Massed written exposure therapy delivered to veterans with posttraumatic stress symptoms on an acute inpatient mental health unit.

Written exposure therapy (WET) is a brief, manualized trauma-focused treatment typically delivered in five individual weekly sessions. Given the brevity and effectiveness of WET, researchers have begun to focus on its delivery in a massed format. However, only one case study examining massed delivery has been published to date. As such, the objective of the current study was to examine the acceptability, feasibility, and preliminary effectiveness of massed WET among veterans with a trauma- and stressor-related disorder receiving care on an acute inpatient mental health unit. Veterans (N = 26) were assessed prior to, immediately after, and 1 month following massed WET. Most veterans found massed WET to be useful and acceptable. Recruitment and retention rates suggested that the treatment was feasible. Notably, the results revealed statistically significant reductions in overall posttraumatic stress symptoms, ηp 2 = .81, p < .001; depressive symptoms, ηp 2 = .71, p < .001; and functional impairment, ηp 2 = .42, p = .002. These findings add to a growing body of literature highlighting the preliminary effectiveness of WET across various settings, populations, and delivery formats. Limitations include the small sample size and uncontrolled design.

Processing of Positive Memories Technique: Feedback From Trauma-Exposed Clients on Processing of Positive Memories Technique Components, Format, and Feasibility.

ABSTRACT: Although the majority of research and clinical interventions focused on posttraumatic stress disorder (PTSD) centers on traumatic memories, recent literature suggests the importance of considering emotionally laden memories more broadly among trauma-exposed individuals. Specifically, trauma-exposed individuals have difficulties retrieving positive and negative memories, and interventions focused on enhancing the retrieval of both traumatic and positive memories benefit overall well-being. These findings led to the development of a novel Processing of Positive Memories Technique (PPMT) for PTSD. As the next step in treatment development, PPMT was piloted among 12 trauma-exposed community members seeking therapeutic or assessment services at a university psychology clinic. In this study, we summarize participants' quantitative and qualitative feedback on the content, format, and feasibility of PPMT. Next, we outline proposed formative changes that are critical to the iterative refinement of PPMT, based on the obtained feedback to enhance its scalability, feasibility, and effectiveness. Within clinical practice, PPMT, as implemented in this study, may be feasible, and there may be potential benefits to incorporating positive memory processing using PPMT.

Interpersonal Decentering and Interpersonal Problems: Testing the Multi-Method Utility of Person-Situation Interactions in Thematic Apperception Tests.

Mature interpersonal decentering is a form of social cognitive role-taking involving reflective thought about one's interpersonal relationships. Previous research examining main effects for persons, card situation content, story content, and person-card interactions found more mature decentering in stories about heterosexual romantic-pull Thematic Apperception Test (TAT) cards (HRC) as compared with stories about nonromantic cards (NRC). To see whether differences in means corresponded to differential criterion validity, this multi-method study examined Inventory of Interpersonal Problems circumplex (IIP-C) scores associated with young adults' decentering maturity and deficits, comparing correlations with IIP-C scores of decentering scores calculated from HRC versus NRC. Similarly, to test the effect of story content, IIP-C scores were correlated with decentering scores calculated from stories having romantic versus nonromantic story content. Using circumplex statistical tests, decentering deficits were associated with domineering/vindictive interpersonal problems, and mature decentering with nonassertive/exploitable problems. Men who reported more exploitable problems decentered more maturely across all situations. Women who decentered more maturely in response to HRC reported more socially avoidant problems, whereas those who decentered more maturely to NRC reported more exploitable problems. Results for romantic versus nonromantic story content were largely uninterpretable (did not meet circumplexity assumption). Findings might assist clinicians' card selection.

Longitudinal relationships among posttraumatic stress disorder symptom clusters in response to positive memory processing.

BACKGROUND AND OBJECTIVES: Avoidance, inherent to posttraumatic stress disorder (PTSD) symptomatology, is theoretically and empirically linked to the maintenance of PTSD symptom severity. While research indicates traumatized individuals avoid positive and trauma memories, several PTSD treatments focus exclusively on traumatic memories. We examined the mediating role of PTSD's avoidance in the relationship between processing positive memories and PTSD cluster severity (intrusion, mood/cognitions, arousal). METHODS: Sixty-five trauma-exposed college students (Mage = 22.52; 86.10% female) were randomly assigned to 3 conditions: narrating/processing, writing/processing, or control (same task across baseline [T0] and follow-up [T1]). RESULTS: Half-longitudinal mediation models indicated participation in the narrating vs. writing and control conditions predicted decreases in T1 intrusion severity via reduction in T1 avoidance severity. Similarly, participation in the narrating vs. writing and control conditions predicted decreases in T1 mood/cognitions' severity via reduction in T1 avoidance severity. Participation in the narrating vs. writing condition predicted decreases in T1 arousal severity via reduction in T1 avoidance severity. LIMITATIONS: Data was obtained from an analogue small-size sample of university students. In addition, sessions were only 6-8 days apart, with the processing component of each session lasting ∼30 min. CONCLUSIONS: Processing positive memories may relate to lower PTSD severity via a reduction in PTSD's avoidance, paralleling effects of processing trauma memories. Our findings support future investigations of the mechanisms underlying impacts of positive memory processing in the context of PTSD treatments.