Impact of veteran-led peer mentorship on posttraumatic stress disorder.

Peer mentorship shows promise as a strategy to support veteran mental health. A community-academic partnership involving a veteran-led nonprofit organization and institutions of higher education evaluated a collaboratively developed peer mentor intervention. We assessed posttraumatic stress disorder (PTSD), postdeployment experiences, social functioning, and psychological strengths at baseline, midpoint, and 12-week discharge using the PTSD Checklist for DSM-5 (PCL-5), Deployment Risk and Resilience Inventory-2, Social Adaptation Self-evaluation Scale, and Values in Action Survey. Brief weekly check-in surveys reinforced mentor contact and assessed retention. The sample included 307 veterans who were served by 17 veteran peer mentors. Mixed-effects linear models found a modest effect for PTSD symptom change, with a mean PCL-5 score reduction of 4.04 points, 95% CI [-6.44, -1.64], d = 0.44. More symptomatic veterans showed a larger effect, with average reductions of 9.03 points, 95% CI [-12.11, -5.95], d = 0.77. There were no significant findings for other outcome variables. Compared to younger veterans, those aged 32-57 years were less likely to drop out by 6 weeks, aORs = 0.32-0.26. Week-by-week hazard of drop-out was lower with mentors ≥ 35 years old, aHR = 0.62, 95% CI [0.37, 1.05]. Unadjusted survival differed by mentor military branch, p = .028, but the small mentor sample reduced interpretability. Like many community research efforts, this study lacked a control group, limiting the inferences that can be drawn. Continued study of veteran peer mentorship is important as this modality is often viewed as more tolerable than therapy.

"Paper in a day": A model to encourage psychology collaboration and participation in research/program evaluation.

Although psychologists are trained to conduct research as well as clinical work, it can be challenging for psychologists outside of traditional academia to find the time or capacity to engage in research. Providing opportunities for practicing psychologists to conduct research may enhance the generalizability of psychological research, as well as provide benefits to psychologists in terms of collaboration, promotion, and engagement. Yet, several barriers exist, including competing demands on time, lack of institutional support, and limited research confidence. This article describes "Paper in a Day" (PiaD), a novel approach to research engagement that is well-suited for busy practitioners. PiaD considers many of the aforementioned factors and provides a method to navigate the often-daunting prospect of research involvement for the practicing clinician. Through PiaD, two Department of Veterans Affairs (VA) Medical Centers engaged clinicians and trainees in collaborating in a time-limited way to write and publish peer-reviewed articles. The current article outlines the process by which clinicians at these two sites structured research engagement utilizing PiaD, and it was also written utilizing the PiaD model. The authors have now led or participated in the PiaD process five times, with 13 teams of clinicians producing nine peer-reviewed articles and five conference presentations. A brief survey indicated that participants felt engaged in the process and would participate again if given the opportunity. This article outlines barriers and facilitators of the PiaD process, with the hope of encouraging other settings to consider using such a method to enhance research productivity and engagement for psychologists. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Symptom change prior to treatment discontinuation (dropout) from a naturalistic Veterans Affairs evidence-based psychotherapy clinic for PTSD and depression.

Dropout or treatment discontinuation from evidence-based psychotherapies (EBPs) has been a concern for clinicians as it is thought that such discontinuation prevents patients from achieving a full course of therapy and obtaining maximum benefit. Recent studies, however, suggest that treatment discontinuation may sometimes be due to symptom improvement. The purpose of the current evaluation was to examine change in self-reported symptoms in participants who completed versus did not complete treatment in a Veterans Affairs outpatient clinic offering EBPs for both depression and posttraumatic stress disorder (PTSD). Data were collected from 128 participants who had at least one treatment session postintake and had been discharged from the clinic. Data were collected on self-reported PTSD and depression symptoms. Of the 128 veterans, 61 completed treatment and 67 did not complete treatment (54.0% noncompletion in PTSD EBPs and 48.7% noncompletion in depression EBPs). Of those who did not complete, 47 were enrolled in a PTSD EBP and 20 in a depression EBP. Of those who did not complete a PTSD EBP, 51.1% had no change in PTSD symptoms prior to treatment discontinuation, whereas 12.8% had a symptom increase, and 27.7% had a symptom decrease. Of those who did not complete a depression EBP, 55% had no change in depression symptoms prior to treatment discontinuation, 15% had a symptom increase, and 30% had a decrease. Overall, results suggest that treatment discontinuation is not as straightforward as it may seem and that prematurely discontinuing an EBP may not necessarily represent treatment failure. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Confirmatory factor and measurement invariance analyses of the emotion regulation questionnaire.

