The goal of this application is to refine and pilot test a brief Group Cognitive Behavioral Treatment (CBT) to address the symptoms of Posttraumatic Stress Disorder (PTSD) following a motor vehicle accident. The application has 2 phases that encompass 3 specific aims. Phase 1 will Consist of completion of the treatment manual for Group CBT for PTSD in MVA survivors (Aim 1). Also included during Phase 1 will be efforts to finalize and empirically test procedures to ensure therapists' adherence and competence in using the treatment manual (including measures to assess adherence and competence - Aim 2). 15 individuals with MVA-reiated PTSD will participate in Phase 1. to be treated in 3 groups of 5 each. Participants will be diagnosed with the Clinician Administered PTSD Scale and will complete a battery of additional clinician and self-report measures before and after treatment. Phase 1 will be an iterative process across the 3 waves of 5 cases each. After each wave, the treatment manual and measures of adherence and competence will be refined. Phase 2 will involve a randomized pilot study, consisting of 2 treatment conditions: Group CBT and a Minimal Contact Control (MCC) condition.
The aim of Phase 2 is to determine if Group CBT produces significant reductions in PTSD symptoms, anxiety, depression, health care use, and pain-related distress and impairment (Aim 3). 48 individuals with MVA-related PTSD will be randomly assigned to one of the 2 conditions. Outcome will be assessed using clinician measures of PTSD symptoms, anxiety disorders, and depressive disorders. As well, participants will complete questionnaires evaluating PTSD, anxiety, depression, health care utilization, and pain. It is hypothesized that patients with PTSD who receive Group CBT will show greater reductions in PTSD symptoms, anxiety, depression, health care use, and pain, relative to patients who receive MCC, at post-treatment assessment. Additionally, it is hypothesized that patients who receive Group CBT will maintain these gains at 3-month follow-up. Following participation, individuals in the MCC condition will be offered Group CBT, permitting uncontrolled replication. Examination of intent-to-treat participants will permit initial evaluation of the acceptability of Group CBT. Because MVAs are the single leading cause of PTSD in the general population, this application has the potential to provide a cost-efficient treatment.
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