Improved Attachment Style for Female Veterans Who Graduated Warrior Renew Sexual Trauma Treatment.

The Warrior Renew sexual trauma treatment program proposes to target perceived attachment style and the internal working models of interpersonal relationships. This study examined scores on the Relationships Scales Questionnaire and Brief Symptom Inventory pre- and posttreatment in a sample of 62 female veterans who graduated the program. Findings revealed that graduates of Warrior Renew reported significant decreases in fearful and dismissive insecure attachment and significant increases in secure attachment. Scores were significantly correlated with symptoms. Findings lend support to an upward spiral hypothesis associated with long-term positive outcomes found in previous research on Warrior Renew.

Delivering brief warrior renew over video teleconferencing to women veterans with military sexual trauma: A pragmatic trial.

This program evaluation examines effectiveness and acceptability of an eight-session brief warrior renew treatment protocol, modified and delivered over video teleconferencing to women veterans who have experienced military sexual trauma. Due to social distancing to prevent the spread of coronavirus disease 2019 (COVID-19), there was a need to adapt and develop a virtual protocol for warrior renew to reach veterans who would otherwise not have access to care. Group exercises were redesigned for video, and class outlines were sent to participants over email. Pre- and postgroup assessments of the Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) yielded significant decreases with large (.84) and close to large (.77) effect sizes, respectively. Notable were decreases on the Posttraumatic Cognitions Inventory-9 (PTCI-9), indicating significant reduction of self-blame (p < .001). Participant feedback found that if given a choice, 80% preferred virtual format, while 20% would prefer in-person care, 96% said it was effective and convenient, and 100% felt virtual brief warrior renew should continue to be offered as an option, Dropout of 30% was higher than in-person evaluations of warrior renew; however, 7.5% dropped due to poor internet connectivity. Minus this factor, dropout (22.5%) would not be different than in-person care. Nonetheless, technological difficulties can pose a potential barrier for some. Positive results of this evaluation can inform local operations to improve access to care for those who need or prefer virtual care. Formal research on virtual warrior renew, including a comparison to a control condition, is warranted. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Military sexual trauma during deployment to Iraq and Afghanistan: prevalence, readjustment, and gender differences.

This study examines military sexual trauma (MST) in men and women deployed in the wars in Iraq and Afghanistan. A diverse sample of 470 (408 men and 62 women) completed anonymous self-report questionnaires. Seventy-seven reported MST: 51 (12.5%) men and 26 (42%) women. MST was significantly related to symptoms and readjustment and most strongly with intimacy problems. Of those with MST, 73% also reported exposure to war-related stressors. Gender differences revealed that women reported a higher prevalence of MST, but men were more likely to endorse MST with multiple war-related stressors. However, no gender differences were found on reports of symptoms, posttraumatic stress disorder (PTSD), or readjustment. Implications of these results are discussed.

Pragmatic trial of brief warrior renew group therapy for military sexual trauma in VA primary care.

This is a pragmatic trial of a brief version of Warrior Renew, an emerging evidence-based treatment for military sexual trauma (MST) delivered in a Department of Veterans Affairs women's health clinic primary care setting. The full protocol meets twice a week for 12 weeks (24 sessions); however, Brief Warrior Renew meets for 8 sessions. Brief Warrior Renew is a manualized protocol addressing coping skills for affect management (e.g., triggers and anxiety) and unique aspects of MST including anger-resentments due to injustice-betrayal, and self-blame. It also addresses interpersonal factors such as relationship patterns. In this evaluation, 39 female veterans enrolled, 38 started, and 30 completed Brief Warrior Renew treatment (21% attrition). Participant scores reflected significant decreases of anxiety, depression, posttraumatic stress disorder, and negative thinking with large to very large effect sizes. Of the sample, 73.3% had reliable clinical change in their reports of negative thinking. This brief treatment appears to be feasible and well tolerated by veterans in a primary care setting. Results suggest formal investigation of this brief protocol is warranted. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Prevalence and nonrandom distribution of exonic mutations in interferon regulatory factor 6 in 307 families with Van der Woude syndrome and 37 families with popliteal pterygium syndrome.

