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Shea MT, Stout RL, Reddy MK, Sevin E, Presseau C, Lambert J, Cameron A. Treatment of anger problems in previously deployed post-911 veterans: A randomized controlled trial. Depress Anxiety 2022; 39:274-285. [PMID: 34878695 PMCID: PMC9299859 DOI: 10.1002/da.23230] [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: 09/09/2021] [Revised: 11/08/2021] [Accepted: 11/20/2021] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Problems with anger and aggression affect many veterans who have deployed to a warzone, resulting in serious impairment in multiple aspects of functioning. Controlled studies are needed to improve treatment options for these veterans. This randomized controlled trial compared an individually delivered cognitive behavioral therapy adapted from Novaco's Anger Control Therapy to a manualized supportive therapy to control for common therapeutic factors. METHODS Ninety-two post-911 veterans deployed during Operation Enduring Freedom (OEF), Operation Iraqi Freedom (OIF), or Operation New Dawn (OND) with moderate to severe anger problems were randomized to receive the cognitive behavioral intervention (CBI) or the supportive intervention (SI). Anger, aggression, multiple areas of functioning and quality of life were assessed at multiple time points inclu\ding 3- and 6-month follow-up. RESULTS Hierarchical linear modeling (HLM) analyses showed significant treatment effects favoring CBI for anger severity, social and interpersonal functioning, and quality of life. The presence of a PTSD diagnosis did not affect outcomes. CONCLUSIONS CBI is an effective treatment for OEF/OIF/OND veterans with anger problems following deployment, regardless of PTSD diagnosis.
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Affiliation(s)
- M. Tracie Shea
- VA Providence Healthcare SystemProvidenceRhode IslandUSA,Department of Psychiatry and Human BehaviorAlpert Medical School of Brown UniversityProvidenceRhode IslandUSA
| | - Robert L. Stout
- Pacific Institute for Research and EvaluationPawtucketRhode IslandUSA
| | | | | | - Candice Presseau
- VA Connecticut Health Care SystemWest HavenConnecticutUSA,Department of PsychiatryYale University School of MedicineNew HavenConnecticutUSA
| | - Jennifer Lambert
- VA Providence Healthcare SystemProvidenceRhode IslandUSA,Department of Psychiatry and Human BehaviorAlpert Medical School of Brown UniversityProvidenceRhode IslandUSA
| | - Amy Cameron
- VA Providence Healthcare SystemProvidenceRhode IslandUSA,Department of Psychiatry and Human BehaviorAlpert Medical School of Brown UniversityProvidenceRhode IslandUSA
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2
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Resick PA, Wachen JS, Dondanville KA, LoSavio ST, Young-McCaughan S, Yarvis JS, Pruiksma KE, Blankenship A, Jacoby V, Peterson AL, Mintz J. Variable-length Cognitive Processing Therapy for posttraumatic stress disorder in active duty military: Outcomes and predictors. Behav Res Ther 2021; 141:103846. [PMID: 33894644 DOI: 10.1016/j.brat.2021.103846] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 03/04/2021] [Accepted: 03/15/2021] [Indexed: 11/28/2022]
Abstract
Cognitive Processing Therapy (CPT) is an evidence-based therapy recommended for posttraumatic stress disorder (PTSD). However, rates of improvement and remission are lower in veterans and active duty military compared to civilians. Although CPT was developed as a 12-session therapy, varying the number of sessions based on patient response has improved outcomes in a civilian study. This paper describes outcomes of a clinical trial of variable-length CPT among an active duty sample. Aims were to determine if service members would benefit from varying the dose of treatment and identify predictors of treatment length needed to reach good end-state (PTSD Checklist-5 ≤ 19). This was a within-subjects trial in which all participants received CPT (N = 127). Predictor variables included demographic, symptom, and trauma-related variables; internalizing/externalizing personality traits; and readiness for change. Varying treatment length resulted in more patients achieving good end-state. Best predictors of nonresponse or needing longer treatment were pretreatment depression and PTSD severity, internalizing temperament, being in precontemplation stage of readiness for change, and African American race. Controlling for differences in demographics and initial PTSD symptom severity, the outcomes using a variable-length CPT protocol were superior to the outcomes of a prior study using a fixed, 12-session CPT protocol. CLINICALTRIALS.GOV IDENTIFIER: NCT023818.
