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Iwankapiya American Indian Pilot Clinical Trial: Historical Trauma and Group Interpersonal Psychotherapy

机译：Iwankapiya美国印度试点临床试验：历史创伤和群体人际心理治疗

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American Indians face pervasive trauma exposure, collective histories of communal suffering, and elevated risk for depression and posttraumatic stress disorder. In addition to socioeconomic barriers. access to culturally responsive treatment is limited, which may compromise treatment engagement. The Iwankapiya study piloted the Historical Trauma and Unresolved Chief Intervention (HTUG), combined with Group Interpersonal Psychotherapy (IPT), to reduce symptoms of depression and related trauma and grief. The study hypothesized that HTUG + IPT would lead to greater group engagement and decreased depression and related symptoms compared with IPT-Only. American Indian adults (n = 52) were randomized into one of two 12-session interventions. HTUG + IPT or IPT-Only, at two tribal sites: one Northern Plains reservation (n = 26) and one Southwest urban clinic (n = 26). Standardized measures assessed depression, posttraumatic stress disorder, grief. trauma, and substance use. Data were collected at screening. baseline. end of intervention, and 8 weeks postintervention; depression and group engagement measures were also collected at Weeks 4 and 8 of the intervention. Depression scores significantly decreased for both treatments, but there were no significant differences in depression between the two groups: IPT-Only (30.2 +/- 6.4 at baseline to 16.7 +/- 12.1 at follow-up) and HTUG + IPT (30.2 +/- 8.1 at baseline to 19.9 +/- 8.8 at follow-up). However, HTUG + IPT participants demonstrated significantly greater group engagement. Postintervention, clinicians expressed preference for HTUG + IPT based upon qualitative observations of greater perceived gains among participants. Given the degree of trauma exposure in tribal communities, these findings in a relatively small sample suggest HTUG should be further examined in context of treatment engagement.
机译：美洲印第安人面临普遍的创伤暴露，公共痛苦的集体历史，抑郁症风险升高，抑郁症患者。除了社会经济障碍。进入文化响应治疗是有限的，这可能会损害治疗接合。 Iwankapiya的研究驾驶历史创伤和未解决的首席干预（HTUG），与群体人际心理治疗（IPT）相结合，以减少抑郁症和相关创伤和悲伤的症状。研究假设HTUG + IPT将导致更大的群体参与和减少抑郁症和相关症状与IPT--IPT。美国印第安人成年人（N = 52）被随机分为两个12会议干预中的一个。 HTUG + IPT或IPT-ock-oc，在两个部落地点：一个北部平原预留（n = 26）和一个西南城市诊所（n = 26）。标准化措施评估了抑郁症，宫外应激障碍，悲伤。创伤和物质使用。在筛选时收集数据。基线。干预结束，临时8周;在干预的第4周和第8周内也收集了抑郁和团体参与度量。治疗的抑郁症显着降低，但两组之间的抑郁症无显着差异：仅限IPT - 仅（基线30.2 +/- 6.4到后续16.7 +/- 12.1）和HTUG + IPT（30.2 + / - 在后续行动中的基线到19.9 +/- 8.8。然而，HTUG + IPT参与者的群体参与均明显更大。 PostIntervention，临床医生基于对参与者之间的更大感知的收益的定性观察表达了对HTUG + IPT的偏好。鉴于部落社区中的创伤暴露程度，在相对较小的样本中的这些发现建议HTUG在治疗订婚背景下进一步研究。

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