PURPOSE: Interferon regulatory factor 6 encodes a member of the IRF family of transcription factors. Mutations in interferon regulatory factor 6 cause Van der Woude and popliteal pterygium syndrome, two related orofacial clefting disorders. Here, we compared and contrasted the frequency and distribution of exonic mutations in interferon regulatory factor 6 between two large geographically distinct collections of families with Van der Woude and between one collection of families with popliteal pterygium syndrome. METHODS: We performed direct sequence analysis of interferon regulatory factor 6 exons on samples from three collections, two with Van der Woude and one with popliteal pterygium syndrome. RESULTS: We identified mutations in interferon regulatory factor 6 exons in 68% of families in both Van der Woude collections and in 97% of families with popliteal pterygium syndrome. In sum, 106 novel disease-causing variants were found. The distribution of mutations in the interferon regulatory factor 6 exons in each collection was not random; exons 3, 4, 7, and 9 accounted for 80%. In the Van der Woude collections, the mutations were evenly divided between protein truncation and missense, whereas most mutations identified in the popliteal pterygium syndrome collection were missense. Further, the missense mutations associated with popliteal pterygium syndrome were localized significantly to exon 4, at residues that are predicted to bind directly to DNA. CONCLUSION: The nonrandom distribution of mutations in the interferon regulatory factor 6 exons suggests a two-tier approach for efficient mutation screens for interferon regulatory factor 6. The type and distribution of mutations are consistent with the hypothesis that Van der Woude is caused by haploinsufficiency of interferon regulatory factor 6. On the other hand, the distribution of popliteal pterygium syndrome-associated mutations suggests a different, though not mutually exclusive, effect on interferon regulatory factor 6 function.

Holographic reprocessing: Empirical evidence to reduce posttraumatic cognitions in women veterans with PTSD from sexual trauma and abuse.

Holographic reprocessing (HR) facilitates holistic reappraisal of attributions regarding interpersonal violence and maltreatment. The authors tested the feasibility to train therapists to run a protocol using HR to reduce negative thoughts associated with posttraumatic stress disorder (PTSD) in women veterans who have had sexual trauma or abuse. The study assessed pre- and postscores on the Posttraumatic Cognitions Inventory (PTCI) in a naturalistic clinical setting with 5 therapists. The protocol consisted of screening for PTSD, followed by an average of 9 HR treatment sessions. Twenty-two women were referred to the study; 17 enrolled and completed treatment (0% dropout rate). Significant decreases were found on all scales of the PTCI, with large effect sizes: total negative thoughts, t(16) = 4.42, p < .000, Cohen's d = 1.52, and 47% of the sample had reliable change (decreased negative thoughts; RC < -1.96). These findings suggest that HR is a promising treatment for sexual trauma PTSD. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

Sex disparities in health and health care utilization after Parkinson diagnosis: Rethinking PD associated disability.

OBJECTIVE: To examine sex differences and trends in comorbid disease and health care utilization in individuals with newly diagnosed Parkinson disease (PD). DESIGN: Retrospective cohort study. PARTICIPANTS: Over 133,000 Medicare beneficiaries with a new PD diagnosis in 2002 followed through 2008. METHODS: We compared the prevalence and cumulative incidence of common medical conditions, trends in survival and health care utilization between men and women with PD. RESULTS: Female PD patients had higher adjusted incidence rate ratio (IRR) of depression (IRR: 1.28, 1.25-1.31), hip fracture (IRR: 1.51, 1.45-1.56), osteoporosis (3.01, 2.92-3.1), and rheumatoid/osteoarthritis (IRR: 1.47, 1.43-1.51) than men. In spite of greater survival, women with PD used home health and skilled nursing facility care more often, and had less outpatient physician contact than men throughout the study period. CONCLUSIONS: Women experience a unique health trajectory after PD diagnosis as suggested by differing comorbid disease burden and health care utilization compared to men. Future studies of sex differences in care needs, care quality, comorbidity related disability, PD progression, and non-clinical factors associated with disability are needed to inform research agendas and clinical guidelines that may improve quality survival for women with PD.

