Heather L. Littleton, Ph.D. - US grants

DESCRIPTION (provided by applicant): Rape is unfortunately a common experience among women, affecting between 13 and 20%. The experience of rape often has a significant psychological impact on victims. College women in particular have been found to have a high prevalence of rape (20%) and college rape victims have a high prevalence of current PTSD in connection to this experience (approximately 25%). Despite the existence of efficacious treatments for victims, the vast majority never seek out psychotherapy. One potential way to aid these victims is through online administered treatment. Thus, we propose to evaluate a self- paced, online cognitive-behavioral intervention for college women who have experienced rape and who have current PTSD. The intervention includes psycho-education about rape and PTSD, relaxation training, coping skills training, and cognitive restructuring. In addition, because the most successful extant online interventions for psychological distress have included therapist facilitation, the intervention also includes regular online (written and video) feedback from a study therapist regarding participants'utilization of program techniques. The program also utilizes video and audio clips and written examples of women modeling using the skills introduced. Specifically, we propose to randomize 86 women who have experienced rape to either the therapist facilitated online intervention or a psycho-educational website. Measures of PTSD symptomatology, anxiety, depression, rape-related coping, coping self-efficacy, and trauma-related cognitions will be collected at pre-treatment, post-treatment, and three-month follow-up assessments. In addition, information about program acceptability, therapeutic alliance, program utilization, and client satisfaction will be collected. It is hypothesized that individuals assigned to the therapist facilitated intervention will experience greater reductions in psychological symptomatology, maladaptive rape-related coping, and distorted rape-related cognitions than individuals assigned to the psycho-educational website. Individuals assigned to the therapist facilitated intervention will also report greater coping self-efficacy than individuals assigned to the psycho-educational website. The impact of this study is the development of an effective, user-friendly intervention that can be utilized by rape victims, including those who will not seek out traditional psychotherapy. PUBLIC HEALTH RELEVANCE: Findings from this study will be highly relevant to public health and fall within the national health policy and priorities set by the NIH/NIMH Healthy People 2010. First, the online intervention being developed has the potential to ameliorate distress among rape victims, a highly prevalent traumatic event often associated with significant and persistent mental health problems, including PTSD. Second, the program also overcomes many barriers to seeking and obtaining treatment by delivering treatment over the Internet. Finally, because the treatment involves structured modules, it can rapidly be disseminated and adopted in the field.

Severe natural disasters carry great economic costs and threaten individuals' health and well-being in both the short and longer-term. Severe natural disasters during the past decade include unprecedented flooding, devastating wildfires, and catastrophic hurricanes. On September 14, 2018, Hurricane Florence made landfall off the coast of Wilmington, North Carolina, causing billions of dollars in damage to the state and surrounding region. Robeson County was one of the hardest hit counties in North Carolina, with catastrophic flooding causing substantial damage to residences, businesses, and infrastructure. The same county had experienced widespread damage following Hurricane Matthew in 2016 as well. Many in the hardest hit areas were still experiencing long-term impacts from Hurricane Matthew in 2018, including loss of employment and physical health problems related to exposure to mold and other contaminants. Research focused on the experiences of individuals in this county offers a unique opportunity to better understand how individuals cope with and recover from severe and ongoing stress in the post-disaster context. This project seeks to gain a richer understanding of how individuals manage post-disaster recovery and the extent to which individual and social factors predict both positive and negative outcomes. By integrating theories of post-disaster adjustment and using advanced data analytic techniques, the current study will lead to a better understanding of individual and community responses to extreme events and inform the development of future interventions.

Online surveys and daily "check in" assessments administered via smart phone technology will be used to study psychological adjustment, social support, community solidarity, and coping efforts among adult residents of Robeson County, North Carolina who were exposed to severe and repeated hurricane-related stress. The surveys and the daily "check-ins" will provide critical data on how people cope with stress over time, including the extent to which social and individual factors affect adjustment. By cultivating a very rich set of data on the same individuals over time, it will be possible to discern patterns of recovery, and understanding which we are currently lacking. Measuring outcomes on a daily basis will generate significant amounts of data and we will use advanced non-linear data analysis methods to identify unique changes or shifts in functioning predicted by guiding theoretical frameworks (self-regulation shift theory and social support deterioration deterrence theory). This project extends current knowledge related to post-disaster recovery by targeting key social and coping mechanisms of change and highlighting possible critical targets for interventions in the near and long-term post disaster context.

This award reflects NSF's statutory mission and has been deemed worthy of support through evaluation using the Foundation's intellectual merit and broader impacts review criteria.