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Objective Advocates of massed prolonged exposure (PE) argue an intensive approach may address between-session distraction, avoidance, and demotivation that can result in dropout or interference with treatment engagement. Despite growing empirical support for the efficacy and effectiveness of massed PE, little evidence suggests massed PE matches patient preferences. Further, program evaluation efforts have not assessed unforeseen or underestimated benefits and drawbacks of massed PE. The current study is the first known study to assess patient reactions to massed PE. Method Participants were 25 military veterans diagnosed with posttraumatic stress disorder who were accepted into a 2-week massed PE program. After the final session, participants completed a written survey using open-ended questions regarding their perceived benefits and drawbacks of massing the full PE protocol into 2 weeks. After demonstrating interrater reliability, coders used a thematic analysis approach to identify themes and subthemes in the qualitative data. Results Overall, participant reactions were much more positive (51.27%) than negative (17.77%). Participants identified benefits that are largely consistent with the justification for massed PE: (a) The structure limits distractions and avoidance, and (b) quick gains enhance motivation and engagement. With respect to drawbacks, participants identified that massed PE causes short-term discomfort and is demanding in terms of effort and time, which is also consistent with clinical theory of PE and justification for massed delivery. Conclusions Participant reactions correspond to the rationale for massed PE; that is, participants identified that despite short-term discomfort and demands, they tend to like and benefit from the intensity of massed PE. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

There is an increasing recognition globally of the role to be played by community science –scientific research and monitoring driven and controlled by local communities, and characterized by place-based knowledge, social learning, collective action and empowerment. In particular, community science can support social-ecological system transformation, and help in achieving better ‘fit’ between ecological systems and governance, at local and higher levels of decision making. This paper draws on three examples of communities as central actors in the process of knowledge co-production to present a typology of community science, and to deduce a set of key principles/conditions for success. The typology involves three social learning models in which the community acquires scientific knowledge by (1) engaging with external bodies, (2) drawing on internal volunteer scientific expertise, and/or (3) hiring (or contracting) in-house professional scientific expertise. All of these models share the key characteristic that the local community decides with whom they wish to engage, and in each case, social learning is fundamental. Some conditions that facilitate community science include: community-driven and community-control; flexibility across leadership models; connection to place and collective values; empowerment, agency and collective action; credible trust; local knowledge; and links to governance. Community science is not a panacea for effecting change at the local level, and there is need for critical assessment of how it can help to fill governance gaps. Nevertheless, a considerable body of experience globally illustrates how local communities are drawing effectively on community science for better conservation and livelihood outcomes, in a manner compatible with broader trends toward ecosystem-based management and local stewardship.

High rates of drop-out from treatment of PTSD have challenged implementation. Care models that integrate PTSD focused psychotherapy and complementary interventions may provide benefit in retention and outcome. The first 80 veterans with chronic PTSD enrolled in a 2-week intensive outpatient program combining Prolonged Exposure (PE) and complementary interventions completed symptom and biological measures at baseline and posttreatment. We examined trajectories of symptom change, mediating and moderating effects of a range of patient characteristics. Of the 80 veterans, 77 completed (96.3%) treatment and pre- and posttreatment measures. Self-reported PTSD (p < .001), depression (p < .001) and neurological symptoms (p < .001) showed large reductions with treatment. For PTSD, 77% (n = 59) showed clinically significant reductions. Satisfaction with social function (p < .001) significantly increased. Black veterans and those with a primary military sexual trauma (MST) reported higher baseline severity than white or primary combat trauma veterans respectively but did not differ in their trajectories of treatment change. Greater cortisol response to the trauma potentiated startle paradigm at baseline predicted smaller reductions in PTSD over treatment while greater reductions in this response from baseline to post were associated with better outcomes. Intensive outpatient prolonged exposure combined with complementary interventions shows excellent retention and large, clinically significant reduction in PTSD and related symptoms in two weeks. This model of care is robust to complex presentations of patients with varying demographics and symptom presentations at baseline. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Since the September 11, 2001, terrorist attacks, military service in the United States has been linked to a range of behavioral health and physical injuries in a significant number of the almost three million service members who have returned from wartime deployment. These injuries have occurred in the larger context of wartime military service, which is characterized by an array of stressors that have been associated with increased risk for behavioral health problems not only for service members but also for their family members. For the past 15 years, military-connected (defined as active-duty, reserve component, and veteran) family members have shared their own experiences of military service, including multiple deployments in the context of danger, high operational stress within their communities, and living with the physical and behavioral health injuries and ongoing care needs of a loved one. This article provides an overview of the evolving research on the specific impact of posttraumatic stress disorder (PTSD) and other war zone–related behavioral health problems among families in the context of contemporary warfare, as well as research on the impact of family adjustment on veteran recovery and care. We propose an empirically supported, family-centered framework to inform a continuum of prevention and care for veterans with PTSD and their families. Gaps in the current continuum of behavioral health services for veterans with PTSD are identified, as well as efforts underway to develop trauma-informed, family-centered screening, prevention, and treatment approaches. Future research recommendations are provided.

