Although there are effective treatments for Posttraumatic Stress Disorder (PTSD), many PTSD sufferers wait years to decades before seeking professional help, if they seek it at all. An understanding of factors affecting treatment initiation for PTSD can inform strategies to promote help-seeking. We conducted a qualitative study to identify determinants of PTSD treatment initiation among 44 U.S. military veterans from the Vietnam and Afghanistan/Iraq wars; half were and half were not receiving treatment. Participants described barriers to and facilitators of treatment initiation within themselves, the post-trauma socio-cultural environment, the health care and disability systems, and their social networks. Lack of knowledge about PTSD was a barrier that occurred at both the societal and individual levels. Another important barrier theme was the enduring effect of experiencing an invalidating socio-cultural environment following trauma exposure. In some cases, system and social network facilitation led to treatment initiation despite individual-level barriers, such as beliefs and values that conflicted with help-seeking. Our findings expand the dominant model of service utilization by explicit incorporation of factors outside the individual into a conceptual framework of PTSD treatment initiation. Finally, we offer suggestions regarding the direction of future research and the development of interventions to promote timely help-seeking for PTSD.

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We conducted two studies to develop and validate a brief self-report measure for assessing the frequency of positive and negative thoughts related to suicidal behavior. Items on this new measure, the Positive and Negative Suicide Ideation inventory, were generated by undergraduates. In Study 1, we administered a 20-item version of the inventory to 150 male and 300 female undergraduates and conducted an exploratory principal axis factor analysis with varimax rotation. Two factors, Positive Ideation and Negative Ideation, were retained. In Study 2, we conducted a confirmatory factor analysis to validate the fit of the one-factor and the oblique two-factor models to data from another sample of 84 men and 202 women. The oblique two-factor model provided an excellent fit to the sample data. We also examined preliminary evidence of concurrent and predictive validity. Over-all, these findings suggested that the inventory is a well-developed self-report measure for assessing the frequency of positive and negative thoughts related to suicidal behavior.

Combat-injured polytrauma patients have complex rehabilitation needs that require a high level of specialized training and skill. Physical medicine and rehabilitation specialists treating war injured service members need a high level of expertise in assessment and treatment of co-occurring pain, TBI, and stress disorders. Physiatrists are playing an important role in providing and coordinating the rehabilitation care for individuals with significant polytraumatic war injuries from the Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) conflicts.

Acceptance and chronic pain is an emerging topic both for research and intervention. Initial studies have demonstrated that acceptance is correlated with higher quality of daily emotional, social, and physical functioning in chronic pain populations. The purpose of the present study was to clarify the nature of the relationship between acceptance, appraisals that are relevant to chronic pain (i.e., control and catastrophizing), and coping among migraine headache sufferers. Seventy four participants with migraine headaches completed self report measures assessing appraisal, coping strategies, acceptance, and pain related disability. Sixty three participants also completed a 28-day daily dairy assessing headache activity, catastrophizing, control, acceptance, and coping strategies. Hierarchical regression and multilevel modeling were used to examine the relations between these variables. Results indicated that higher levels of pain-related acceptance were associated with lower levels of catastrophizing and pain-related interference, and increased perceived control. Participants who endorsed higher levels of pain-related acceptance also reported engaging in a higher level of activity and indicated they used fewer coping strategies on a daily basis. Acceptance continues to show promise as a way of viewing pain that lessens the detrimental impact of certain types of thoughts (i.e., catastrophizing), and leads to increased participation in daily life.

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The Mizes Anorectic Cognitions-Revised (MAC-R) questionnaire is a 24-item self-report instrument designed to assess cognitions associated with anorexia and bulimia nervosa. We examined the factor structure and psychometric properties of the MAC-R in a sample of 290 undergraduates. We found that a brief 3-factor oblique model (composed of 12 items) of the MAC-R provided acceptable fit to the present sample data. This model was largely invariant across male and female participants. The brief version of the MAC-R (the BMAC) and subscale scores correlated significantly with scores from related measures of eating disorders, showing evidence of concurrent validity. The BMAC total and subscales also showed evidence of discriminant validity by differentiating between empirically defined subclinical eating disorders and control participants. Both logistic regression and discriminant function analyses showed that only the self-control and self-esteem subscale was most useful in distinguishing between the subgroups.