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Cognitive-behavioral conjoint therapy for posttraumatic stress disorder (CBCT for PTSD; Monson & Fredman, 2012) is efficacious in improving PTSD symptoms and relationship adjustment among couples with PTSD. However, there is a need for more efficient delivery formats to maximize engagement and retention and to achieve faster outcomes in multiple domains. This nonrandomized trial was designed to pilot an abbreviated, intensive, multi-couple group version of CBCT for PTSD (AIM-CBCT for PTSD) delivered over a single weekend for 24 couples that included an active-duty service member or veteran with PTSD who had deployed in support of combat operations following September 11, 2001. All couples completed treatment. Assessments conducted by clinical evaluators 1 and 3 months after the intervention revealed significant reductions in clinician-rated PTSD symptoms (ds = -0.77 and -0.98, respectively) and in patients' self-reported symptoms of PTSD (ds = -0.73 and -1.17, respectively), depression (ds = -0.60 and -0.75, respectively), anxiety (ds = -0.63 and -0.73, respectively), and anger (ds = -0.45 and -0.60, respectively), relative to baseline. By 3-month follow-up, partners reported significant reductions in patients' PTSD symptoms (d = -0.56), as well as significant improvements in their own depressive symptoms (d = -0.47), anxiety (d = -0.60), and relationship satisfaction (d = 0.53), relative to baseline. Delivering CBCT for PTSD through an abbreviated, intensive multi-couple group format may be an efficient strategy for improving patient, partner, and relational well-being in military and veteran couples with PTSD.

In response to high suicide rates among veterans, the Department of Veterans Affairs (VA) has mandated that veterans at risk for suicide be given Safety Plans (SP). Research on the efficacy of SPs, however, is unclear and no prior study has examined the degree to which more personally relevant (i.e., higher quality) SPs may be associated with better outcomes or evaluate which components of SPs may be most effective at reducing suicidal behavior. The goal of the present study was to examine whether more personally relevant (i.e., higher quality) SPs reduce future suicide-related outcomes (psychiatric hospitalization, self-harm, and suicide attempts), and to determine which components of a SP may be most effective at reducing these outcomes. Participants were 68 individuals enrolled in a longitudinal national registry of returning military veterans receiving care from the VA, and who had at least one suicide-related event in the VA Suicide Prevention Applications Network. Data were collected between December 2009 and September 2016 and were analyzed between March 2016 and February 2017. Scores of SP quality were used to predict suicide-related outcomes. SP quality was low. Higher SP quality scores predicted a decreased likelihood of future suicide behavior reports (note entered into veteran's chart after a report of any self-harm behavior, including a suicide attempt). Higher scores on Step 3 (people and places that serve as distractions) predicted a decreased likelihood of future suicide behavior reports. More personally relevant SPs may reduce future suicide-related outcomes among veterans. Low SP quality scores highlight the need for training around SP implementation in the VA.

Individuals with posttraumatic stress disorder (PTSD) related to a serious motor vehicle accident were randomly assigned to either group cognitive behavioral treatment(GCBT) or a minimum contact comparison group (MCC).Compared to the MCC participants (n=16), individuals who completed GCBT (n=17) showed significant reductions in PTSD symptoms, whether assessed using clinical interview or a self-report measure. Among treatment completers, 88.3% of GCBT participants did not satisfy criteria for PTSD at posttreatment assessment, relative to31.3% of the MCC participants. Examination of anxiety,depression, and pain measures did not show a unique advantage of GCBT. Treatment-related gains were maintained over a 3-month follow-up interval. Patients reported satisfaction with GCBT, and attrition from this treatment was comparable with individually administered CBTs.Results are discussed in light of modifications necessitated by the group treatment format, with suggestions for future study of this group intervention.

In a randomized clinical trial, 24 Vietnam veterans with a diagnosis of post-traumatic stress disorder (PTSD) were randomly assigned either to a group receiving 14 to 16 sessions of implosive (flooding) therapy or to a waiting-list control. Standard psychometrics were administered before, following, and six months after treatment, and therapist ratings of symptomotology were concurrently obtained in personal interviews. When compared to the waiting-list control, those subjects receiving implosive therapy showed significant improvement across many of the psychometric measures and the therapist ratings of psychopathology. Specific changes in the re-experiencing dimension of PTSD, anxiety, and depression were notable, while treatment did not seem to influence the numbing and social avoidance aspects of PTSD. The results are discussed with respect to the importance of systematic exposure to traumatic memories, as one component of comprehensive treatment of combat-related PTSD, and the need for skills training interventions directed at improving social competence in interpersonal interactions.

There has been debate regarding the validity of an obse eating style. Some investigations have documented differences in eating style between obese and nonobese populations, although others have failed to denote differences. Generally, these studies have been conducted in naturalistic settings, (e.g., restaurants, cafeterias, etc.), and consequently are susceptible to several sources of uncontrollable variance. The present experiment investigated the eating style of obese children, while controlling for a number of subject and setting characteristics. Obese children ( X = 35% overweight) were compared with normal weight children during the consumption of a standardized meal. In the laboratory setting, obese children ate their meals faster (i.e., total meal duration and more bites per min) than the nonobese children. Although total number of bites and sips did not statistically differentiate the groups, the trend was in the predicted direction. Results are discussed in terms of social validation of behavioral management programs for weight reduction and the relevance of such interventions for children.

An issue of major concern in the behavioral treatment of posttraumatic stress disorders (PTSD) is the extent to which the extinction of anxiety to the memory of one event generalizes to other traumatic events that the individual may have experienced. In the present study each of two Vietnam veterans presented multiple traumatic events from combat which reoccurred in the form of intrusive thoughts, nightmares, and flashbacks. Using imaginal flooding as the treatment, it was possible to document the effect of treating the memory of one traumatic event upon the anxiety-provoking nature of the remaining traumas. For the first patient, subjective units of distress measures (SUDS) verified treatment efficacy and provided some evidence for generalization of extinction along thematic (stimulus) cues. With the second patient, physiological data in conjunction with SUDS ratings documented the relative independence of the anxiety associated with different traumatic events.

Although a great deal of clinical research attention has been directed toward assertiveness training, few studies have examined the social impact or interpersonal evaluation of assertive versus unassertive behavior, including the differential evaluation of assertiveness exhibited by males and females. In the present study, subjects observed a videotape showing a male or female stimulus model behaving either assertively or unassertively during four interactions similar to those used in assertiveness training research. Subjects then completed an interpersonal attraction inventory to evaluate the model they observed. Results indicated that while assertive models were viewed as skilled and able, they were given lower ratings on measures of likeability than unassertive models. Further, interaction effects indicated that assertive behavior exhibited by females resulted in more negative evaluations than the identical behavior in males.