The global impact of war and violence has resulted in many, who suffer from post-traumatic stress disorder (PTSD). Over the past 20 years, the efficacy of several of variants of cognitive behavioral treatments (CBT) for the treatment of PTSD have received empirical support for PTSD related to a wide variety of traumatic experiences. However, these studies have been largely conducted in treatment samples from western cultural groups (e.g, American, European, or European decent). Thus, there is little evidence to support the use of CBT for PTSD in diverse cultural groups. This study seeks to 1) culturally and linguistically adapt Prolonged Exposure (PE), an extensively studied cognitive-behavioral treatment for PTSD for the Eritrea culture; 2) determine its acceptability in this cultural group; and 3) obtain initial evidence of its efficacy. Eritrea underwent a 30-year war with Ethiopia with hostilities ending in 2000. Approximately 1.6 million Eritreans were affected by war, drought and displacement. We propose to work with the Eritrea culture as we have 1) clinical and education collaborations with the Eritrean Ministry of Health, 2) bilingual, bicultural psychologists and psychiatrists to develop the protocol and to conduct treatment, 3) an extensive knowledge of the culture through our collaborations, and 4) a sufficiently large Eritrean population in Boston to conduct this proposal. Modification of the PE protocol and manual will be guided by a methodology endorsed by the World Health Organization for cultural and linguistic translation of research instruments. We will work closely with members of the Eritrean community both in Boston to achieve a culturally and linguistically acceptable translation. Following the development of the culturally adapted PE, we propose to conduct a pilot study with Eritrean refugees and immigrants in the Boston area to assess both acceptability and efficacy of the treatment. If this treatment is effective, we plan to apply for a Fogarty International Grant to conduct a randomized clinical trial in Eritrea.
