Testing the efficacy of a CBT-enhanced text message intervention to reduce symptom burden in individuals with post-traumatic stress disorder symptoms and co-occurring hazardous drinking

测试 CBT 增强短信干预的功效，以减轻患有创伤后应激障碍症状和同时发生危险饮酒的个体的症状负担

• 批准号: 10679044
• 负责人: MICHELE A BEDARD-Gilligan
• 金额: $ 52.36万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-20 至 2026-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10679044
• 关键词: Address; Adult; Alcohol consumption; Basic Science; Behavior Therapy; Behavioral; Behavioral Research; Caring; Cognitive Science; Cognitive Therapy; Communities; Complex; Data; Decision Making; Development; Disease; Dropout; Drops; Employment; Ethnic Origin; Evaluation; Event; Evidence based treatment; Feedback; Future; Gender; General Population; Growth; Health Services Accessibility; Heavy Drinking; Individual; Intervention; Intervention Studies; Legal; Literature; Motivation; National Institute on Alcohol Abuse and Alcoholism; Natural Disasters; Outcome; Participant; Persons; Phase; Pilot Projects; Post-Traumatic Stress Disorders; Poverty; Public Health; Randomized, Controlled Trials; Reporting; Research; Sampling; Self Direction; Severities; Social Psychology; Strategic Planning; Structure; Symptoms; Techniques; Technology; Testing; Text Messaging; Trauma; Treatment Efficacy; Veterans; alcohol related consequences; alcohol use disorder; avoidance behavior; behavior change; brief intervention; clinically significant; cognitive enhancement; comparative; comparative efficacy; coping; cost; design; drinking; efficacious intervention; efficacy testing; evidence base; follow-up; hazardous drinking; innovation; intervention delivery; intervention refinement; mass casualty; medical specialties; mobile application; novel; pandemic disease; portability; primary outcome; psychologic; recruit; reduce symptoms; response; revictimization; skills; social stigma; societal costs; suicidal behavior; text messaging intervention; theories; trauma exposure; web app

PROJECT SUMMARY Posttraumatic stress disorder (PTSD) and hazardous drinking (HD: heavy alcohol use and negative alcohol- related consequences) commonly develop and co-occur following trauma exposure. The individual and public health burden of PTSD and co-occurring HD is substantial. Although there are evidence-based behavioral treatments for co-occurring PTSD and HD, they have limitations that result in many individuals not accessing these treatments and limited intervention reach – i.e., existing interventions tend to be complicated, burdensome, and require contact with an in-person therapist. Thus, there is a need to develop additional, novel interventions that use evidenced-based strategies and that have greater portability and reach. There is a nascent, scant literature evaluating such types of interventions for veterans, and we know of none aimed at the general public. The current application, therefore, seeks to refine and test a brief, self-directed, intervention for individuals from the general public with PTSD and co-occurring HD that can be delivered via text-messaging. The proposed intervention draws on evidence-based strategies from cognitive behavioral therapy (CBT) for treating PTSD and co-occurring HD, and it yielded promising findings in a recent pilot study conducted by the research team. This application seeks to refine the intervention further by testing whether theoretically-driven, evidence-based strategies from basic cognitive psychology (message framing) and social psychology (facilitating growth mindsets) result in better outcomes for PTSD symptoms and HD by addressing pilot participant feedback related to avoidance and motivation. We will identify the most efficacious intervention and test it in a fully-powered RCT. Thus, Study 1, which will recruit an adult community sample (N = 500), will test the efficacy of enhancing the CBT text message intervention with message framing (protect against loss vs. imagine future gains vs. no framing) and mindsets (provide growth mindset message for using skills vs. simple reminder to use skills) via a fully-crossed 3x2 factorial design. Study 2 will build on Study 1, by conducting a fully powered (N = 333) randomized controlled trial (RCT) that will test the comparative and long-term efficacy of the most efficacious CBT-based text message intervention from Study 1 versus an assessment only control in a community sample of adults with co-occurring HD and PTSD. This proposal is innovative in its approach to adding to the menu of treatment options for co-occurring PTSD and HD and with its evaluation of the utility of integrating basic social and cognitive psychology strategies with those from CBT. If successful, it will result in an efficacious, novel, theory-driven, low burden behavioral intervention co-occurring PTSD and HD that is readily scalable. Such an intervention could be implemented as a stand-alone intervention or be integrated into stepped-care approaches, including following mass trauma exposure (natural disasters, mass casualty events, pandemics) and thus, has the potential for a substantial impact on public health.

项目摘要 创伤后应激障碍（PTSD）和危险饮酒（HD：大量酒精饮酒和阴性酒精 - 相关后果）通常在创伤暴露后发展和同时发生。个人和公众 PTSD和同时发生高清的Health Burnen很重要。尽管有循证行为 同时发生的PTSD和HD治疗，它们的局限性导致许多人无法访问 这些治疗方法和有限的干预措施 - 即现有干预措施往往很复杂， 繁重，需要与面对面的治疗师接触。那需要开发其他新颖的 使用基于证据的策略并具有更大可移植性和影响力的干预措施。有一个 新生的文献评估了退伍军人的这种类型的干预措施，我们知道没有针对 公众。因此，当前的应用程序试图完善和测试简短的，自我指导的干预措施 可以通过文本传输提供的PTSD和共同出现高清的公众的个人。 拟议的干预措施借鉴了认知行为疗法（CBT）的基于证据的策略 治疗PTSD和同时发生的HD，并在最近的一项试点研究中得出了希望的发现。 研究团队。该应用程序旨在通过测试理论驱动的，以进一步完善干预措施 基于基本认知心理学（消息框架）和社会心理学的循证策略 （促进成长心态）通过解决飞行员来为PTSD症状和HD带来更好的结果 参与者的反馈与回避和动机有关。我们将确定最有效的干预措施， 以完全动力的RCT进行测试。研究1将招募成人社区样本（n = 500），将测试 通过消息框架增强CBT短信干预的效率（防止损失VS。 想象力未来获得与无框架和思维方式（为使用技能与简单的技能提供增长心态信息 提醒使用技能）通过完全杂交的3x2阶乘设计。研究2将通过研究1来建立 全功率（n = 333）随机对照试验（RCT）将测试比较和长期有效性 研究1与评估控制最有效的基于CBT的文本消息干预措施 在具有同时发生高清和PTSD的成年人的社区样本中。该提议的方法是创新的 加入共同出现的PTSD和HD的治疗选项菜单，并评估其实用性 将基本的社会和认知心理学策略与CBT的基本心理学策略相结合。如果成功，它将导致 高效，新颖，理论驱动的，低燃烧行为干预措施同时出现的PTSD和HD 容易扩展。这样的干预措施可以作为独立干预实施，也可以集成到 阶梯护理的方法，包括遵循大规模创伤（自然灾害，大规模伤亡事件， 因此，大流行物具有对公共卫生的重大影响的潜力。