Self-Defense Training in Women With Trauma
Previous research has shown that self-defense training can lead to gains in women's assertiveness, self-esteem, self-efficacy, and physical competence, and decreases in anxiety, helplessness, fear, and avoidant behaviors. However, most of this research has been conducted with healthy women who had not previously experienced physical or sexual violence. The investigators believe that women with such trauma histories require additional care because of potential triggering symptoms. As such, the investigators are mindful of the potential for triggering trauma symptoms and will work with the women so that they feel safe and comfortable in their participation. This pilot study aims to examine whether similar psychological gains from self-defense training are made in women who have previous experiences of physical and/or sexual violence.
Stress Disorders, Post-Traumatic
Behavioral: Life skills and self-defense training
|Study Design:||Allocation: Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Treatment
|Official Title:||A Pilot Study of Self-Defense Training in Women With Trauma|
- Change in self-efficacy from baseline to post-treatment and maintenance at 6 and 12-months post intervention [ Time Frame: 8 weeks, 6 and 12- months post-treatment ] [ Designated as safety issue: No ]Several measures of self-efficacy will be assessed. General self-efficacy (Schwartz and Jerusalem, 1993) will assess overall self-efficacy. More specific aspects of self efficacy will include one's physical self-efficacy (Rychman et al., 1982) and coping self-efficacy (Chesney et al., 2006)
- Change in assertiveness between baseline and post-intervention and maintenance at 6 anad 12 months [ Time Frame: post class and 6 and 12 months post-class ] [ Designated as safety issue: No ]Measured by the Rathus Assertiveness Schedule (Rathus, 1973)
- Change in self-esteem between baseline and post-intervention and maintenance at 6 anad 12 months [ Time Frame: post class and 6 and 12 months post-class ] [ Designated as safety issue: No ]Measured by the Rosenberg Self-esteem inventory (Rosengerb, 1955)
- Change in trauma symptoms and depression between baseline and post-intervention and maintenance at 6 and 12 months [ Time Frame: post class and 6 and 12 months post-class ] [ Designated as safety issue: No ]Measured by the Trauma Symptom Inventory-2 (Briere, 2010)
- Change in Risk perception between baseline and post-intervention and maintenance at 6 and 12 months [ Time Frame: post class and 6 and 12 months post-class ] [ Designated as safety issue: No ]Measured by the Risk Perception Survey (Messman-Moore & Brown, 2006)
- Relationship of shame to type and severity of trauma history [ Time Frame: baseline ] [ Designated as safety issue: No ]Measured by the TOSCA-3 (Tangney et al.,1989) and ETI-SR.
|Study Start Date:||April 2011|
|Estimated Study Completion Date:||November 2013|
|Estimated Primary Completion Date:||August 2013 (Final data collection date for primary outcome measure)|
Experimental: Life skills and self-defense training
Women will participate in a therapeutic group which covers education, skills, and empowerment activities.
Behavioral: Life skills and self-defense training
8 week class which meets once per week for 2.5 hours. Each class contains the following components: 1) life skills/education training. This includes basic education about physical and sexual assaults, assault risks, dating and communication, assertiveness training and boundary setting, 2) physical self-defense training, 3) supportive therapy/debriefing.
No Intervention: Wait-list control
This group will not receive any intervention during the time period that the first experimental group receives the life skills and self-defense class. After completion of this class, the wait-list control group will be offered the same class.
There is a high rate of violence against women in the United States. For example, at least 1 in 6 women will experience an attempted or completed rape in their lifetime (Tjaden & Thoenees, 2000). The high physical, emotional, economic and social costs of such violence are staggering. In particular, there can be a serious impact on mental health, with both immediate and long-term consequences (e.g., Coker et al., 2000). The aim of this project is to examine the psychological benefits of a class, which incorporates psychological and physical self-defense skills, for women who have been the victim of sexual or physical violence.
A small literature suggests that women who take self-defense classes have increases in general self-efficacy and self-esteem (e.g.,Ozer and Bandura, 1990). This project is focusing on women who already have a history of physical or sexual violence. The investigators hypothesize that women who already have such a history of violence will benefit from a self-defense class that incorporates psychoeducation and brief psychology treatments in order to successfully participate in such a class and that ultimately it will improve their psychological well-being.
Potential participants will first do a short phone screening to see whether they may be eligible for the study. If so, they will be brought into the clinic for a full eligibility assessment.
Eligibility Procedures: Before entering the study, participants will participate in an eligibility interview. This will consist of a psychiatric interview (e.g., portions of the SCID and psychiatric rating scales), trauma history (e.g. CAPS), and physical health assessment. Participants will either need approval from their primary care physician to participate in the physical self-defense portion of the study or have a brief physical exam will a physician on the research team.
If the participant is eligible for the study, they will be added to the list of participants. Once 16-20 participants have been screened and determine eligible for the study, all will be randomly assigned to either the first self-defense class or a wait-list group. Those in the first class will actively participate in the class for the first 8 weeks of the study. Those in the wait-list group will receive no specific treatment during the first 8 weeks. After completion of the first course, participants on the wait-list group will then be offered the same 8-week course. All woman will participate in the class - either in the 1st or 2nd 8-week class session.
During the initial 8 weeks, all participants, regardless of group assigned, will be asked to fill out a series of questionnaires prior to the course, and after 4 and 8 weeks. Each set of questionnaires should take less than 1 hour to complete. In addition, the investigators will conduct a 6-month post-class, follow up assessment, which will also be on-line.
Self-defense class: The self-defense program is an eight week curriculum that meets once per week for 2.5 hours per session. The course which involves three components. The first component is a psycho-educational component which provides current basic information about physical and sexual assaults and also skill building, such as assertiveness, communication skills, and boundary setting. The second component of each class is physical resistance techniques which offers ample training. This includes information about basic targets, punches, and kicks, as well as breaking out of holds and other resistance skills. The third component of each class includes a supportive psychotherapy debriefing session. Following participation in the self-defense class all participants will be required to come for an in-person, debriefing interview.
Please refer to this study by its ClinicalTrials.gov identifier: NCT01380379
|United States, California|
|Stanford University School of Medicine|
|Stanford, California, United States, 94305|
|Principal Investigator:||Jennifer Keller||Stanford University|