This application is the last resubmission to request a Mentored Patient-Oriented Research Career Development Award (K-23) that will provide me with necessary training to become an independent research scientist with expertise in developing and evaluating culturally competent cognitive behavioral treatment for Latino patients with posttraumatic stress disorder (PTSD) and co-occurring Medical Unexplained Physical Symptoms (MUPS). Both PTSD and MUPS are common, debilitating, and chronic psychological disorders that are associated with impaired social and occupational functioning. No treatment, to date, has been developed or tested to treat both groups of symptoms despite research and clinical evidence suggesting that these two groups of symptoms often co-occur as a result of trauma and that patients who suffer from trauma and develop PTSD are more likely to experience MUPS than those who do not have PTSD diagnoses. Latina/os report higher levels of trauma exposure, PTSD, and MUPS relative to the general population. They have been systematically neglected from treatment studies, especially treatment for PTSD, are less likely to access or engage in mental health care. My initial goal is to adapt and integrate existing cognitive behavioral treatments for PTSD and for MUPS and to collect preliminary data on the feasibility, acceptability, and efficacy of the adapted treatment. My training goals are 1) to advance my skills in designing and implementing randomized clinical trials in order to adapt treatment modalities, develop new treatment, and test established treatment for PTSD with comorbid MUPS;2) continue enhancing my knowledge in phenomenology and developing skills in assessment of PTSD and somatization disorder;3) extend competence in conducting treatment research with Latino populations in primary care;4) become a certified cognitive behavioral therapist that will allow me to supervise therapists for large clinical trials;5) receive training in research ethics, including ethical issues conducting research with participants who come from disadvantaged backgrounds;and 6) improve my grant-writing and manuscript preparation skills.

Public Health Relevance

Despite the increasing numbers of Latinos in the United States, there is a dearth of substantial clinical knowledge about culturally competent treatments for Latino patients with mental disorders. They report higher levels of PTSD, and Medical Unexplained Physical Symptoms relative to the general population. This project will provide a novel treatment to reduce debilitating disorders and holds promise for providing insight into the socio-cultural factors associated with treatment outcomes among underserved minorities.

National Institute of Health (NIH)
National Institute of Mental Health (NIMH)
Mentored Patient-Oriented Research Career Development Award (K23)
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Interventions Committee for Adult Mood and Anxiety Disorders (ITMA)
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Wynne, Debra K
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University of Miami Coral Gables
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Coral Gables
United States
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Perez Benitez, Carlos I; Yen, Shirley; Shea, M Tracie et al. (2010) Ethnicity in trauma and psychiatric disorders: findings from the collaborative longitudinal study of personality disorders. J Clin Psychol 66:583-98
Benitez, Carlos Israel Perez; Shea, M Tracie; Raffa, Susan et al. (2009) Anxiety sensitivity as a predictor of the clinical course of panic disorder: a 1-year follow-up study. Depress Anxiety 26:335-42