Depression, Mental Disorders, Post-Traumatic Stress Disorder
Conditions
Keywords
PTSD, Physical Abuse, Sexual Abuse, Women, Trauma, Group Therapy, Substance Abuse
Brief summary
This study will determine the effectiveness of the Trauma Recovery and Empowerment Model in reducing the severity of post-traumatic stress disorder symptoms in women with mental disorders and who have experienced sexual or physical abuse.
Detailed description
Post-traumatic stress disorder (PTSD) is an anxiety disorder that can develop after exposure to a terrifying event in which grave physical harm occurred or was threatened. Rates of PTSD are extremely high among people with severe mental disorders and such individuals find themselves at increased risk for depression, substance abuse, and poor overall health. In turn, these issues lead to high rates of utilization of mental health services. Unfortunately, there is currently a lack of effective trauma treatments that can be implemented in routine mental health settings. Trauma Recovery and Empowerment Model (TREM) is a group-based intervention that addresses PTSD and other closely related consequences of sexual and physical abuse among women with severe mental disorders. This study will determine the effectiveness of TREM in reducing the severity of PTSD symptoms in women with mental disorders who have experienced sexual or physical abuse. Participants in this open label study will be randomly assigned to receive either usual care alone or usual care combined with TREM for 18 months. Usual care will include medication, case management, and therapy administered by a primary clinician. Participants assigned to usual care will report to the study site at least once a week, or as often as necessary. Participants assigned to usual care plus TREM will also be assigned to a primary clinician and will receive usual care as often as necessary. In addition, TREM participants will take part in 29 group sessions that will focus on increasing self-esteem and trauma-coping skills and reducing self-blame. PTSD symptom severity, trauma beliefs, depressive symptoms, substance use, and mental health service utilization will be measured at Months 6, 12, and 18 for all participants.
Interventions
BEHAVIORALTrauma Recovery and Empowerment Model (TREM)
TREM is a 29-session group intervention for women who have experienced psychological trauma (e.g., childhood physical or sexual abuse), focusing on skill development, understanding the effects of trauma, and empowerment.
BEHAVIORALUsual care
Participants will receive usual care for women who have experienced psychological trauma.
Sponsors
National Institute of Mental Health (NIMH)
Dartmouth-Hitchcock Medical Center
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
FEMALE
Age
20 Years to 60 Years
Healthy volunteers
No
Inclusion criteria
* History of physical and/or sexual abuse * Diagnosis of a severe mental disorder * Diagnosis of PTSD with a symptom severity score of 21 or higher
Exclusion criteria
* Severe developmental disabilities or organic brain damage
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| PTSD symptom severity | Measured at baseline and Months 6, 12, and 18 |
Secondary
| Measure | Time frame |
|---|---|
| Distorted beliefs | Measured at baseline and Months 6, 12, and 18 |
| Depressive symptoms | Measured at baseline and Months 6, 12, and 18 |
| Substance use | Measured at baseline and Months 6, 12, and 18 |
| Mental health service utilization | Measured at Months 6, 12, and 18 |
Countries
United States
Outcome results
None listed