Please select the eligibility criteria that correspond to the clinical trial below.
Title: Effectiveness of Combined Intervention Approaches in the Treatment of Affective Disorders and Chronic Pain in Victims of Torture and Massive Violence in Kosovo: A Randomized Controlled Trial
Brief Summary: This study will measure the effects of biofeedback supported cognitive behavioral therapy (BF-CBT) and group physiotherapy intervention in victims of torture and massive violence in Kosovo. The investigators aim to restore physical and psychosocial functioning of the victims of torture and massive violence with available rehabilitation practice and integrate them into the community. It is also our objective to build local knowledge and expertise to apply measurement principles and CBT methods in the Balkan region.


Options:
A: Inclusion Criteria:

* Meets DSM-IV (Diagnostic and Statistical Manual of Mental Disorders) criteria for primary, chronic PTSD
* At least moderately severe symptoms, defined by a minimum total (frequency plus severity) Clinician-Administered PTSD Scale score greater than 50
* Willing to undergo an independent clinical assessment and other ratings

Exclusion Criteria:

* Diagnosis of schizophrenia, bipolar disorder, or other psychotic disorders
* Psychiatric disorder due to a general medical condition
* Current substance abuse or dependence
* Acute suicide or homicide risk
* Unstable or life-threatening medical condition
* Primary diagnosis of borderline personality disorder, major depressive disorder, or major depression, melancholic subtype
* Diagnosis of antisocial personality disorder
* At least partial benefit from current treatment regimen
* Unwillingness to discontinue current ineffective psycho- or pharmacotherapy
* Inability to speak or read English
B: Inclusion Criteria:

* Victims of massive violence from northern Kosovo who reported one or more of the following experiences: 1) torture and other cruel, inhuman or degrading treatment or punishment (TCIDTP); 2) sexual harassment, molestation, rape or insertion of a blunt object into a genital organ and/or the rectum; 3) arrest and detention without warrant or order; or 4) extrajudicial execution of family members, perpetrated by members of law enforcement agency.
* Clinical diagnosis of PTSD and one of following symptoms: depression, anxiety or chronic pain

Exclusion Criteria:

* With mental retardation or significant speech or cognitive impairment that would impede assessments
* With past or present schizophrenia
* With major alcoholic or substance abuse problems
* Having recently undergone chemotherapy or chemo-radiotherapy for cancer or will have these therapy within following 6 months,
* Having had any CBT in the past three years
C: Inclusion Criteria:

* War-affected children and adolescents

Exclusion Criteria:

* No traumatic war events experienced
* Psychosis
* Inability to speak Swahili, French or English
D: Once youth are referred to the study, a screening tool will be administered to determine whether or not they meet eligibility requirements as described below.

The screening tool contains four sections;

1. Consent and Age: assures that participants meet the age requirements
2. Oxford Refugees Psychosocial Adjustment Scale: assesses depression, anxiety and hostility
3. Functioning: assesses the participant's ability to carry out activities of daily living
4. Psychological Analysis: clinician's assessment of the psychological state of the participant.

Inclusion Criteria:

* Participants must be between 15-24 years of age;
* Participants must prefer to have the opportunity to join an educational program but not currently be enrolled in school;
* A participant's total score on the Oxford scale must equal or exceed 30 AND
* Participants must display at least one non-zero score on the functioning questions.

Exclusion Criteria:

* Participant does not plan to reside in the Freetown urban area for the duration of the study (9 months from start date);
* Participant fails to meet age requirements;
* Participant is currently enrolled in school;
* Participant is not in favor of joining an educational program;
* Participant fails to meet Oxford psychosocial or functioning thresholds;
* Participant is judged by clinical staff as:

  * Needing mental health treatment beyond the scope of the YRI
  * Otherwise not suitable for a group treatment setting
* Participant displays the following:

  * Cognitive delays
  * Active suicidality
  * Psychosis
  * Risk of harm to themselves or others

Participants at risk of harm to themselves or others, as well as those requiring treatment beyond the scope of the YRI, will be referred to local mental health or social work treatment facilities as appropriate.

Answer: B