Adapting Alcohol Behavioral Couple Therapy for Service Members in Post-Deployment

对部署后的服役人员进行酒精行为夫妻治疗

基本信息

批准号：
8684506
负责人：
Elizabeth Ellen Epstein
金额：
$ 6.13万
依托单位：
RUTGERS, THE STATE UNIV OF N.J.
依托单位国家：
美国
项目类别：
财政年份：
2014
资助国家：
美国
起止时间：
2014-05-15 至 2015-01-02
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8684506
关键词：
Abstinence Address Advocacy Affect Aftercare Alcohol abuse Alcohol consumption Alcohols Behavioral Commit Complex Couples Couples Therapy Depression and Suicide Development Family Feeling suicidal Female Freedom Gender Goals Heterogeneity Human Resources Institute of Medicine (U.S.)Intervention Interview Manuals Marital Relationships Massachusetts Mediator of activation protein Mental Depression Military Personnel Modeling Modification Outpatients Population Post-Traumatic Stress Disorders Protocols documentation Public Health Randomized Randomized Controlled Trials Recruitment Activity Reporting Services Social support Soldier Solid Staging Suicide Symptoms Testing Thinking Traumatic Brain Injury Treatment Protocols Veterans Woman alcohol misuse alcohol related problem alcohol use disorder base binge drinking cohort conflict resolution coping design drinking empowerment evidence base fitness follow-up high risk drinking intimate partner violence male marital violence meetings member men operation post-traumatic stress primary outcome programs psychoeducation psychologic public health relevance reconstitution repaired response standard of care stressor therapy development treatment as usual treatment planning trial comparing

项目摘要

DESCRIPTION (provided by applicant): This R34 proposal, "Adapting Alcohol Behavioral Couple Therapy for Service Members in Post-Deployment," in response to PA-13-078, "Behavioral & Integrative Treatment Development Program," seeks to adapt and test a well-established civilian Alcohol Behavioral Couple Therapy (ABCT) approach (McCrady & Epstein, 2009) to meet the unique needs and challenges facing returning service members from Operation Enduring Freedom (OEF), Operation Iraqi Freedom (OIF), and Operation New Dawn (OND). Among the two million personnel who have served in OIF/OEF/OND, up to 38% report alcohol problems, 50% report marital violence, 25% suffer from depression and/or thoughts of suicide, 31% have Post Traumatic Stress Disorder (PTSD), and 19-22% have Traumatic Brain Injury (TBI). For the 65% of solders re-integrating into marital relationships, these alcohol and related problems are associated with significant discord. Our proposed manual-guided treatment protocol, ABCT_Military, will deliver our existing core sets of (a) abstinence-based, alcohol-related interventions, and (b) couple interventions, but with adaptations in content, illustration, and delivery, to make the treatment palatable and relevant to post-deployment service members. Four new optional modules will be developed to address issues exacerbated by and aggravating problem drinking among soldiers and their families following return from theater; the modules are designed to help couples cope with symptoms of: 1. Intimate Partner Violence; 2. Depression; 3. PTSD, and 4.TBI. Specific Aims in the current proposal are: (1)To modify our existing, ABCT_civilian model to treat soldiers in post deployment, and develop optional content modules to address relevant co-morbid challenges in this population in a 15 session outpatient format; (2) To test feasibility and preliminary efficacy of the treatment protocol using a Stage 1a successive cohort design, and (3) To complete a Stage 1b small Randomized Controlled Trial (RCT) comparing Treatment as Usual (TAU) to TAU+ABCT_Military. To achieve these aims, male and female OIF/OEF/OND service members who are in post-deployment or separated from active service, are drinking excessively, and are married or in a committed relationship with a partner willing to participate in the treatment, will be recruited through the Massachusetts Statewide Advocacy for Veterans' Empowerment (SAVE) program, which provides referrals to over 700 service men and women annually across all branches of the military. After manual development and iterative testing on two cohorts of 6 couples each (Stage 1a), 44 couples in the small RCT (stage 1b) will be randomly assigned to either TAU (n=22 couples) or TAU + ABCT_Military (n=22 couples), then will complete a follow up interview post treatment. The

描述（由申请人提供）：此 R34 提案“为部署后的服役人员调整酒精行为夫妻治疗”，以回应 PA-13-078“行为与综合治疗开发计划”，旨在调整和测试完善的民用酒精行为夫妻疗法 (ABCT) 方法（McCrady & Epstein，2009），以满足从持久行动中返回的军人所面临的独特需求和挑战自由行动（OEF）、伊拉克自由行动（OIF）和新黎明行动（OND）。在曾在 OIF/OEF/OND 服役的 200 万名人员中，高达 38% 的人报告酗酒问题，50% 的人报告婚姻暴力，25% 的人患有抑郁症和/或自杀念头，31% 的人患有创伤后应激障碍 (PTSD) ），19-22% 患有创伤性脑损伤 (TBI)。对于 65% 重新融入婚姻关系的焊工来说，这些酒精和相关问题与严重的不和谐有关。我们提出的手动指导治疗方案 ABCT_Military 将提供我们现有的核心组（a）基于戒酒的酒精相关干预措施和（b）夫妇干预措施，但在内容、插图和交付方面进行了调整，以使待遇对于部署后服役人员来说是可接受的且相关的。将开发四个新的可选模块，以解决士兵及其家人从战区返回后因饮酒问题而加剧和加剧的问题；这些模块旨在帮助夫妻应对以下症状： 1. 亲密伴侣暴力； 2.抑郁症； 3.创伤后应激障碍（PTSD）和 4.创伤性脑损伤（TBI）。当前提案的具体目标是： (1) 修改我们现有的 ABCT_civilian 模型来治疗部署后的士兵，并开发可选内容模块，以 15 次门诊形式解决该人群中的相关共病挑战； (2) 使用 1a 阶段连续队列设计测试治疗方案的可行性和初步疗效，以及 (3) 完成 1b 阶段小型随机对照试验 (RCT)，比较常规治疗 (TAU) 与 TAU+ABCT_Military。为了实现这些目标，服役后或退役、酗酒、已婚或与愿意参与治疗的伴侣有忠诚关系的男性和女性 OIF/OEF/OND 服役人员将通过马萨诸塞州退伍军人赋权倡导 (SAVE) 计划招募，该计划每年向军队所有部门的 700 多名男女军人提供推荐。在对两组各 6 对夫妇进行手动开发和迭代测试（第 1a 阶段）后，小型 RCT（第 1b 阶段）中的 44 对夫妇将被随机分配到 TAU（n = 22 对夫妇）或 TAU + ABCT_Military（n = 22 对夫妇）），然后将完成治疗后的后续访谈。这