Efficacy of Warrior Renew group therapy for female veterans who have experienced military sexual trauma.

This is a program evaluation of the Warrior Renew treatment protocol delivered in an outpatient therapy group for survivors of military sexual trauma (MST) at a Department of Veterans Affairs medical center. The group was delivered via a manualized protocol with 12 weekly topics. It includes coping skills for affect management (e.g., triggers and anxiety) and addresses unique aspects of MST including anger/resentments because of injustice and lack of closure, betrayal, and self-blame. It also addresses interpersonal factors such as relationship patterns and healthy interpersonal skills. This evaluation was conducted as part of routine clinical care in a naturalistic setting. Forty-three female veterans started and 34 completed treatment (21% dropout rate). Of the 34 graduates, 32 opted to complete pre- and posttreatment assessments. Findings revealed significant decreases in symptoms of anxiety, depression, posttraumatic negative thinking, and posttraumatic stress disorder (PTSD) all with large effect sizes. In addition, 75% of the sample had a reliable clinical change at the 95% confidence interval. These results are promising and further investigation is warranted to examine Warrior Renew to address the unique issues related to MST. (PsycINFO Database Record

Delivering Integrative Restoration-Yoga Nidra Meditation (iRest®) to Women with Sexual Trauma at a Veteran's Medical Center: A Pilot Study.

OBJECTIVE: This pilot study examines iRest, a form of guided mindfulness meditation, and its ability to reduce symptoms associated with sexual trauma, including military sexual trauma (MST), in a sample of women seeking psychotherapy services at a Department of Veterans Affairs (VA) medical center. METHODS: 90-minute sessions were held 19 times, twice a week for 10 weeks, except for the week with a holiday. Participants completed self-report measures Brief Symptom Inventory-18 (BSI), Posttraumatic Cognitions Inventory (PTCI), and the Post-traumatic Stress Disorder Check List (PCL) pre- and post-treatment. Sixteen women were recruited: 15 enrolled, 5 dropped due to transportation issues, and 10 completed the protocol. RESULTS: Completers reported significant decreases in symptoms of posttraumatic stress disorder (PCL, t (9) = 3.17, p < 0.01, d = 0.66), negative thoughts of self-blame (PTCI t (9) = 2.96, p < 0.05, d = 0.52), and depression (BSI, t (9) = 2.33, p < 0.05, d = 0.64). Participants also offered verbal reports of decreased body tension, improved quality of sleep, improved ability to handle intrusive thoughts, improved ability to manage stress, and an increased feeling of joy. Participants also enthusiastically endorsed the class and stated they would take it again and recommend it to others. CONCLUSIONS: This small pilot study showed promising results for delivering iRest to women with sexual trauma in a VA medical center. Further research is warranted.

The relation of cancer-prone personality to exceptional recovery from cancer: a preliminary study.

An exceptional cancer-recovered group (n = 7) was compared with 2 other recovered groups: a non-exceptional cancer-recovered group (n = 27), and a non-exceptional heart disease (HD)-recovered group (n = 31). In support of the hypothesis that mitigation of a cancer-prone personality is associated with very unusual recoveries from cancer, the exceptional cancer group reported a greater prevalence of attributes of a cancer-prone personality before diagnosis and a greater decrease in these attributes from before diagnosis to after recovery than the other groups reported. Both cancer groups reported greater stress from life events within the 2-year period preceding diagnosis, particularly for loss (or threatened loss) of a close relationship, than the HD group reported. The high internal-consistency reliability of a Cancer-prone Personality Inventory (CPPI) and its discrimination of the 2 cancer groups from the HD group make it a promising measure of a cancer-prone personality.