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Affiliation(s)
- Patricia A Resick
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA.
| | - Jennifer Schuster Wachen
- National Center for PTSD, VA Boston Healthcare System, Boston, MA, USA; Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA.
| | - Katherine A Dondanville
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA.
| | - Stefanie T LoSavio
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA.
| | - Stacey Young-McCaughan
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA.
| | | | - Kristi E Pruiksma
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA.
| | - Abby Blankenship
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA.
| | - Vanessa Jacoby
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA.
| | - Alan L Peterson
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA; Research and Development Service, South Texas Veterans Health Care System, San Antonio, TX, USA; Department of Psychology, University of Texas at San Antonio, San Antonio, TX, USA.
| | - Jim Mintz
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA.
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Cassiello-Robbins C, Sauer-Zavala S, Wilner JG, Bentley KH, Conklin LR, Farchione TJ, Barlow DH. A Preliminary Examination of the Effects of Transdiagnostic Versus Single Diagnosis Protocols on Anger During the Treatment of Anxiety Disorders. J Nerv Ment Dis 2018; 206:549-554. [PMID: 29905658 PMCID: PMC6028319 DOI: 10.1097/nmd.0000000000000834] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Dysregulated anger is often present in the emotional (i.e., anxiety, mood, and related) disorders; however, it is rarely targeted in treatment. Transdiagnostic treatments, which focus on processes that contribute to dysregulated emotions across the range of psychopathology, might represent an efficient way to treat this anger. Using a subset of data from a recently completed equivalency trial comparing the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP) to single diagnosis protocols (SDPs) for specific disorders, this study began exploring whether the UP led to great reductions in anger compared with the SDPs. Results indicated that there was a small, nonsignificant, decrease in anger in the UP condition, whereas there was a moderate, nonsignificant increase in anger in the SDP condition. At posttreatment, UP patients had significantly lower anger scores than patients who received an SDP. These preliminary results suggest that transdiagnostic treatments may be well poised to target dyregulated anger in the context of emotional disorders.
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Affiliation(s)
| | - Shannon Sauer-Zavala
- Center for Anxiety and Related Disorders at Boston University, Boston University
| | - Julianne G. Wilner
- Center for Anxiety and Related Disorders at Boston University, Boston University
| | - Kate H. Bentley
- Depression Clinical and Research Program at Massachusetts General Hospital
| | | | - Todd J. Farchione
- Center for Anxiety and Related Disorders at Boston University, Boston University
| | - David H. Barlow
- Center for Anxiety and Related Disorders at Boston University, Boston University
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4
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Clifton EG, Feeny NC, Zoellner LA. Anger and guilt in treatment for chronic posttraumatic stress disorder. J Behav Ther Exp Psychiatry 2017; 54:9-16. [PMID: 27218605 DOI: 10.1016/j.jbtep.2016.05.003] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2015] [Revised: 04/17/2016] [Accepted: 05/12/2016] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND OBJECTIVES Feelings of anger and guilt are important to consider when treating PTSD as they are related to higher PTSD severity and may be related to avoidance during treatment. Avoidance may impede emotional engagement, the process of connecting with distressing, fear-related emotions during imaginal exposure, which is considered an important mechanism for successful PTSD treatment in prolonged exposure (PE). Yet, little research has examined possible complications in achieving emotional engagement, such as anger and guilt. METHODS The present study utilized data from 116 individuals with PTSD who received PE to investigate whether anger and guilt were associated with poorer emotional engagement, as captured by pre, peak, post, and mean subjective units of distress (SUDs), during the initial imaginal exposure, and whether anger and guilt predicted worse treatment outcome generally and as a result of lessened emotional engagement. RESULTS Neither initial anger nor guilt hindered engagement nor predicted worse outcome. Contrary to hypotheses, higher guilt was predictive of greater anticipatory distress and slightly better PTSD outcome. The relationship between pre-treatment guilt cognitions and post-treatment PTSD severity was not mediated by engagement. LIMITATIONS This study used a trauma-specific measure of guilt and general measure for anger, however both are commonly used. In addition, this study examined emotional engagement during imaginal exposure to the exclusion of engagement with other therapy components, such as in vivo exposure. CONCLUSIONS These findings help dispel concerns that those with higher anger and guilt will avoid emotionally engaging during the initial imaginal exposure due to feeling distressed by intense negative emotionality.
