This is an application for a Mentored Patient-Oriented Research Career Development Award with a focus on developing expertise in treatment development and outcome assessment for anxiety disorders in minority and refugee populations. The Candidate proposes to build upon his clinical and research experience treating refugee populations in order to develop cognitive-behavioral interventions for refugee populations and to test the outcome with standard assessment measures and measures of culture-specific anxiety psychopathology. Post-traumatic stress disorder and panic attacks are common in Southeast Asian refugee populations but there is relatively little research available to guide the provision of culturally sensitive treatment for affected individuals. The proposed study is designed as an early step in addressing this treatment gap in a systematic manner. Research Plan: The study investigates the efficacy of a 12-week cognitive-behavioral therapy intervention for Cambodian refugees with PTSD, the treatment guided by a manual, and outcome assessed with standard psychometric instruments, culturally specific scales, and orthostatic challenge. Environment: The proposed study will be based at a Southeast Asian Refugee Clinic affiliated with the Massachusetts General Hospital and will complement a program of training and supervised research under the mentorship of Dr. Mark Pollack with consultation from experts. Career Development Plan: Training will emphasize learning skills to develop culturally appropriate assessment and treatment for traumatized non-English speaking groups. To lay the foundation for future independent investigation by the candidate, training will include supervision with consultants regarding outcome assessment, cognitive behavioral therapy, instrument validation, a psychophysiological outcome measure (i.e., orthostatic challenge), and a structured ethnographic interview, as well as taking courses at the Harvard School of Public Health on statistics and instrument development and evaluation. ? ?
