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• Modifications document the delivery of trauma-focused treatments to 131 veteran–clinician pairs in an urban PTSD clinical setting using the adapted FRAME. • Modifications to trauma-focused treatments were reported in over 60% of veteran–clinician pairs. • Common modifications included spreading (27%), repeating (24%), drift with return (22%), and integrating (21%). • A large portion of veterans continued to engage in care following TF-EBT engagement. Clinicians in naturalistic settings regularly modify the delivery of trauma-focused treatments to enhance client engagement and retention. However, what types of modifications are made in clinical settings, why, and when, and their impact on client outcomes has seldom been examined. As an initial step to address this, the current study applied elements of the updated Framework for Reporting Adaptations and Modifications—Expanded (FRAME; Wilstey Stirman et al., 2019) to examine content-level modifications documented in the delivery of posttraumatic stress disorder (PTSD) treatment to veterans via medical records review in an urban PTSD clinic. Results indicated that the updated FRAME suited the data well, and that modifications occurred in most veteran–clinician pairs over the course of treatment. The four most common modifications documented were spreading (27%), repeating (24%), drift with return (22%), and integrating (21%). Three composite case examples are discussed that describe the application of the most common modifications observed in medical record documentation. This is an important first step toward understanding the real-world modifications of evidence-based trauma-focused interventions that in turn will lead to critical recommendations for improving treatment implementation. [ABSTRACT FROM AUTHOR]

Many of the 700,000 American military personnel deployed to the Persian Gulf region in 1990 and 1991 have since reported health symptoms of unknown etiology. This cluster of symptoms has been labeled Gulf War Illness and include chronic musculoskeletal pain, fatigue, headaches, memory and attention difficulties, gastrointestinal complaints, skin abnormalities, breathing problems, and mood and sleep problems [ 1 , 2 ]. There have been few high-quality intervention trials and no strong evidence to support available treatments [ 3 ]. Tai Chi is an ancient Chinese martial art with benefits that include enhancing physical and mental health and improving quality of life for those with chronic conditions. In this randomized controlled trial, GW Veterans are randomly assigned to either Tai Chi or a Wellness control condition, with both remotely delivered intervention groups meeting twice a week for 12 weeks. The primary aim is to examine if Tai Chi is associated with greater improvements in GWI symptoms in Veterans with GWI compared to a Wellness intervention. Participants will receive assessments at baseline, 12 weeks (post-intervention), and follow-up assessments 3- and 9-months post-intervention. The primary outcome measure is the Brief Pain Inventory that examines pain intensity and pain interference. This trial will produce valuable results that can have a meaningful impact on healthcare practices for GWI. If proven as a helpful treatment for individuals with GWI, it would support the implementation of remotely delivered Tai Chi classes that Veterans can access from their own homes. • There is a need for high-quality intervention trials for Gulf War Illness. • Tai Chi shows promise to address pain and improve functioning in Gulf War Illness. • Using telehealth therapies for Gulf War Veterans can improve access to care. [ABSTRACT FROM AUTHOR]

Trauma exposure and posttraumatic stress are highly prevalent and comorbid with health problems. Despite the apparent systemic nature of posttraumatic stress, recommended treatments neglect trauma's deleterious effects on health. Integrative mind-body treatments for posttraumatic stress, such as Tai Chi and Qigong (TCQ), may offer a promising adjunct to first-line treatments. A systematic search was conducted to identify trials that examined Tai Chi and/or Qigong as treatments for trauma-exposed populations. Studies were examined for rigor; design, sample and intervention characteristics, dropout, attendance, satisfaction, acceptability, and key findings were systematically extracted. The 6 studies included are all pilot or feasibility trials with descriptive or mixed-methods outcomes. No randomized trials or rigorous studies were identified. Dropout rates ranged widely, and adverse reactions were not evident. Reported satisfaction was high and benefits of relaxation, reductions in mental health symptoms, and improvements in pain and physical and cognitive functioning were noted. All the studies were non-rigorous and relatively small, with no comparison groups, or follow-up assessments; in many cases, posttraumatic stress symptoms were not formally assessed. The paucity and lack of rigor of the studies identified for this review highlights the need for larger, methodologically sound clinical trials. The reviewed studies suggest that TCQ practices have the potential to reduce symptoms and improve functioning for individuals exposed to trauma and provide evidence that TCQ is feasible, acceptable, and low risk in these populations. Possible mechanistic pathways supporting TCQ as a treatment for posttraumatic stress are considered. • Six studies of Tai Chi and/or Qigong (TCQ) for trauma populations were reviewed. • TCQ appears to be safe, feasible, and acceptable for individuals post trauma. • TCQ may improve wellbeing and functioning and reduce post trauma symptoms. • Rigorous clinical trial methodology is lacking and needed to advance the field. [ABSTRACT FROM AUTHOR]