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Affiliation(s)
- Erin G Clifton
- Department of Psychological Sciences, Case Western Reserve University, Cleveland, OH, USA.
| | - Norah C Feeny
- Department of Psychological Sciences, Case Western Reserve University, Cleveland, OH, USA
| | - Lori A Zoellner
- Department of Psychology, University of Washington, Seattle, WA, USA
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5
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Cassiello-Robbins C, Barlow DH. Anger: The unrecognized emotion in emotional disorders. ACTA ACUST UNITED AC 2016. [DOI: 10.1111/cpsp.12139] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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6
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Mackintosh MA, Morland LA, Kloezeman K, Greene CJ, Rosen CS, Elhai JD, Frueh BC. Predictors of anger treatment outcomes. J Clin Psychol 2014; 70:905-13. [PMID: 24752837 DOI: 10.1002/jclp.22095] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE This study investigated predictors of therapeutic outcomes for veterans who received treatment for dysregulated anger. METHOD Data are from a randomized controlled trial investigating the effectiveness of video teleconferencing compared to in-person delivery of anger management therapy (AMT) among 125 military veterans. Multilevel modeling was used to assess 2 types of predictors (demographic characteristics and mental health factors) of changes in anger symptoms after treatment. RESULTS Results showed that while veterans benefited similarly from treatment across modalities, veterans who received two or more additional mental health services and who had longer commutes to care showed the greatest improvement on a composite measure of self-reported anger symptoms. CONCLUSION Results highlight that veterans with a range of psychosocial and mental health characteristics benefited from AMT, while those receiving the most additional concurrent mental health services had better outcomes.
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Rosen C, Adler E, Tiet Q. Presenting concerns of veterans entering treatment for posttraumatic stress disorder. J Trauma Stress 2013; 26:640-3. [PMID: 24123262 DOI: 10.1002/jts.21841] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Patient-centered care involves engaging patients as partners in establishing treatment priorities. No prior studies have examined what specific problems veterans hope to address when they enter posttraumatic stress disorder (PTSD) treatment. Veterans starting outpatient (n = 216) and residential (n = 812) PTSD treatment in 2 multisite care management trials specified (open-ended) the 2 or 3 problems that they most wanted to improve through treatment. Over 80% mentioned PTSD-symptom-related concerns including PTSD or trauma (19.2% to 19.9% of patients), anger (31.0% to 36.7%), sleep problems (14.3% to 27.3%), nightmares (12.3% to 19.4%), and estrangement/isolation (7.9% to 20.8%). Other common problems involved depression (23.1% to 36.5%), anxiety not specific to PTSD (23.9% to 27.8%), relationships (20.4% to 24.5%), and improving coping or functioning (19.2% to 20.4%). Veterans' treatment goals varied significantly by outpatient versus residential setting, gender, and period of military service. Our findings confirm the importance of educating patients about how available efficacious treatments relate to clients' personal goals. Our results also suggest that clinicians should be prepared to offer interventions or provide referrals for common problems such as anger, nightmares, sleep, depression, or relationship difficulties if these problems do not remit with trauma-focused psychotherapy or if patients are unwilling to undergo trauma-focused treatment.
