Randomized controlled trial of acceptance and commitment therapy for distress and impairment in OEF/OIF/OND veterans.

Lang, Ariel J.; Schnurr, Paula P.; Jain, Sonia; He, Feng; Walser, Robyn D.; Bolton, Elisa; Benedek, David M.; Norman, Sonya B.; Sylvers, Patrick; Flashman, Laura A.; Strauss, Jennifer; Raman, Rema; Chard, Kathleen M.

doi:10.1037/tra0000127

Cited by 64 publications

(57 citation statements)

References 36 publications

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“…Research on ACT for PTSD (e.g., Boals & Murrell, ) and AUD (Thekiso et al., ) is preliminary. A recent randomized controlled trial in a sample of veterans and military personnel with a range of diagnoses found that ACT led to improvements in PTSD symptoms, functioning, and QoL that were similar in magnitude to those reported with present‐centered therapy (Lang et al., ). Notably, participants with alcohol dependence were excluded from this trial, limiting generalizability to people with PTSD–AUD; however, a manual development study suggests that ACT for PTSD–AUD is feasible (Hermann, Meyer, Schnurr, Batten, & Walser, ).…”

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confidence: 69%

“…We explored whether veterans would report improvement in PTSD symptom severity, AUD severity, functional disability, QoL, and depressive symptoms at posttreatment and at 3‐month follow‐up. Based on prior research and theory (Lang et al., ; Walser et al., ), we expected that if such improvements were observed, they would be associated with reductions in experiential avoidance and psychological inflexibility. We also explored whether the amount of mindfulness practice was associated with better outcomes as well as whether there were changes in use of nonalcohol substance use during the study.…”

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confidence: 99%

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Acceptance and Commitment Therapy for Co‐Occurring Posttraumatic Stress Disorder and Alcohol Use Disorders in Veterans: Pilot Treatment Outcomes

Meyer

Walser

Hermann

et al. 2018

Journal of Traumatic Stress

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Posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD) frequently co‐occur and are associated with worse outcomes together than either disorder alone. A lack of consensus regarding recommendations for treating PTSD–AUD exists, and treatment dropout is a persistent problem. Acceptance and Commitment Therapy (ACT), a transdiagnostic, mindfulness‐ and acceptance‐based form of behavior therapy, has potential as a treatment option for PTSD–AUD. In this uncontrolled pilot study, we examined ACT for PTSD–AUD in 43 veterans; 29 (67%) completed the outpatient individual therapy protocol (i.e., ≥ 10 of 12 sessions). Clinician‐assessed and self‐reported PTSD symptoms were reduced at posttreatment, ds = 0.79 and 0.96, respectively. Self‐reported symptoms of PTSD remained lower at 3‐month follow‐up, d = 0.88. There were reductions on all alcohol‐related outcomes (clinician‐assessed and self‐reported symptoms, total drinks, and heavy drinking days) at posttreatment and 3‐month follow‐up, dmean = 0.91 (d range: 0.65–1.30). Quality of life increased at posttreatment and follow‐up, ds = 0.55–0.56. Functional disability improved marginally at posttreatment, d = 0.35; this effect became significant by follow‐up, d = 0.52. Fewer depressive symptoms were reported at posttreatment, d = 0.50, and follow‐up, d = 0.44. Individuals experiencing suicidal ideation reported significant reductions by follow‐up. Consistent with the ACT theoretical model, these improvements were associated with more between‐session mindfulness practice and reductions in experiential avoidance and psychological inflexibility. Recommendations for adapting ACT to address PTSD–AUD include assigning frequent between‐session mindfulness practice and initiating values clarification work and values‐based behavior assignments early in treatment.