Emotion regulation is widely studied in many areas of psychology and the number of publications on emotion regulation has increased exponentially over the past few decades. Additionally, interest in the relationships between emotion dysregulation processes and psychopathology has drastically increased in recent years. The Emotion Regulation Questionnaire (ERQ) was developed to measure two specific constructs related to emotion control: reappraisal and suppression (Gross & John, 2003). In its initial validation study and subsequent analyses, the instrument was shown to possess sound psychometric properties, but, to date, inquiry regarding the measure's characteristics has been limited. Factor analytic examinations of commonly used instruments are recommended to validate the properties of a given measure and increase researchers understanding of the measured constructs. The current study examined the psychometric properties of the ERQ in a sample of 1,188 undergraduates through confirmatory factor analysis. Additionally, tests of measurement invariance were employed in order to examine potential structural differences based on gender and ethnicity. The current study supported the original structure of the measure with all demographic groups and exceptional fit was demonstrated. Additional normative data for gender and ethnic groups are included. Results support the use of the instrument in future research.

Social anxiety across ethnicity: a confirmatory factor analysis of the FNE and SAD.

Previous research has established that social anxiety occurs at different rates in African American and European American populations (Grant et al., 2005), while psychometric investigations of widely used measures of psychopathology show differences in factor structure based on ethnic background (Carter, Miller, Sbrocco, Suchday, & Lewis, 1999; Chapman, Williams, Mast, & Woodruff-Borden, 2009). The current study examined response characteristics of 1276 African American and European American undergraduates completing the Fear of Negative Evaluation and Social Avoidance and Distress Scales (Watson & Friend, 1969). Confirmatory factor analyses failed to demonstrate factorial invariance in the two ethnic samples, and Wald tests suggested several items on both measures be dropped for African Americans. Results suggest the FNE and SAD operate differently across ethnic groups. Implications for the cross-cultural measurement of social anxiety and the importance of continued rigorous psychometric inquiry of commonly used measures are discussed.

A factor analytic comparison of five models of PTSD symptoms.

This study examined the factor structure of PTSD symptoms in a sample of college students (n=344) reporting exposure to a range of traumatic events. The sample was randomly split and an exploratory factor analysis was conducted with half of the sample. The factor structure obtained in the exploratory analysis was evaluated against three other models using confirmatory factor analysis utilizing the second half of the sample. This series of factor analyses identified and confirmed a three-factor symptom structure consisting of intrusion/avoidance, dysphoria, and hyperarousal clusters. These results add to the body of literature which has found that PTSD includes a cluster of symptoms shared with other diagnoses (dysphoria) and a more specific factor related directly to the effects of encountering traumatic experiences.

An examination of the differential effects of the experience of DSM-IV defined traumatic events and life stressors.

Recent evidence suggests that individuals exposed to traumatic events report similar, if not lower, levels of posttraumatic stress disorder (PTSD) symptoms than individuals exposed to nontraumatic stressful life events [J. Anxiety Disord. 19 (2005) 687-698; Br. J. Psychiatry 186 (2005) 494-499]. The current study compared the level of self-reported PTSD symptoms in a large sample (n=668) of trauma and nontrauma exposed college students. Participants were assessed for past trauma history as well as current symptoms of PTSD, depression, social interaction anxiety, and current positive and negative affect. Results indicated that while those who had experienced a traumatic event reported statistically significantly higher levels of PTSD symptoms, these differences were no longer clinically significant after other psychological distress factors were accounted for. Additional analyses suggested that those who had experienced events of an interpersonal nature had significantly higher levels of PTSD symptoms than those who had experienced other types of events.