Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, 67 President St., 2nd Fl. S., MSC 861, Charleston, SC, USA.
Department of Psychiatry, Boston University School of Medicine, 720 Harrison Avenue, Boston, MA 02118, USA.
Contemp Clin Trials. 2023 Feb;125:107002. doi: 10.1016/j.cct.2022.107002. Epub 2022 Nov 24.
The co-occurrence of posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD) is common following sexual assault and associated with more severe symptomology and increased likelihood of sexual revictimization. Integrated interventions aimed at reducing PTSD and AUD symptoms following recent sexual assault are needed and should address barriers to care and early treatment termination. The proposed study will test a novel, brief (5 to 7 sessions) intervention that integrates Written Exposure Therapy for PTSD and Cognitive Behavioral Therapy for AUD, and is initiated within the first six weeks post-assault. In Phase 1, qualitative analysis of content gathered during focus groups with treatment providers will be conducted to inform intervention development. In Phase 2, a proof-of-concept pilot study (n = 10) of the intervention, Substance Use Skills Training and Exposure Post-Sexual Assault (STEPS), will be conducted. In Phase 3, a pilot randomized controlled trial (RCT) among 54 recent sexual assault survivors will be implemented using the updated manualized STEPS intervention to evaluate feasibility and preliminary efficacy in reducing PTSD and AUD symptoms. Ecological momentary assessments will be used to assess daily alcohol use, craving, affect, intrusions and avoidance. The effects of STEPS on commonly associated symptoms (e.g., depression, substance use) will be examined. The proposed study has the potential to make a significant public health impact by advancing knowledge on the link between sexual assault and co-occurring PTSD and AUD and informing early intervention efforts for this high-risk population.
创伤后应激障碍（PTSD）和酒精使用障碍（AUD）在性侵犯后常同时发生，与更严重的症状和更高的性再受害风险相关。需要针对近期性侵犯后 PTSD 和 AUD 症状的综合干预措施，且应解决护理障碍和早期治疗终止问题。拟议的研究将测试一种新的、简短的（5-7 次）干预措施，将 PTSD 的书面暴露疗法和 AUD 的认知行为疗法相结合，并在性侵犯后 6 周内启动。在第 1 阶段，将对治疗提供者焦点小组收集的内容进行定性分析，为干预措施的发展提供信息。在第 2 阶段，将对该干预措施 Substance Use Skills Training and Exposure Post-Sexual Assault (STEPS)进行概念验证性试点研究（n=10）。在第 3 阶段，将对 54 名近期性侵犯幸存者实施一项试点随机对照试验（RCT），使用更新后的 STEPS 干预措施评估该干预措施的可行性和初步疗效，以减少 PTSD 和 AUD 症状。将使用生态瞬时评估来评估每日饮酒、渴求、情绪、侵入和回避情况。还将研究 STEPS 对常见相关症状（如抑郁、物质使用）的影响。该研究有可能通过推进性侵犯与同时发生的 PTSD 和 AUD 之间联系的知识，并为这一高风险人群提供早期干预措施，从而对公共卫生产生重大影响。