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Affiliation(s)
- Craig Rosen
- National Center for PTSD, Dissemination & Training Division, VA Palo Alto Health Care System, Menlo Park, California, USA; Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, California, USA
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8
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Alcázar RJ, Deffenbacher JL, Guzmán LH, Wilson GI. High and Low Trait Anger, and the Recognition of Anger Problems. SPANISH JOURNAL OF PSYCHOLOGY 2013; 14:851-8. [DOI: 10.5209/rev_sjop.2011.v14.n2.32] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
This study compared three groups of people: (a) high trait anger individuals who recognized personal anger problems (HR); (b) high trait anger individuals who did not recognize personal anger problems (HNR); and (c) low trait anger individuals not reporting personal anger problems (LNR). Compared to LNR participants, HR and HNR groups reported more anger-out (i.e., outward negative expression of anger such as arguing with others), anger-in (i.e., anger suppression and harboring grudges), greater desire to use and actual use of physically aggressive anger expression (e.g., pushing or shoving someone), and less anger control-in (i.e., emotionally focused strategies to lower anger such as relaxation) and anger control-out (i.e., behaviorally focused strategies such as being patient with others). HR individuals reported more trait anger (i.e., higher propensity to experience anger) and less anger control-out than the HNR group. Gender did not relate to the recognition of anger problems. Findings were discussed with regard to theory and clinical implications.
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9
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Chang MC, Chen PF, Lung FW. Anxiety in predicting suicide-related symptom of typhoon disaster victims: a one-year follow-up study in southern Taiwan. Psychiatr Q 2012; 83:481-7. [PMID: 22422410 DOI: 10.1007/s11126-012-9216-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
The aim of this study was to screen those at high risk of psychological distress in areas affected by typhoon Morakot, which hit Taiwan on August 7th, 2009. Screening was conducted a year later to assess the changes in psychiatric symptoms and investigate the factors which may be predictive of psychological distress and suicide ideation. One-hundred and fifty-two participants were collected at the first screening and 125 a year later. The five-item Brief Symptom Rating Scale was used to measure the level of psychological distress. Our results showed the prevalence of psychological distress immediately post-disaster was 2.4% and increased to 4.0% the next year. The level of anxiety post-disaster could predict continuous psychological distress and the development of suicidal ideation a year later. Traumatic events prior to the typhoon were not associated with the level of psychological distress a year after the disaster. Difference was found in the level of hostility immediately post-disaster and a year later. Our follow-up study found anxiety was the only indicator which predicted psychological distress a year later, and hostility was a transient state which was lower a year after the disaster. Policy-makers and future programs should focus on high anxiety cases post-disaster to prevent mental symptom and suicide ideation development.
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10
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Morland LA, Love AR, Mackintosh M, Greene CJ, Rosen CS. Treating anger and aggression in military populations: Research updates and clinical implications. ACTA ACUST UNITED AC 2012. [DOI: 10.1111/cpsp.12007] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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11
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Barrett EL, Mills KL, Teesson M. Hurt people who hurt people: violence amongst individuals with comorbid substance use disorder and post traumatic stress disorder. Addict Behav 2011; 36:721-8. [PMID: 21411235 DOI: 10.1016/j.addbeh.2011.02.005] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2010] [Revised: 01/18/2011] [Accepted: 02/20/2011] [Indexed: 12/25/2022]
Abstract
AIMS The association between substance use disorder (SUD) and the perpetration of violence has been well documented. There is some evidence to suggest that the co-occurrence of post traumatic stress disorder (PTSD) may increase the risk for violence. This study aims to determine the prevalence of violence perpetration and examine factors related to violence amongst individuals with comorbid SUD and PTSD. DESIGN AND PARTICIPANTS Data was collected via interview from 102 participants recruited to a randomised controlled trial of an integrated treatment for comorbid SUD and PTSD. MEASUREMENTS The interview addressed demographics, perpetration of violent crime, mental health including aggression, substance use, PTSD, depression, anxiety and borderline personality disorder. FINDINGS Over half of participants reported committing violence in their lifetime and 16% had committed violence in the past month. Bivariate associations were found between violence perpetration and trait aggression, higher levels of alcohol and cannabis use, lower levels of other opiate use, and experiencing more severe PTSD symptoms, particularly in relation to hyperarousal. When entered into a backward stepwise logistic regression however, only higher levels of physical aggression and more severe PTSD hyperarousal symptoms remained as independent predictors of violence perpetration. CONCLUSIONS These findings highlight the importance of assessing for PTSD amongst those with SUD particularly in forensic settings. They also indicate that it is the hyperarousal symptoms of PTSD specifically that need to be targeted by interventions aimed at reducing violence amongst individuals with SUD and PTSD.