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confidence: 69%

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confidence: 99%

Acceptance and Commitment Therapy for Co‐Occurring Posttraumatic Stress Disorder and Alcohol Use Disorders in Veterans: Pilot Treatment Outcomes

Meyer

Walser

Hermann

et al. 2018

Journal of Traumatic Stress

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“…Positive expectancies are also broadly relevant to other evidence‐based therapies such as Acceptance and Commitment Therapy (ACT), which demonstrates solid research support for treating various anxiety disorders (A‐Tjak et al, ; Division 12 of the American Psychological Association, ; Swain, Hancock, Hainsworth, & Bowman, ) as well as a growing evidence base supporting its efficacy in treating PTSD (Boals & Murrell, ; Fiorillo, McLean, Pistorello, Hayes, & Follette, ; Lang et al, ). A primary goal of ACT is to improve psychological flexibility, or the ability to remain in contact with private experiences (e.g., thoughts and emotions) without avoiding them and to adjust behavior based on current circumstances and personal goals/values (Hayes, Luoma, Bond, Masuda, & Lillis, ).…”

Section: Discussionmentioning

confidence: 99%

Hope, optimism, self‐efficacy, and posttraumatic stress disorder: A meta‐analytic review of the protective effects of positive expectancies

2019

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Objective The present meta‐analysis consolidated research examining how positive expectancies (e.g., hope, self‐efficacy, and optimism) may protect against the development of posttraumatic stress disorder (PTSD). Method Articles were identified by searching PILOTS, PsycINFO, PubMed, and ProQuest Dissertations and Theses databases. Results Aggregated results from 154 studies indicated that positive expectancies were associated with lower levels of PTSD symptoms. This relationship was stronger for coping‐specific self‐efficacy (k = 38, r = −.49; −.54 to −.43) and hope (k = 20, r = −.34; −.39 to −.28) compared with general self‐efficacy (k = 45, r = −.25; −.30 to −.20) and optimism (k = 59, r = −.29; −.33 to −.25) when examining cross‐sectional studies, and results were consistent in prospective studies. Age and gender did not moderate the cross‐sectional relationships. Conclusions These findings indicate that positive expectancies predict post‐trauma resilience. Future research should identify moderators and examine positive expectancies as mechanisms of change in therapy.

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“…A recent study used a universally applied therapeutics approach to treat veterans who had post-deployment distress [44••]. Participants were randomized to transdiagnostic versions of ACT [45] or Present Centered Therapy, a comparison treatment designed to control for the nonspecific benefits of psychotherapy [PCT; [46]].…”

Section: Transdiagnostic Treatments For Ptsdmentioning

confidence: 99%

Emergence of Transdiagnostic Treatments for PTSD and Posttraumatic Distress

Gutner

Galovski

Bovin

et al. 2016

Curr Psychiatry Rep

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Both theoretical and empirical findings have demonstrated similarities across diagnoses, leading to a growing interest in transdiagnostic interventions. Most of the evidence supporting transdiagnostic treatment has accumulated for depression, anxiety, and eating disorders, with minimal attention given to posttraumatic stress disorder and other reactions to traumatic stressors. Although single-diagnosis protocols are effective for posttraumatic stress disorder (PTSD) and other trauma-related disorders, in principle, transdiagnostic approaches may have beneficial applications within a traumatized population. This paper defines different types of transdiagnostic treatments, reviews transdiagnostic approaches used in related disorders, and discusses their applicability to PTSD. Examples are drawn from existing transdiagnostic treatments in order to provide a framework for the application of such interventions to the field of traumatic stress. Implications for implementation and dissemination are also discussed.

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Randomized controlled trial of acceptance and commitment therapy for distress and impairment in OEF/OIF/OND veterans.

Abstract: ACT's efficacy in this group was modest and generally did not differ from that for PCT. Additional work is needed to understand the reasons that ACT did not perform as well as predicted in this veteran sample. (PsycINFO Database Record

Cited by 64 publications

References 36 publications

Acceptance and Commitment Therapy for Co‐Occurring Posttraumatic Stress Disorder and Alcohol Use Disorders in Veterans: Pilot Treatment Outcomes

Acceptance and Commitment Therapy for Co‐Occurring Posttraumatic Stress Disorder and Alcohol Use Disorders in Veterans: Pilot Treatment Outcomes

Hope, optimism, self‐efficacy, and posttraumatic stress disorder: A meta‐analytic review of the protective effects of positive expectancies

Emergence of Transdiagnostic Treatments for PTSD and Posttraumatic Distress

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