Relation of positive memory recall count and accessibility with post-trauma mental health.

Positive memory encoding and retrieval deficits have an empirical relation with several post-trauma outcomes. Drawing from the Contractor et al. model, we examined relations between positive memory characteristics and post-trauma mental health indicators. A trauma-exposed community sample of 203 participants (Mage = 35.40 years; 61.10% female) was recruited via Amazon's Mechanical Turk. Participants completed measures of posttraumatic stress disorder (PTSD; PTSD Checklist for DSM-5), depression (Patient Health Questionnaire-9), posttraumatic cognitions (Posttraumatic Cognitions Inventory), affect (Positive and Negative Affect Schedule), count/number of recalled specific positive memories (Autobiographical Memory Test) and accessibility of a specific positive memory (i.e., subjective ease of recalling details of a memory; Memory Experiences Questionnaire-Short Form). Linear regression results indicated that PTSD intrusion severity, PTSD negative alterations in cognitions and mood (NACM) severity, PTSD alterations in arousal and reactivity (AAR) severity, self-blame, and positive affect significantly and negatively predicted the count of specific positive memories. Further, PTSD NACM severity, PTSD AAR severity, negative cognitions about the self, and negative affect significantly and negatively predicted accessibility of a specific positive memory. Thus, count/accessibility of specific positive memories was associated with several post-trauma mental health indicators; this highlights the relevance and potential impact of integrating positive memories into trauma treatment.

Recent Advances in Delivering Mental Health Treatment via Video to Home.

PURPOSE OF REVIEW: Telemental health has rapidly evolved as technology and policy advances have allowed new and innovative approaches, including the remote delivery of services directly to patients' homes. This review examined the literature on video to home (VTH) delivery of mental health services to synthesize information regarding (1) the comparative clinical effectiveness of VTH to in-person mental health treatment, (2) impact of VTH on treatment adherence, (3) patient and provider satisfaction with VTH, (4) cost effectiveness of VTH, and (5) clinical considerations for VTH use. RECENT FINDINGS: Clinical effectiveness, treatment adherence, and patient satisfaction outcomes are comparable for VTH and in-person delivery of psychotherapy and psychiatric consultation services. Clinical applications for VTH have expanded in an effort to provide mental health care to difficult to reach, underserved populations. VTH is less costly than in-person care when assuming that patients could employ existing personal technologies. VTH delivery offers a safe and effective option for increasing access to mental health care for patients who face logistical and stigma-related barriers to receiving in-person treatment. VTH should be routinely offered to patients as an option for receiving care, maximizing patient choice, and coordination of care.

Positive Internal Experiences in PTSD Interventions: A Critical Review.

Evidence suggests that individuals with post-traumatic stress disorder (PTSD) symptoms exhibit deficits in positive internal experiences. This study critically reviewed empirically validated PTSD interventions to determine (1) whether positive memories, cognitions, and emotions were explicitly addressed and (2) the goals of focusing on these positive internal experiences. We selected 11 empirically validated PTSD interventions listed as "recommended/strongly recommended" in recently published reviews, reviewed existing literature for studies using these interventions (N = 1,070), short-listed randomized controlled trial studies meeting predetermined inclusion criteria for the selected interventions (in English, developed for adults, individual therapy modality, in-person administration, tailored to PTSD; N = 47), and emailed authors (N = 41) to obtain the unique intervention manuals. Hereby, we reviewed 13 unique empirically validated PTSD intervention manuals. Findings indicated 53.85%, 69.23%, and 69.23% of reviewed manuals explicitly discussed positive memories, emotions, and cognitions, respectively. Primarily, positive memories were integral to mechanisms underlying PTSD, a precursor to targeting negative experiences, an indicator of treatment progress, or a way to identify client problems; positive emotions were discussed when providing psychoeducation on PTSD/trauma reactions; and positive cognitions were addressed in reference to coping with negative experiences or as targets to enhance self-concept. This review demonstrates that comparatively, positive memories are infrequently elicited in the reviewed interventions; positive emotions and cognitions are explicitly referenced in two-thirds of the reviewed interventions but are included as a primary focus for therapeutic processing only in a few interventions; and eye movement desensitization and reprocessing has the most comprehensive focus on positive internal experiences.

Examining indirect effects of emotion dysregulation between PTSD symptom clusters and reckless/self-destructive behaviors.

