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Ennis CR, Raines AM, Boffa JW, Shapiro MO, Dornbach-Bender A, Ferrie ML, Fondren AH, Vidaurri DN, Walton JL, Chambliss JL, Franklin CL. Massed written exposure therapy delivered to veterans with posttraumatic stress symptoms on an acute inpatient mental health unit. J Trauma Stress 2024; 37:643-651. [PMID: 38583141 DOI: 10.1002/jts.23042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Revised: 03/04/2024] [Accepted: 03/05/2024] [Indexed: 04/09/2024]
Abstract
Written exposure therapy (WET) is a brief, manualized trauma-focused treatment typically delivered in five individual weekly sessions. Given the brevity and effectiveness of WET, researchers have begun to focus on its delivery in a massed format. However, only one case study examining massed delivery has been published to date. As such, the objective of the current study was to examine the acceptability, feasibility, and preliminary effectiveness of massed WET among veterans with a trauma- and stressor-related disorder receiving care on an acute inpatient mental health unit. Veterans (N = 26) were assessed prior to, immediately after, and 1 month following massed WET. Most veterans found massed WET to be useful and acceptable. Recruitment and retention rates suggested that the treatment was feasible. Notably, the results revealed statistically significant reductions in overall posttraumatic stress symptoms, ηp 2 = .81, p < .001; depressive symptoms, ηp 2 = .71, p < .001; and functional impairment, ηp 2 = .42, p = .002. These findings add to a growing body of literature highlighting the preliminary effectiveness of WET across various settings, populations, and delivery formats. Limitations include the small sample size and uncontrolled design.
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Affiliation(s)
- Chelsea R Ennis
- Southeast Louisiana Veterans Health Care System, New Orleans, Louisiana, USA
- South Central Mental Illness Research, Education and Clinical Center (MIRECC), New Orleans, Louisiana, USA
- Department of Psychiatry and Behavioral Sciences, Tulane University School of Medicine, New Orleans, Louisiana, USA
| | - Amanda M Raines
- Southeast Louisiana Veterans Health Care System, New Orleans, Louisiana, USA
- South Central Mental Illness Research, Education and Clinical Center (MIRECC), New Orleans, Louisiana, USA
- School of Medicine, Louisiana State University, New Orleans, Louisiana, USA
| | - Joseph W Boffa
- Southeast Louisiana Veterans Health Care System, New Orleans, Louisiana, USA
- South Central Mental Illness Research, Education and Clinical Center (MIRECC), New Orleans, Louisiana, USA
- Department of Psychiatry and Behavioral Sciences, Tulane University School of Medicine, New Orleans, Louisiana, USA
| | - Mary O Shapiro
- Southeast Louisiana Veterans Health Care System, New Orleans, Louisiana, USA
- South Central Mental Illness Research, Education and Clinical Center (MIRECC), New Orleans, Louisiana, USA
- Department of Psychiatry and Behavioral Sciences, Tulane University School of Medicine, New Orleans, Louisiana, USA
| | | | - Mara L Ferrie
- Southeast Louisiana Veterans Health Care System, New Orleans, Louisiana, USA
- South Central Mental Illness Research, Education and Clinical Center (MIRECC), New Orleans, Louisiana, USA
| | - Alana H Fondren
- Southeast Louisiana Veterans Health Care System, New Orleans, Louisiana, USA
| | - Desirae N Vidaurri
- Southeast Louisiana Veterans Health Care System, New Orleans, Louisiana, USA
- South Central Mental Illness Research, Education and Clinical Center (MIRECC), New Orleans, Louisiana, USA
- Department of Psychiatry and Behavioral Sciences, Tulane University School of Medicine, New Orleans, Louisiana, USA
| | - Jessica L Walton
- Southeast Louisiana Veterans Health Care System, New Orleans, Louisiana, USA
- South Central Mental Illness Research, Education and Clinical Center (MIRECC), New Orleans, Louisiana, USA
- Department of Psychiatry and Behavioral Sciences, Tulane University School of Medicine, New Orleans, Louisiana, USA
| | - Jessica L Chambliss
- Southeast Louisiana Veterans Health Care System, New Orleans, Louisiana, USA
| | - C Laurel Franklin
- Southeast Louisiana Veterans Health Care System, New Orleans, Louisiana, USA
- South Central Mental Illness Research, Education and Clinical Center (MIRECC), New Orleans, Louisiana, USA
- Department of Psychiatry and Behavioral Sciences, Tulane University School of Medicine, New Orleans, Louisiana, USA
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Azizian A, Terzyan L, Gasparyan K, Khachatryan S, English P. Inpatient residential treatment program for combat-related posttraumatic stress disorder (PTSD): Results from the 2020 Artsakh (Nagorno-Karabakh) War. MILITARY PSYCHOLOGY 2023; 35:252-261. [PMID: 37133545 PMCID: PMC10197988 DOI: 10.1080/08995605.2022.2117536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 08/23/2022] [Indexed: 10/14/2022]
Abstract
Inpatient residential treatment programs to evaluate active military service members for potential return to service or discharge are considered an integral component of rehabilitation for trauma related conditions. This retrospective study was conducted on combat-exposed military service members who were admitted to an inpatient residential treatment program for evaluation of fitness to serve and treatment of trauma related conditions. The PTSD Checklist for DSM-5 (PCL-5) was used to screen for PTSD, determine symptom severity, and monitor symptom change. At the time of admission, 54.3% of the service members met the provisional PTSD diagnosis, whereas at the time of discharge, 16.28% of the service members met the provisional diagnostic criteria. The most common symptoms rated moderately or higher were sleep troubles, followed by super alert, disturbing memories, feeling upset, disturbing dreams, physical reactions, avoiding memories, and negative feelings. Paired t-test results comparing the PCL-5 five Subscales and Total Score at the time of admission and discharge showed significant reductions. The five symptoms that improved the least were sleep troubles, feeling upset, avoiding memories, difficulty concentrating, and trouble remembering. The successful creation and implementation of an Armenian version of the PCL-5 was realized and, when put to the test, aided in screening, diagnosing, and monitoring PTSD symptoms among Armenian Army Service members. The results suggest that PTSD symptoms in an inpatient residential treatment program decreased over time. The symptoms that bothered the service members at most during the time of admission, however, improved the least at the time of discharge.
