The relationship between three ACT core processes of change, PTSD, and depressive symptoms

Grau, Peter P.; McDonald, James E.; Clark, Michael N.; Wetterneck, Chad T.

doi:10.1016/j.jcbs.2020.04.004

Cited by 14 publications

(6 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Consistent with our exploratory analysis of potential mechanisms, a study of Israeli veterans suggested centrality of the DSM-V negative alterations in cognitions and mood (NACM) symptom cluster in bridging among PTSD, depressive symptoms, and moral injury ( 25 ). Similarly, consistent with our findings on the centrality of hyperarousal across PTSD and depressive symptom groups, other research suggests anxiety sensitivity and avoidance of inner experiences broadly may be transdiagnostic processes underlying PTSD and internalizing symptomatology ( 32 , 47 , 48 ). Further longitudinal research should consider the mechanisms connecting hyperarousal, NACM, and other internalizing symptoms that could play a transdiagnostic role in comorbidities.…”

Section: Discussionsupporting

confidence: 91%

Causal discovery replicates symptomatic and functional interrelations of posttraumatic stress across five patient populations

Pierce

Kirsh²,

Ferguson³

et al. 2023

Front. Psychiatry

View full text Add to dashboard Cite

IntroductionApproximately half of individuals with posttraumatic stress disorder (PTSD) may meet criteria for other psychiatric disorders, and PTSD symptoms are associated with diminished health and psychosocial functioning. However, few studies examine the longitudinal progression of PTSD symptoms concurrent with related symptom domains and functional outcomes, such that may neglect important longitudinal patterns of symptom progression beyond PTSD specifically.MethodsTherefore, we used longitudinal causal discovery analysis to examine the longitudinal interrelations among PTSD symptoms, depressive symptoms, substance abuse, and various other domains of functioning in five longitudinal cohorts representing veterans (n = 241), civilians seeking treatment for anxiety disorders (n = 79), civilian women seeking treatment for post-traumatic stress and substance abuse (n = 116), active duty military members assessed 0–90 days following TBI (n = 243), and civilians with a history of TBI (n = 43).ResultsThe analyses revealed consistent, directed associations from PTSD symptoms to depressive symptoms, independent longitudinal trajectories of substance use problems, and cascading indirect relations from PTSD symptoms to social functioning through depression as well as direct relations from PTSD symptoms to TBI outcomes.DiscussionOur findings suggest PTSD symptoms primarily drive depressive symptoms over time, tend to show independence from substance use symptoms, and may cascade into impairment in other domains. The results have implications for refining conceptualization of PTSD co-morbidity and can inform prognostic and treatment hypotheses about individuals experiencing PTSD symptoms along with co-occurring distress or impairment.

show abstract

Section: Discussionsupporting

confidence: 91%

Causal discovery replicates symptomatic and functional interrelations of posttraumatic stress across five patient populations

Pierce

Kirsh²,

Ferguson³

et al. 2023

Front. Psychiatry

View full text Add to dashboard Cite

show abstract

“…Consistent with our exploratory analysis of potential mechanisms, a study of Israeli veterans suggested centrality of the DSM-V NACM symptom cluster in bridging among PTSD, depressive symptoms, and moral injury (25). Similarly, consistent with our findings on the centrality of hyperarousal across PTSD and depressive symptom groups, other research suggests anxiety sensitivity and avoidance of inner experiences broadly may be transdiagnostic processes underlying PTSD and internalizing symptomatology (32,68,69). Further longitudinal research should consider the mechanisms connecting hyperarousal, NACM, and other internalizing symptoms that could play a transdiagnostic role in comorbidities.…”

Section: Discussionsupporting

confidence: 91%

Causal discovery identifies posttraumatic stress as a driver of internalizing symptoms across independent veteran and civilian populations

Pierce

Kirsh

Ferguson

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: Approximately half of patients with posttraumatic stress disorder (PTSD) also meet criteria for internalizing disorders, yet few studies assess reciprocal longitudinal relations among these symptoms. Methods: We used longitudinal causal discovery in a veteran cohort for hypothesis-generation about PTSD and internalizing symptom drivers (n=240), followed by hypothesis-testing in two independent civilian cohorts with similar symptom assessments over time (n=79 and n=116). Results: In the veteran cohort, causal discovery revealed PTSD symptoms drove internalizing symptoms, which subsequently impacted social functioning; all independent of problematic alcohol use. This replicated in treatment-seeking anxiety disorders (AD, n = 79) and substance abuse (SA, n = 116) samples with significantly better model fit for PTSD symptoms driving internalizing symptoms, versus internalizing symptoms driving PTSD symptoms (BIC change for AD sample = 175.1, p<.001; BIC change for SA sample = 571.6, p<.001). We also found better model fit with PTSD symptoms driving anxiety symptoms, versus anxiety symptoms driving PTSD symptoms (BIC change for AD sample = 71.8, p < .001; BIC change for SA sample = 568.9, p < .001). Posthoc analysis in the veteran sample revealed that hyperarousal and cognitive and affective disturbance bridged between other PTSD symptoms and internalizing symptoms. Conclusions: Our findings suggest that internalizing symptoms that emerge in the context of PTSD are more likely to be driven by PTSD symptoms. These results highlight the need for a PTSD- and trauma-informed approach to treating internalizing symptoms, and provide preliminary evidence for cognition and mood disruption as a factor driving comorbidity.

show abstract

“…ACT has found to be an effective treatment to reduce PI and mental health problems, and has therefore potential in future intervention ( Daks et al, 2020 ; Tarbox et al, 2022 ). Previous studies have demonstrated the benefits of ACT-based interventions for non-suicidal self-injury ( Callahan et al, 2021 ), PTSD symptoms ( Grau et al, 2020 ), and PI ( Pakenham et al, 2020 ). Given the particular situation of the COVID-19 pandemic, ACT self-help books or online ACT interventions could be effectively employed ( Huang et al, 2021 ), which have proved to be effective in prior studies ( Probst et al, 2019 ; Levin et al, 2020 ).…”

Section: Discussionmentioning

confidence: 99%

Associations between psychological inflexibility and mental health problems during the COVID-19 pandemic: A three-level meta-analytic review

Yao

Xu²,

Chan³

et al. 2023

Journal of Affective Disorders

View full text Add to dashboard Cite

The relationship between three ACT core processes of change, PTSD, and depressive symptoms

Cited by 14 publications

References 22 publications

Causal discovery replicates symptomatic and functional interrelations of posttraumatic stress across five patient populations

Causal discovery replicates symptomatic and functional interrelations of posttraumatic stress across five patient populations

Causal discovery identifies posttraumatic stress as a driver of internalizing symptoms across independent veteran and civilian populations

Associations between psychological inflexibility and mental health problems during the COVID-19 pandemic: A three-level meta-analytic review

Contact Info

Product

Resources

About