OBJECTIVES: Emotion dysregulation theoretically and empirically explains the link between posttraumatic stress disorder (PTSD) and posttrauma reckless and self-destructive behaviors (RSDBs). METHOD: The current study uniquely examined the role of emotion dysregulation in the association between the four heterogeneous PTSD clusters (intrusions, avoidance, negative alterations in cognitions and mood [NACM], and alterations in arousal and reactivity [AAR]) and an overall measure of posttrauma RSDBs. Trauma-exposed participants (n = 411) completed self-report measures assessing PTSD symptoms (PTSD Checklist for DSM-5), emotion dysregulation (Difficulties in Emotion Regulation Scale-16), and engagement in RSDBs (Posttrauma Risky Behaviors Questionnaire). RESULTS: Direct and indirect effects were examined using PROCESS Model 4. The bias-corrected bootstrap revealed a significant indirect effect of emotion dysregulation in posttrauma RSDBs' relation with PTSD's intrusions (B = -.13, SE = .04, 95% CI [-.23, -.06]), avoidance (B =.15, SE =.07, 95% CI [.04, .33]), NACM (B =.17, SE =.05, 95% CI [.09, .27]), and AAR (B =.14, SE =.05, 95% CI [.05, .27]). CONCLUSIONS: Emotion dysregulation explained associations between the severity of each PTSD symptom cluster and overall posttrauma RSDBs. PTSD treatments targeting emotion dysregulation may help to reduce posttrauma RSDBs for trauma-exposed individuals. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Effects of processing positive memories on posttrauma mental health: A preliminary study in a non-clinical student sample.

BACKGROUND AND OBJECTIVES: Although trauma research and therapy primarily focus on traumatic memories, recent evidence indicates positive memory processes play a role in the etiology/maintenance of posttraumatic stress disorder (PTSD) symptom severity. We examined the effects of a novel positive memory processing technique on PTSD symptom severity, depression symptom severity, affect, posttrauma cognitions, and self-esteem. METHODS: Sixty-five trauma-exposed participants were randomly assigned to one of three conditions (narrating/processing vs. writing/processing two specific positive memories, or a time-matched control) and completed self-report measures pre- and post-task (T0). About one week later, participants repeated their assigned task condition and completed self-report measures pre- and post-task (T1). We conducted mixed ANOVAs to examine the impact of the technique on study variables over time. RESULTS: The narrating condition had significant decreases in PTSD symptom severity, posttrauma cognitions, and negative affect from T0 pre-task to T1 post-task; and significant increases in positive affect from T0 pre-to-post-task and from T1 pre-to-post-task. The writing condition had significant increases in positive affect from T0 pre-to-post-task, but a significant decrease from T0 post-task to T1 post-task; and significant decreases in negative affect from T0 pre-to-post-task with an increase from T0 post-task to T1 post-task. LIMITATIONS: Use of self-report measures, non-clinical convenience sample with less gender/ethnic/racial diversity, small sample size, methodological differences in time frames for measures, and no examination of follow-up effects. CONCLUSIONS: Narrating and processing specific positive memories had a beneficial impact on PTSD symptom severity, posttrauma maladaptive cognitions, and affect; such results provide an impetus to examine positive memory interventions in trauma clinical work.

Video to Home Delivery of Evidence-Based Psychotherapy to Veterans With Posttraumatic Stress Disorder.

Background: The Veterans Health Administration (VHA) has pioneered the implementation of video to home (VTH) technology to increase access to mental health treatments for Veterans facing barriers to receiving in-person care, particularly for posttraumatic stress disorder (PTSD). Randomized controlled trials have established the noninferiority of evidence-based psychotherapies (EBPs) for PTSD delivered through VTH, compared to in-person delivery. Less is known about the use of VTH to deliver EBPs for PTSD in routine clinical practice. Objective: We examined the provision of EBPs for PTSD delivered via VTH at a large Southwestern VHA PTSD outpatient clinic. Methods: Data were obtained from chart review of the electronic medical records of Veterans receiving at least one session of Cognitive Processing Therapy or Prolonged Exposure via VTH in the VHA PTSD clinic during the study time frame. Results: Fourteen providers (including six psychology trainees) delivered EBPs for PTSD via VTH between 2016 and 2018. Providers treated 74 Veterans (33.8% women) from diverse sociocultural backgrounds who ranged in age from 25 to 79. Each provider treated about 3.08 (± 2.18) Veterans using VTH, not including one provider who saw more than 30. A hybrid approach, in which VTH-delivery was coupled with in-person delivery, was used with 70.3% of Veterans across treatment (including sessions completed before initiation and after termination of the EBP). This demonstrates the versatility of VTH for meeting individual patient needs. Most EBP sessions (85.4%) were conducted over VTH. Despite Veterans attending an average of 6.85 (± 4.88) EBP sessions, 50% terminated before session 7. This dropout rate is consistent with national and local EBP completion averages within the VHA. Veterans receiving Cognitive Processing Therapy via VTH were more likely to complete treatment than those receiving Prolonged Exposure. No other patient factors predicted attrition. Conclusions: This study highlights the use of VTH as "tool in the toolbox" that expands the scope of practice for providers and increases opportunities for Veterans to receive EBPs for PTSD. We describe other potential advantages of using VTH to deliver EBPs for PTSD.