Breaking the Cycle of Posttraumatic Stress Disorder for High-Risk Perinatal Populations

Indiana University Indianapolis, Indianapolis IN

Investigators

Abstract

The overall goal of this mentored career award is to establish my independent research career centered on improving perinatal health outcomes among women who have experienced trauma. One untested, promising way to do so is to examine how reduction in post-traumatic stress disorder (PTSD) symptoms experienced during pregnancy and the postpartum period may affect subsequent health outcomes. PTSD is an under-recognized and untreated risk factor for adverse perinatal health outcomes. Engaging pregnant and postpartum individuals in PTSD treatment is critical as there are serious risks associated with untreated perinatal PTSD that often extend into the next generation. Making efforts to include the most traumatized and highest risk perinatal patients with PTSD, including rural-dwelling women and Black women, in treatment research presents a unique opportunity to improve maternal health for all perinatal women. To address these gaps in the literature, I propose a randomized controlled pilot study (the New Empowerment after eXposure to Trauma (NEXT) study). This study will evaluate the acceptability and feasibility of a revised brief (6-week) virtual PTSD protocol (Narrative Exposure Therapy (NET)) targeting high-risk traumatized women. Training activities utilizing community engaged methods and qualitative data collection will be used to tailor the protocol for maximal acceptability and uptake prior to the pilot trial. This pilot study will evaluate a revised NET protocol against a standard care control condition. This will be the first rigorous evaluation of a brief perinatal PTSD protocol specifically tailored to include high-risk, traumatized individuals across Indiana, and results will be of high interest to local and national stakeholders. The proposed study will lay the foundation for an R01 application for an RCT designed and powered to examine if reduction in PTSD symptoms can reduce the likelihood of adverse perinatal outcomes in highly traumatized perinatal populations. This project is specifically designed to address my training goals to develop expertise in: (1) participant-centered methodological approaches to increase participant recruitment and engagement; (2) physical and mental health considerations for perinatal research participants; and (3) conducting rigorous clinical trials that improve healthcare in all groups of women. To complete these goals, I have assembled an extraordinary mentorship team with expertise in perinatal physical and mental health, academic community partnerships, qualitative data, and conducting clinical trials with perinatal women. I have created a highly structured training plan that will be supported by the rich training environment at the Indiana University School of Medicine and affiliated hospitals and clinics.