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Affiliation(s)
- Emma L Barrett
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia.
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12
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Anger and posttraumatic stress disorder in disaster relief workers exposed to the September 11, 2001 World Trade Center disaster: one-year follow-up study. J Nerv Ment Dis 2008; 196:844-6. [PMID: 19008736 PMCID: PMC4073301 DOI: 10.1097/nmd.0b013e31818b492c] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Although anger is an important feature of posttraumatic stress disorder (PTSD) it is unclear whether it is simply concomitant or plays a role in maintaining symptoms. A previous study of disaster workers responding to the terrorist attacks of September 11, 2001 () indicated that those with PTSD evidenced more severe anger than those without. The purpose of this study was to conduct a 1-year follow-up to assess the role of anger in maintaining PTSD. Workers with PTSD continued to report more severe anger than those without; there were statistically significant associations between changes in anger, PTSD severity, depression, and psychiatric distress. Multiple regression analysis indicated initial anger severity to be a significant predictor of PTSD severity at follow-up, which is consistent with the notion that anger maintains PTSD. One implication is that disaster workers with high anger may benefit from early intervention to prevent chronic PTSD.
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Kirby AC, Hertzberg BP, Collie CF, Yeatts B, Dennis MF, McDonald SD, Calhoun PS, Beckham JC. Smoking in help-seeking veterans with PTSD returning from Afghanistan and Iraq. Addict Behav 2008; 33:1448-1453. [PMID: 18571871 PMCID: PMC2556875 DOI: 10.1016/j.addbeh.2008.05.007] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2008] [Revised: 05/08/2008] [Accepted: 05/14/2008] [Indexed: 10/22/2022]
Abstract
Past research has shown that veterans and individuals with posttraumatic stress disorder (PTSD) have increased rates of smoking. However, the rates of smoking in younger help-seeking veterans returning from Afghanistan and Iraq, and possible correlates of smoking among this population are unknown. In this study, we evaluated the rate of lifetime and current smoking among a sample of 90 returning male veterans diagnosed with PTSD. Fifty-nine percent reported a lifetime history of smoking including 32% that were current smokers. Current smokers were significantly younger than non-smokers. Current smokers (mean age=31) reported a mean age of smoking onset as 15.86 with a pack year history of 8.89. These smokers reported on average five previous quit attempts. According to a stages of change model, one-half of the smokers were in the contemplation phase of stopping smoking (50%), 29% were in the pre-contemplation phase and 21% were in the preparation phase. The results are placed in the context of non-psychiatric and psychiatric smokers.