This study examines childhood emotional maltreatment as a developmental predictor of psychological aggression perpetration in young adult dating couples, using a dyadic framework to account for individual and partner effects. We further investigate observations of skillful emotion communication (i.e., discussion of emotional experiences, including emotion identification and disclosure) as potential moderator. In a sample of 60 young adult romantic couples, actor–partner interdependence model analyses found significant actor effects of emotional maltreatment on psychological aggression perpetration, but no partner effects. Consistent with hypotheses, observations of higher skillful emotion communication attenuated associations between childhood emotional maltreatment and young adult psychological aggression, but only for female participants. Findings are discussed in the context of implications for prevention and intervention for couples at risk of psychological aggression.

The aims of the current study were to use dyadic data analysis to examine the associations of history of childhood emotional maltreatment to current relationship satisfaction among young adult romantic partners as moderated by the effects of hostile behavioral observations within these romantic couples. Our sample included 52 young adult romantic dyads recruited from a large southeastern university. Current relationship satisfaction and history of childhood emotional maltreatment were obtained via self-report; behavioral interactions were rated on a behavioral coding system to determine level of dyadic hostility. Results revealed a significant interaction effect: Females’ history of childhood emotional maltreatment significantly predicted relationship satisfaction for women at low or average (but not high) levels of dyadic hostility. Our findings suggest that for young women, romantic relationship satisfaction is compromised by their own history of emotional maltreatment, particularly when the couple’s conflict resolution style is characterized by low to average levels of hostility.

This initial feasibility study examined the use of virtual reality exposure therapy (VRE) in the treatment of MST-related PTSD, with newly developed content tailored to MST. Participants included 15 veterans (26% male) with MST-related PTSD. Assessment of PTSD, depression, and psychophysiological indicators of distress occurred at pre-treatment, post-treatment, and 3-month follow-up. Treatment included 6-12 VRE sessions. There were significant reductions in pre- to post-treatment PTSD (CAPS severity: t(10) = 3.69, p = .004; PCL-5: t(10) = 3.79, p = .004) and depressive symptoms, (PHQ-9: t(8) = 2.83, p = .022), which were maintained at follow-up. There also was a significant pre- to post-treatment reduction in heart rate response to a trauma cue. Cohen's d effect sizes were large (CAPS: d = 1.11; PCL-5: d = 1.14, PHQ-9: d = .94), and the percentage of participants meeting PTSD criteria continued to decline from post-treatment (53%) to follow-up (33%). Findings indicate VRE can be safely delivered and is a promising treatment for MST-related PTSD.

This paper examines why market and government institutions failed to prevent over fishing in the Southern Gulf snow crab fishery, whereas non-market institutions succeeded. A general conclusion is that the institutional environment in which economic behaviour must be coordinated for successful fisheries management is complex. More specifically, collective action dilemmas arise from the interdependency of human and fish species interactions. However, successful institutions are capable of resolving these dilemmas when they achieve credible commitment. Coordination mechanisms such as co-management contracts, horizontal patterns of communication and win–win negotiations all contribute to building an institutional arrangement in which participants are motivated to comply with conservation objectives.

The authors of this chapter focussed first on the question of who was using the term co-management in North America and what was meant by it. We used the definition proposed by the editors of this book: ‘an arrangement where responsibility for resource management is shared between the government and user groups’ (Sen and Nielsen, 1996). However, much of our discussion soon shifted into a comparison of power sharing in Canada and the United States, particularly who has decision-making authority over fisheries resources and how this changes over time. In discussing the ideal conditions for government user cooperation and a mutual willingness to support local governance, the idea of Jeffersonian Democracy came to mind. Jefferson envisioned a national government limited purely to national concerns and subsequent divisions into state, county and township governments such that ‘... each might do for itself what concerns itself directly, and what it can so much better do than a distant authority’ (McHugh, 1972).