Browsing by Author "Barnes, John Benjamin"
Now showing 1 - 2 of 2
Results Per Page
Sort Options
Item The structure of PTSD and depression symptoms in marines before and after deployment(University of Delaware, 2014) Barnes, John BenjaminSome research has suggested that the symptoms of Posttraumatic Stress Disorder (PTSD) and Major Depressive Disorder may constitute one post-trauma reaction. The current study aimed to extend this research by investigating the extent to which symptoms of PTSD and depression [as measured by the Posttraumatic Stress Disorder Checklist (PCL) and the Beck Depression Inventory-II (BDI-II)] are hierarchical in nature, with a common general distress factor and variance specific to each measure, and whether this structure changes before and after a stressful military deployment. The same sample of 298 marines deployed to Afghanistan in 2010 was assessed 1-month before deployment, and 1- and 5-months after returning from deployment, using self-report measures of PTSD and depression, as well as measures of affectivity, lifetime trauma, current deployment trauma, and coping. At all three assessments, PTSD and depression symptoms loaded onto one higher-order factor. In addition, there was remaining variance specific to each measure at the baseline and 5-month post-return assessments. At the 1-month assessment, the PTSD-specific factor was less strong, and the depression-specific factor did not reach statistical significance. These findings suggest a robust and stable common symptom presentation that might be particularly strong in the aftermath of exposure to potentially traumatic experiences. Yet, there are also symptom patterns specific to PTSD and depression that warrant investigation.Item Therapeutic processes in written exposure therapy and cognitive processing therapy(University of Delaware, 2017) Barnes, John BenjaminPosttraumatic stress disorder (PTSD) is an important focus of research, given its high prevalence rates and significant impairment across several domains of functioning. Cognitive processing therapy (CPT) is a 12-session cognitive-behavioral treatment for PTSD that has been shown to have good efficacy and effectiveness and is being disseminated widely. In addition, researchers have developed a brief 5-session written exposure treatment (written exposure therapy; WET) for PTSD that requires limited therapist involvement to increase client acceptability, reduce dropout, and improve access to care. The developers of this treatment have completed a non-inferiority randomized controlled trial in a sample of 126 adults with PTSD, demonstrating equivalent efficacy between WET and CPT. The current study examined processes of change by coding the content of the written narrative components from these treatments. Levels of multimodal trauma network activation, avoidance, assimilation, overgeneralization, and accommodation were compared and examined as predictors of dropout and of 6- and 12-week PTSD treatment outcomes within and between groups. Word count, level of narrative detail, and extent of trauma focus were also compared. Results suggested that although the CPT treatment group wrote longer trauma recounting narratives with more detail and therapeutic focus, both treatments showed similar levels of avoidance and multimodal trauma network activation and that higher levels of trauma network activation predicted better outcomes for the WET group. Across written components of both treatments, overgeneralization decreased in the CPT group only, and accommodation improved across both treatments. In terms of outcomes, improvements in overgeneralization and accommodation predicted better 12-week outcomes in both groups, and these changes predicted outcome over and above levels of trauma network activation. Finally, higher levels of assimilation in initial narratives were positively associated with dropout, which was higher in the CPT group (40% versus 6%). These findings add to the primary RCT by demonstrating similar change processes in WET, but with lower dropout rates and less burden.