Abstract: Mindfulness is increasingly conceptualized in terms of its regulatory function with research suggesting that mindfulness may have a salutary effect on psychological well-being. The present cross-sectional study of 514 college students (84% Caucasian and 62% females), using self-report questionnaires, tested a proposed model for understanding the relationship between dispositional mindfulness and depressive symptoms through three types of affect regulation: emotion regulation, mood regulation and self-regulation, as measured by positive emotions, mood regulation expectancies (i.e., perceived mood repair ability), and self-acceptance, respectively. Structural equation modeling revealed that the model fit the data well, with the relationship between mindfulness, as measured by the Freiburg Mindfulness Inventory, and depressive symptoms, as measured by the Center for Epidemiological Studies-Depression Scale, fully mediated by the proposed regulatory processes. Higher levels of dispositional mindfulness were associated with higher levels of positive emotions, mood regulation expectancies, and self-acceptance, which in turn, were all inversely related to depressive symptoms. Self-acceptance emerged as the strongest mediator of mindfulness and depressive symptoms. Our findings suggest that mindfulness might serve a regulatory function by targeting low positive emotionality, poor mood regulation, and negative self-concept, risk factors implicated in the onset, development, and maintenance of depressive symptoms. [Copyright &y& Elsevier]

Cognitive-behavioral conjoint therapy for posttraumatic stress disorder (CBCT for PTSD; Monson & Fredman, 2012) is efficacious in improving PTSD symptoms and relationship adjustment among couples with PTSD. However, there is a need for more efficient delivery formats to maximize engagement and retention and to achieve faster outcomes in multiple domains. This nonrandomized trial was designed to pilot an abbreviated, intensive, multi-couple group version of CBCT for PTSD (AIM-CBCT for PTSD) delivered over a single weekend for 24 couples that included an active-duty service member or veteran with PTSD who had deployed in support of combat operations following September 11, 2001. All couples completed treatment. Assessments conducted by clinical evaluators 1 and 3 months after the intervention revealed significant reductions in clinician-rated PTSD symptoms (ds = -0.77 and -0.98, respectively) and in patients' self-reported symptoms of PTSD (ds = -0.73 and -1.17, respectively), depression (ds = -0.60 and -0.75, respectively), anxiety (ds = -0.63 and -0.73, respectively), and anger (ds = -0.45 and -0.60, respectively), relative to baseline. By 3-month follow-up, partners reported significant reductions in patients' PTSD symptoms (d = -0.56), as well as significant improvements in their own depressive symptoms (d = -0.47), anxiety (d = -0.60), and relationship satisfaction (d = 0.53), relative to baseline. Delivering CBCT for PTSD through an abbreviated, intensive multi-couple group format may be an efficient strategy for improving patient, partner, and relational well-being in military and veteran couples with PTSD. [ABSTRACT FROM AUTHOR]

The STRONG STAR Consortium (South Texas Research Organizational Network Guiding Studies on Trauma and Resilience) and the Consortium to Alleviate PTSD are interdisciplinary and multi-institutional research consortia focused on the detection, diagnosis, prevention, and treatment of combat-related posttraumatic stress disorder (PTSD) and comorbid conditions in military personnel and veterans. This manuscript outlines the consortia's state-of-the-science collaborative research model and how this can be used as a roadmap for future trauma-related research. STRONG STAR was initially funded for 5 years in 2008 by the U.S. Department of Defense's (DoD) Psychological Health and Traumatic Brain Injury Research Program. Since the initial funding of STRONG STAR, almost 50 additional peer-reviewed STRONG STAR-affiliated projects have been funded through the DoD, the U.S. Department of Veterans Affairs (VA), the National Institutes of Health, and private organizations. In 2013, STRONG STAR investigators partnered with the VA's National Center for PTSD and were selected for joint DoD/VA funding to establish the Consortium to Alleviate PTSD. STRONG STAR and the Consortium to Alleviate PTSD have assembled a critical mass of investigators and institutions with the synergy required to make major scientific and public health advances in the prevention and treatment of combat PTSD and related conditions. This manuscript provides an overview of the establishment of these two research consortia, including their history, vision, mission, goals, and accomplishments. Comprehensive tables provide descriptions of over 70 projects supported by the consortia. Examples are provided of collaborations among over 50 worldwide academic research institutions and over 150 investigators. [ABSTRACT FROM AUTHOR]