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Affiliation(s)
- A C Kirby
- Durham VA Medical Center, 508 Fulton Street, Durham, NC 27705, United States; VA Mid-Atlantic Region Mental Illness Research, Education, and Clinical Center, 508 Fulton Street, Durham, NC 27705, United States
| | | | - C F Collie
- Durham VA Medical Center, 508 Fulton Street, Durham, NC 27705, United States
| | - B Yeatts
- Durham VA Medical Center, 508 Fulton Street, Durham, NC 27705, United States
| | - M F Dennis
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27710, United States
| | - S D McDonald
- Durham VA Medical Center, 508 Fulton Street, Durham, NC 27705, United States; VA Mid-Atlantic Region Mental Illness Research, Education, and Clinical Center, 508 Fulton Street, Durham, NC 27705, United States
| | - P S Calhoun
- Durham VA Medical Center, 508 Fulton Street, Durham, NC 27705, United States; Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27710, United States; VA Mid-Atlantic Region Mental Illness Research, Education, and Clinical Center, 508 Fulton Street, Durham, NC 27705, United States
| | - J C Beckham
- Durham VA Medical Center, 508 Fulton Street, Durham, NC 27705, United States; Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27710, United States; VA Mid-Atlantic Region Mental Illness Research, Education, and Clinical Center, 508 Fulton Street, Durham, NC 27705, United States.
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Hunt YM, Kyle TL, Coffey SF, Stasiewicz PR, Schumacher JA. University of Rhode Island Change Assessment-Trauma: preliminary psychometric properties in an alcohol-dependent PTSD sample. J Trauma Stress 2006; 19:915-21. [PMID: 17195967 DOI: 10.1002/jts.20161] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The co-occurrence of posttraumatic stress disorder with substance use disorders (PTSD-SUD) is common and is associated with poorer treatment outcomes. Attrition represents an ongoing, but poorly understood challenge in PTSD-SUD treatment research. The current study examined the initial psychometric properties of the University of Rhode Island Change Assessment-Trauma (URICA-T), a scale designed to assess attitudes and behaviors related to addressing trauma issues, in a sample of 42 individuals meeting diagnostic criteria for PTSD and alcohol dependence. Results suggest that the URICA-T may have acceptable psychometric properties as a continuous measure of motivational readiness in a PTSD-SUD sample. Preliminary data also suggests higher URICA-T scores are associated with retention of alcohol dependent-PTSD participants in a study utilizing trauma-focused exposure.
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Affiliation(s)
- Yvonne M Hunt
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, MI 39216, USA
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15
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Evans S, Giosan C, Patt I, Spielman L, Difede J. Anger and its association to distress and social/occupational functioning in symptomatic disaster relief workers responding to the September 11, 2001, World Trade Center disaster. J Trauma Stress 2006; 19:147-52. [PMID: 16568457 DOI: 10.1002/jts.20107] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Empirical evidence suggests that anger plays a significant role in posttraumatic stress disorder (PTSD) and may impede recovery from traumatic events. The purpose of this study was to assess the role of anger and its relationship to distress and social/occupational functioning in disaster relief workers (DRWs) who had PTSD symptoms who were deployed to the World Trade Center after September 11, 2001. Six hundred twenty-six utility workers (96% male) completed measures of anger, distress, PTSD severity, and social/occupational functioning. Results indicated that anger was significantly higher in DRWs who had PTSD symptoms than in those who did not, and statistically significant associations were found among anger, distress, PTSD severity, and social/occupational functioning in workers who had PTSD symptoms. Careful assessment of anger in DRWs exposed to traumatic events is warranted as well as longitudinal studies to further understand the relationship between anger and PTSD.
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Affiliation(s)
- Susan Evans
- Department of Psychiatry, Weill Medical College of Cornell University, 525 East 68th Street, Box 147, New York, NY 10021, USA.
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16
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Rooney K, Hunt C, Humphreys L, Harding D, Mullen M, Kearney J. A test of the assumptions of the transtheoretical model in a post-traumatic stress disorder population. Clin Psychol Psychother 2005. [DOI: 10.1002/cpp.441] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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17
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Murphy RT, Rosen CS, Cameron RP, Thompson KE. Development of a group treatment for enhancing motivation to change PTSD symptoms. COGNITIVE AND BEHAVIORAL PRACTICE 2002. [DOI: 10.1016/s1077-7229(02)80025-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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