilitation Facility. Our primary aims are to 1) use a randomized control trial design to determine the efficacy of an 8-week, 24 session manualized PTSD/SAUD intervention, 13 compared to the 'treatment as usual' [TAU] (8-week, 24 sessions) provided by the Probation Department for SAUD problems and 2) determine if cognitive factors (verbal skills, executive function) are related to treatment outcomes for SS and TAU. Our secondary aims are to 1) evaluate possible modifications to the SS treatment for improving services to the subject population and 2) use this study as a model for importing EBTs to other high-risk youth in Child Welfare and the JJS by partnering with (a) UC San Diego Comprehensive Research Center in Health Disparities to determine the best approach for fostering collaborative relationships within the alliance of San Diego's community clinics and identify funding streams to provide community-based services for a larger high- risk youth population and (b) Center for Criminality & Addiction Research, Training & Application to learn how to disseminate data about EBTs for youth in JJS across the nation and explore strategies to train correctional officers to work more effectively with traumatized and SAUD youth. With unprecedented support and access through the San Diego County Juvenile Court and Probation Department and a currently embedded multi- disciplinary, translational research program (spanning neurocognitive, psychiatric, imaging, genetics research), we are in a unique position to implement this proposed study that bears far reaching policy implications.

DESCRIPTION (provided by applicant): Many youth with the most serious mental health problems resulting from violence exposure and maltreatment never receive mental health services [MHS].8,11 These youth are disproportionately found in juvenile delinquent populations where 67% - 75% have impairing psychiatric disorders, 20% have severe mental disorders and more than 1/3 need ongoing clinical MHS care- a figure twice the rate of the general adolescent人口。7-10-12女孩是最脆弱，研究局面，服务不足但增长最快的犯罪亚组，数据强烈表明她们的MHS需求最严重：75-95％的儿童虐待历史，95-100％的历史，95-100％的人患有暴力，性侵犯和儿童的多种病历史，当前的疾病和50％的疾病[酒精使用障碍[SAUD]比犯罪男孩的PTSD和自杀率更高。7,10,12,26-28，但是对于少年司法系统[JJS]，对于患有这些合并问题的青少年司法系统[JJS]中，几乎没有严格测试的干预措施。我们在这项拟议的研究中的主要目的是评估寻求安全的功效[SS]，这是一种同时处理合并症PTSD和SAUD的干预措施，该干预措施也解决了女性犯罪者的自我伤害和负面影响调节。这项研究为开发一种用于进口证据治疗的模型（EBT]的模型为引起JJS注意的高风险青年的基础奠定了基础。我们将通过圣地亚哥缓刑部门的女孩康复设施招募250名女性犯罪者，分别为13至18岁。我们的主要目的是1）使用随机对照试验设计来确定与“像往常一样的治疗” [像往常一样的治疗方法（8周，24个会话），由SAUD问题和2）与认知因素（Verbal Skills，执行功能）相关的“ tau”（8周，24个会话）与SS SS SS SS SS SS SS SS SS SS SS SS SS SS SS SS SS SS SS SS SS SS SS SS SS SS SS SS SS SS SS SS SS SS SS SS SS CAMES CAMES相关。我们的次要目的是1）评估对SS治疗的可能修改，以改善对受试者的服务以及2）使用本研究作为模型，将EBT导入儿童福利中的其他高风险青年和JJS，通过（a）与（a）San Diego San Diego综合研究中心在健康方面的努力来确定社区融合的最佳方法，以确定San Diego的最佳努力，以确定San Diego的最佳接触。较大的高风险青年人口和（b）犯罪和成瘾研究，培训和应用中心，以学习如何传播全国JJS年轻人的EBT数据，并探索培训惩教人员的策略，以在受创伤和沙特的青年中更有效地工作。通过圣地亚哥县少年法院和缓刑部的前所未有的支持和访问，以及目前嵌入的多学科，转化研究计划（跨越神经认知，精神病学，成像，遗传学研究），我们处于独特的地位，可以实施这项拟议的研究，以实施较远的政策影响。