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1. A pilot randomized effectiveness trial of the unified protocol in trauma-exposed veterans.

Author

Gutner, Cassidy, Song, Jiyoung, Canale, Caroline, Suvak, Michael, Litwack, Scott, Niles, Barbara, and Stirman, Shannon

Subjects
PTSD, anxiety, comorbidity, depression, transdiagnostic, trauma, veteran, Male, Female, Humans, Veterans, Stress Disorders, Post-Traumatic, Pilot Projects, Anxiety, Comorbidity, Treatment Outcome
Abstract

BACKGROUND: The unified protocol (UP) is a promising transdisgnostic treatment for emotional disorders; limited data exists with trauma-exposed populations. This study compared effectiveness of the UP, presented centered therapy (PCT), and treatment as usual (TAU) in trauma-exposed veterans presenting to routine care. METHOD: Trauma-exposed veterans with one or more emotional disorder diagnoses participated in a pilot hybrid-1 effectiveness/preimplementation study. Thirty-seven male and female veterans were randomized to one of three conditions. RESULTS: Multilevel growth curve modeling demonstrated improvement over time across conditions with large effect sizes (range: -2.15 to -3.32), with the UP demonstrating the greatest change. The between group effect sizes for reductions in number of comorbid diagnoses were medium to small and statistically significant (TAU and UP, d = 0.49, p = .056; TAU and PCT d = 0.18, p = .166, UP and PCT d = 0.31, p = .229). Only the UP led to a decrease in the number of comorbid diagnoses (d = -0.71). Psychosocial functioning varied by group, with slight increases in impairment in PCT and TAU, and medium effect size reduction in the UP. Only the UP exhibited significant decreases in self-reported anxiety and depression. Between group differences for UP and PCT were medium to large and statistically significant for depression across two measures (d = -0.72 to d = -1.40). CONCLUSIONS: This represents the first trial examining effectiveness of the UP, PCT, and TAU in trauma-exposed veterans. Despite a small sample, large effect size differences demonstrated promising advantages for the UP. Trial Registration Number: NCT02944994.

Published
2022

5. STRONG STAR and the Consortium to Alleviate PTSD: Shaping the future of combat PTSD and related conditions in military and veteran populations

Author

Peterson, Alan L., Young-McCaughan, Stacey, Roache, John D., Mintz, Jim, Litz, Brett T., Williamson, Douglas E., Resick, Patricia A., Foa, Edna B., McGeary, Donald D., Dondanville, Katherine A., Taylor, Daniel J., Wachen, Jennifer Schuster, Fox, Peter T., Bryan, Craig J., McLean, Carmen P., Pruiksma, Kristi E., Yarvis, Jeffrey S., Niles, Barbara L., Abdallah, Chadi G., Averill, Lynnette A., Back, Sudie E., Baker, Monty T., Blount, Tabatha H., Borah, Adam M., Borah, Elisa V., Brock, Matthew S., Brown, Lily A., Burg, Matthew M., Cigrang, Jeffrey A., DeBeer, Bryann B., DeVoe, Ellen R., Fina, Brooke A., Flanagan, Julianne C., Fredman, Steffany J., Gardner, Cubby L., Gatchel, Robert R., Goodie, Jeffrey L., Gueorguieva, Ralitza, Higgs, Jay B., Jacoby, Vanessa M., Kelly, Kevin M., Krystal, John H., Lapiz-Bluhm, M. Danet, López-Roca, Argelio L., Marx, Brian P., Maurer, Douglas M., McDevitt-Murphy, Meghan E., McGeary, Cindy A., Meyer, Eric C., Miles, Shannon R., Monson, Candice M., Morilak, David A., Moring, John C., Mysliwiec, Vincent, Nicholson, Karin L., Rauch, Sheila A.M., Riggs, David S., Rosen, Craig S., Rudd, M. David, Schobitz, Richard P., Schrader, Christian C., Shinn, Antoinette M., Shiroma, Paulo R., Sloan, Denise M., Stern, Stephen L., Strong, Randy, Vannoy, Steven D., Young, Keith A., and Keane, Terence M.

Published
2021
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10. Intensive, Multi-Couple Group Therapy for PTSD: A Nonrandomized Pilot Study With Military and Veteran Dyads

Author

Fredman, Steffany J., Macdonald, Alexandra, Monson, Candice M., Dondanville, Katherine A., Blount, Tabatha H., Hall-Clark, Brittany N., Fina, Brooke A., Mintz, Jim, Litz, Brett T., Young-McCaughan, Stacey, Hancock, Allison K., Rhoades, Galena K., Yarvis, Jeffrey S., Resick, Patricia A., Roache, John D., Le, Yunying, Wachen, Jennifer S., Niles, Barbara L., McGeary, Cindy A., Keane, Terence M., and Peterson, Alan L.

Published
2020
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14. A Double-Blind Randomized Controlled Trial of Doxazosin for Co-Occurring PTSD and Alcohol Use Disorder in Veterans

Author

Back, Sudie E., primary, Flanagan, Julianne C., additional, Mintz, Jim, additional, Brady, Kathleen T., additional, Jones, Jennifer, additional, Jarnecke, Amber M., additional, Joseph, Jane E., additional, Shirley, David W., additional, Malcolm, Robert J., additional, Hamner, Mark, additional, Litz, Brett T., additional, Niles, Barbara L., additional, Young-McCaughan, Stacey, additional, Keane, Terence M., additional, and Peterson, Alan L., additional

Published
2023
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35. Promoting physical activity in individuals with diabetes: telehealth approaches

Author

Mori, DeAnna L., Silberbogen, Amy K., Collins, Allison E., Ulloa, Erin W., Brown, Kirstin L., and Niles, Barbara L.

