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Behavioral Sciences
Special Issues
Innovations for Addressing Posttraumatic Stress and Co-occurring Conditions
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Innovations for Addressing Posttraumatic Stress and Co-occurring Conditions

A special issue of Behavioral Sciences (ISSN 2076-328X). This special issue belongs to the section "Developmental Psychology".

Deadline for manuscript submissions: closed (31 March 2025) | Viewed by 6132

Special Issue Editors

Dr. Naomi Ennis

E-Mail Website
Guest Editor
Carepoint Health, Mississauga, ON L5K 2N6, Canada
Interests: PTSD; cognitive behavioral therapy; trauma recovery; social support; interpersonal interactions
Dr. Candice M. Monson

E-Mail Website
Guest Editor
Department of Psychology, Toronto Metropolitan University, Toronto, ON M5B 2K3, Canada
Interests: trauma recovery; PTSD; intimate relationships; cognitive behavioral therapy; couple therapy; clinical trials

Special Issue Information

Dear Colleagues,

Posttraumatic stress disorder (PTSD) is associated with high rates of psychological comorbidities. Individuals with PTSD also present for treatment with factors that may interfere with their recovery, such as ongoing risks of re-exposure to trauma, substance use disorders, self-injury/suicidality, and interpersonal relationship distress. There is a need to better understand how cognitive behavioral therapies (CBT), considered the gold standard in PTSD treatment, can effectively and efficiently address these co-occurring concerns.

This Special Issue aims to identify papers on novel interventions or innovations in treatment that address PTSD and co-occurring concerns. Papers may present data on treatments that address PTSD and comorbidities such as substance use disorders, insomnia, personality disorders, eating disorders, severe mental illness, and depression. We also welcome papers on treatments and treatment innovations that address PTSD and clinically relevant issues such as support with return to work, chronic pain, racial trauma, dissociation, safety concerns, high risk of re-exposure to trauma, gender-based violence, interpersonal relationships and family distress, and traumatic brain injury/concussion, among others. We are in search of papers with both original data from treatment trials and basic science research that could have implications for treatments, as well as review papers. Of importance, these papers should describe the application of their findings to diverse populations and how diversity, equity, and inclusion are factored into treatment development or innovations.

Dr. Naomi Ennis
Dr. Candice M. Monson
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Behavioral Sciences is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2200 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • comorbidities
  • posttraumatic stress disorder
  • CBT
  • substance use disorders
  • personality disorders
  • insomnia
  • eating disorders
  • ongoing risk

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Published Papers (6 papers)

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Research

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9 pages, 210 KiB  
Article
Furthering Our Understanding of Post-Traumatic Mental Health Conditions and Intimate Relationship Outcomes in Veterans of the Wars in Afghanistan and Iraq
by Camara A. T. Azubuike, Alexander O. Crenshaw and Candice M. Monson
Behav. Sci. 2025, 15(6), 719; https://doi.org/10.3390/bs15060719 - 23 May 2025
Viewed by 346
Abstract
Objective: Although there has been substantial research on post-traumatic stress disorder and its commonly comorbid conditions, the unique associations among these mental health symptoms and relationship adjustment have not been investigated. The purpose of this paper is to extend understanding of the associations [...] Read more.
Objective: Although there has been substantial research on post-traumatic stress disorder and its commonly comorbid conditions, the unique associations among these mental health symptoms and relationship adjustment have not been investigated. The purpose of this paper is to extend understanding of the associations among PTSD and relationship adjustment for female and male veterans, as well as to account for the impact of comorbid symptoms of depression and problematic alcohol use in a large sample. Method: Participants were 2325 (n = 1122 men and 1203 women) veterans of the wars in Iraq and Afghanistan from a larger study exploring wartime experiences and post-deployment adjustment. Chi-square analyses and regressions tested the associations among mental health symptoms (PTSD symptom severity, depressive symptoms, and problematic alcohol use) and relationship status and adjustment. Results: For both men and women, those with probable PTSD were less likely to be in an intimate relationship than those without probable PTSD, and those in intimate relationships had lower PTSD symptom severity compared with those not in intimate relationships. However, when accounting for PTSD, depression, and problematic alcohol use simultaneously, only depression emerged as a significant negative predictor of relationship adjustment. Conclusions: Shared variance among these common post-traumatic mental health conditions comorbidities may be most responsible for PTSD’s negative association with relationship adjustment. Unique remaining variance of depression is also negatively associated with relationship adjustment. Treatment implications of these findings for individual and couple therapy post-trauma are provided. Full article
(This article belongs to the Special Issue Innovations for Addressing Posttraumatic Stress and Co-occurring Conditions)
10 pages, 263 KiB  
Article
An Initial Examination of Couple Therapy for PTSD Outcomes Among Black/African American Adults: Findings from an Uncontrolled Trial with Military Dyads
by Steffany J. Fredman, Alyssa A. Gamaldo, August I. C. Jenkins, Yunying Le, Jacqueline A. Mogle, Candice M. Monson, Charlene E. Gamaldo, Roland J. Thorpe, Jr., Brittany N. Hall-Clark, Tabatha H. Blount, Brooke A. Fina, Orfeu M. Buxton, