Date of Award:

5-2017

Document Type:

Dissertation

Degree Name:

Doctor of Philosophy (PhD)

Department:

Psychology

Committee Chair(s)

Michael P. Twohig

Committee

Michael P. Twohig

Committee

Michael E. Levin

Committee

Rebecca Blais

Committee

Scott DeBerard

Committee

Tyra Sellers

Abstract

Posttraumatic stress disorder (PTSD) is a common condition among military personal and veterans. Despite strong empirical support for first line treatments for PTSD, many veterans do not complete or respond to treatment. Research suggests that experiential avoidance is a contributing factor to both treatment dropout and minimal treatment gains. Acceptance and commitment therapy (ACT) is an empirically supported cognitive behavioral intervention that aims to decrease experiential avoidance while increasing psychological flexibility. Research has shown ACT to be a promising intervention for the treatment of PTSD; however, its effectiveness in veterans with PTSD is limited.

In conjunction with Utah State University (USU) and the Salt Lake City Veterans Affairs Medical Center, Ellen Bluett, a USU doctoral psychology student and staff psychologist at the VA conducted a study to examine a next-step treatment for veterans with PTSD. The main purpose of this study was to examine the effectiveness of an 8- week closed group design ACT intervention for veterans with PTSD and subclinical PTSD who had previously completed a first line intervention for PTSD. Thirty-three veterans enrolled in the intervention, which focused on vitality (e.g., increasing valued living and decreasing experiential avoidance) rather than symptom reduction. Symptom and process of change measures including PTSD symptoms, valued living, and quality of life were measured at pretreatment, posttreatment, and again at 1-month follow-up.

Findings from this study showed that 64.7% of veterans showed a favorable response to treatment as measured by a 5-point change in PTSD symptoms. Additionally, outcomes of interest including PTSD symptoms, valued living, depression, wellbeing, and moral injury by transgressions improved from pretreatment to posttreatment. Of note, a majority of treatment gains were not maintained at follow-up. Overall, results provide preliminary support for ACT as a second-line intervention for veteran PTSD.

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