Subjects
Exercise -- Health aspects, Exercise therapy -- Health aspects, Type 2 diabetes -- Risk factors -- Development and progression -- Care and treatment -- Research, Hypertension -- Risk factors -- Care and treatment -- Research, Health
Abstract

Abstract 'Health is the vital principle of bliss, and exercise, of health.' --James Thomson, 18th century Scottish poet Exercise is considered a crucial component of disease management for individuals with [...]

Published
2011

36. Managing suicidal emergencies: recommendations for the practitioner

Author

Kleespies, Phillip M., Deleppo, James D., Gallagher, Patricia L., and Niles, Barbara L.

Subjects
Suicidal behavior -- Care and treatment, Suicide -- Prevention, Psychiatric services -- Methods, Health risk assessment -- Methods, Psychology and mental health
Abstract

All practicing psychologists with an active caseload occasionally encounter a patient or client whom they consider to be a suicidal emergency. Few psychologists, however, have had education or training focused on managing such cases. The current article conceptualizes what a 'behavioral emergency' is, gives recommendations for containing the emergency client's emotional turmoil, and sets forth an evidence-based approach, using diagnosis-specific risk factors, for improving the clinician's ability to estimate suicide risk. Recommendations are also given for appropriate responses to the patient or client on the basis of the level of estimated risk. Having such an algorithm or plan for dealing with the suicidal client is essential to good practice.

Published
1999

37. Cognitive-behavioral treatment with and without response prevention for bulimia

Author

Wilson, G. Terence, Eldredge, Kathleen L., Smith, Delia, and Niles, Barbara

Subjects
Eating disorders -- Research, Bulimia -- Research, Cognitive therapy -- Research, Psychology and mental health
Abstract

We compared cognitive-behavior therapy (CBT) with and without exposure and response prevention (ERP) in the treatment of eating disorder patients who both binged and purged, and reported abnormal attitudes concerning body weight and shape. Both treatments produced significant and comparable reductions in binge-eating and purging, eating patterns, and attitudes about weight and shape at posttreatment. Treatment effects were generalized to improvements in different measures of general psychology, and were maintained over follow-ups of 3 and 12 months. The findings are consistent with prior research showing that CBT is an effective treatment for patients with the core features of bulimia nervosa. Furthermore, the data suggest that the addition of in-session exposure and response prevention does not enhance the effectiveness of the basis CBT program.

Published
1991

44. Temporal Associations Among Chronic PTSD Symptoms in U.S. Combat Veterans

Author

Doron-LaMarca, Susan, Niles, Barbara L., King, Daniel W., King, Lynda A., Kaiser, Anica Pless, and Lyons, Michael J.

Subjects
Male, Time Factors, Severity of Illness Index, Article, United States, Vietnam Conflict, Stress Disorders, Post-Traumatic, Sickness Impact Profile, Chronic Disease, Humans, Prospective Studies, Arousal, Boston, Veterans
Abstract

The present study examined fluctuation over time in symptoms of posttraumatic stress disorder (PTSD) among 34 combat veterans (28 with diagnosed PTSD, 6 with subclinical symptoms) assessed every 2 weeks for up to 2 years (range of assessments = 13-52). Temporal relationships were examined among four PTSD symptom clusters (reexperiencing, avoidance, emotional numbing, and hyperarousal) with particular attention to the influence of hyperarousal. Multilevel cross-lagged random coefficients autoregression for intensive time series data analyses were used to model symptom fluctuation decades after combat experiences. As anticipated, hyperarousal predicted subsequent fluctuations in the 3 other PTSD symptom clusters (reexperiencing, avoidance, emotional numbing) at subsequent 2-week intervals (rs = .45, .36, and .40, respectively). Additionally, emotional numbing influenced later reexperiencing and avoidance, and reexperiencing influenced later hyperarousal (rs = .44, .40, and .34, respectively). These findings underscore the important influence of hyperarousal. Furthermore, results indicate a bidirectional relationship between hyperarousal and reexperiencing as well as a possible chaining of symptoms (hyperarousal → emotional numbing → reexperiencing → hyperarousal) and establish potential internal, intrapersonal mechanisms for the maintenance of persistent PTSD symptoms. Results suggested that clinical interventions targeting hyperarousal and emotional numbing symptoms may hold promise for PTSD of long duration.

Published
2015

47. Explication and Definition of Mental Health Recovery: A Systematic Review.

Author

Ellison, Marsha Langer, Belanger, Lindsay K., Niles, Barbara L., Evans, Leigh C., and Bauer, Mark S.

Subjects
MENTAL health services, MENTAL illness treatment, HEALTH policy, PATIENT-centered care, SYSTEMATIC reviews
Abstract

This review assessed the concordance of the literature on recovery with the definition and components of recovery developed by the Substance Abuse and Mental Health Services Administration (SAMHSA). Each SAMHSA identified recovery component was first explicated with synonyms and keywords and made mutually exclusive by authors. Inter-rater reliability was established on the coding of the presence of 17 recovery components and dimensions in 67 literature reviews on the recovery concept in mental health. The review indicated that concordance varied across SAMHSA components. The components of recovery with greatest concordance were: individualized/person centered, empowerment, purpose, and hope. [ABSTRACT FROM AUTHOR]

Published
2018
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