Data from the National Women's Study of 4,008 female Americans (Kilpatrick et al., 1992; Resnick et al., 1993) indicate that approximately 12,100,000 women have been lifetime victims of completed rape, and more than 683,000 women are raped in a given year. Findings from assessment studies indicate that sequelae of rape include PTSD, drug abuse, depression, panic sexual dysfunction and risky health behaviors. Unfortunately, resource limitations and difficulty maintaining contact with victim preclude offering comprehensive, multi-session treatments that address each of the identified risk areas to all reporting rape victims. Thus, attention is justifiably fumed toward preventive, hospital-based interventions. The ongoing (until 9/31198) two-year pilot treatment-development study on which this application is based represents the first economically feasible preventive hospital-based intervention designed to reduce risk of developing post-rape psychopathology and substance abuse. The intervention is delivered in the form of a two-part videotape. The initial component of the video describes the forensic rape exam and is designed to reduce immediate distress during the forensic evaluation. The second component of the video contains psychoeducational information formally targeting prevention of PTSD, substance abuse, and other psychopathology. Preliminary findings regarding the efficacy this preventive intervention is encouraging. The video appears to be helpful in reducing distress during forensic exams. Moreover, the video is associated with higher """"""""quality"""""""" ratings of the forensic exam experience. The limited time frame of assessment and the study design of the original project precluded knowledge of either longer-term effects of the video and differential effects of the two major components of the video (i.e., the forensic exam review vs. the psychoeducational component). The present proposal, therefore, is to follow the initial treatment development pilot study with a large scale controlled mixes factorial study to fully assess the impact of the video intervention and each of its components on post-rape psychopathology substance abuse. Note that this intervention will be potentially available to all rape victims immediately during their first emergency room contact, and: (1) contains components to reduce anxiety and distress immediately during the forensic exam; (2) addresses risk of PTSD, drug abuse, and other psychopathology, (3) does not over-tax financial resources of rape victims o hospitals, (4) is brief and easily administered, (5) considers relevant cultural characteristics of rape victims; and (6) is offered in format that is easily standardized.
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