PTSD Clinical Trial
Official title:
Breaking the Cycle for Women With Behavioral Problems and Crime
The study is a randomized trial of two manualized 12-session one-to-one educational and therapeutic interventions for post-traumatic stress disorder (PTSD), to test and compare their efficacy for reducing PTSD symptoms as a means of prevention of intergenerational victimization by or involvement in criminal activities with at-risk mothers. The two therapies are (1) Trauma Affect Regulation: Guide for Education and Therapy (TARGET) and (2) Present Centered Therapy (PCT). The study also included a wait-list comparison condition in which participants were offered one of the two therapies following completion of baseline and posttest assessments.
Hypotheses, Objectives and Aims:
The study is a randomized clinical trial comparing two stress management counseling
interventions with a wait-list comparison condition to determine their efficacy in
addressing behavioral, cognitive, affective, and interpersonal effects of PTSD that often
occurs for persons living in adverse socioeconomic circumstances and in violent families and
communities. One goal of the study is to reduce the severity of or produce remission from
PTSD, in order to reduce impulsivity, aggression, dissociation, and isolation by high-risk
or previously incarcerated women. The long-term goal, which will be assessed in subsequent
studies over time is to reduce the likelihood of their or their children becoming involved
in, or victimized by other persons' involvement in, illegal activities. Children will not be
involved in the present study, only women who are the mothers of young children.
Aim #1: To test the efficacy of TARGET and PCT. TARGET (Frisman, L., Ford, J. D., Lin, H.,
Mallon, S., & Chang, R., 2008) and PCT (McDonagh A, Friedman M, McHugo G, Ford J, Sengupta
A, Mueser K, Demment CC, Fournier D, Schnurr PP, Descamps M., 2005) have demonstrated
efficacy in randomized trial studies, but have not been tested specifically with mothers of
young children. The study will assess outcomes that are of potential importance not only for
the well being of the participating women but for their ability to develop secure
attachments with their child which are protective against exposure to violence, crime, and
victimization and associated with positive psychosocial development by children. Outcome
measures reflect self-regulatory capacities compromised by trauma that are essential for
effective caregiving by adults.
Aim #2: To compare the efficacy of TARGET and PCT on theory-based differential outcomes.
TARGET and PCT use similar but different therapeutic strategies. Each teaches skills for
managing negative emotions and critical symptoms (e.g., inhibiting impulsivity). TARGET
teaches a skill sequence for affect regulation and social/interoceptive information
processing, while PCT teaches a skill sequence for recognizing and solving problems in
relationships. We expect that TARGET and PCT will reduce stress-related avoidance and
depression and enhance active coping with current stressors. TARGET should be superior to
PCT in enhancing the ability to cope with trauma memories, stress reactivity, and anxiety,
and therefore the ability to remain free from illegal activities or future or further
involvement with criminal justice systems. PCT should be superior to TARGET in enhancing the
participant's overall social adjustment.
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Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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