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Affiliation(s)
- Allen Azizian
- Department of Criminology, California State University, Fresno, California, USA
- Department of Medical Psychology, Yerevan State Medical University after Mkhitar Heratsi, Yerevan, Armenia
| | - Liana Terzyan
- Department of Medical Psychology, Yerevan State Medical University after Mkhitar Heratsi, Yerevan, Armenia
| | - Khachatur Gasparyan
- Department of Medical Psychology, Yerevan State Medical University after Mkhitar Heratsi, Yerevan, Armenia
| | - Samson Khachatryan
- Department of Neurology and Neurosurgery, Armenian National Institute of Health, Yerevan, Armenia
- Sleep Disorders Center, Somnus Neurology Clinic, Yerevan, Armenia
| | - Peter English
- Department of Criminology, California State University, Fresno, California, USA
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The association of mindfulness and psychological well-being among individuals who have recovered from COVID-19 in Jianghan District, Wuhan, China: A cross-sectional study. J Affect Disord 2022; 319:437-445. [PMID: 36162667 PMCID: PMC9502442 DOI: 10.1016/j.jad.2022.09.062] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 07/28/2022] [Accepted: 09/20/2022] [Indexed: 11/23/2022]
Abstract
BACKGROUND In the global pandemic of the coronavirus disease 2019 (COVID-19), depression and post-traumatic stress disorder (PTSD) have commonly occurred among COVID-19 patients, whose experiences of infection and subsequent treatment might develop negative consequences on their mental well-being even after recovery. Despite the general recognition of efficacy of mindfulness-based interventions in reducing psychological distress among various populations, there were insufficient studies on the relationship between mindfulness and mental health among individuals who have recovered from COVID-19. OBJECTIVE The current study aims to identify the prevalence of common mental health challenges among recovered COVID-19 patients in Jianghan District, Wuhan, China and to explore the potential mechanism through which mindfulness alleviate depression and PTSD. METHODS A cross-sectional survey on mental health was conducted among a convenience sample of adults recovered from COVID-19 in Jianghan District, Wuhan, China. The study participants completed questionnaires under the assistance of trained investigators. The questionnaire included Chinese version of Five Facets of Mindfulness Questionnaire-Short Form (FFMQ-SF), Generalized Anxiety Disorder Questionnaire (GAD-7), Resilience Style Questionnaire (RSQ), Impact of Events Scale-Revised (IES-R), and Patient Health Questionnaire (PHQ-9) to measure mindfulness, anxiety, resilience, PTSD, and depression respectively. Structural equation modeling was used to explore the relationship between mindfulness and mental health outcomes of this population. RESULTS 1541 respondents (654 [42.4 %] men and 887 [57.6 %] women) completed the questionnaire between June 10 and July 25, 2021, of whom 36.2 % and 27.1 % had mild and severe levels of depressive and anxiety symptoms respectively, and 15.2 % was indicated with PTSD. The average score of mindfulness of the study participants was (3.100 ± 0.387), and that of resilience was (3.560 ± 0.877). The structural equation model fit the data well, demonstrating that mindfulness was negatively associated with depressive symptoms directly (β = -0.031, P = 0.021) or indirectly through the mediation effect of resilience (β = -0.019, P = 0.009) and anxiety symptoms (β = -0.208, P < 0.001), and was negatively associated with PTSD through the mediation effect of anxiety symptoms (β = -0.142, P < 0.001). CONCLUSION Individuals who have recovered from COVID-19 commonly experienced psychological distress. Mindfulness is associated with alleviation of depressive and PTSD symptoms directly or indirectly. Interventions based on mindfulness are suggested to improve the mental well-being of this population.
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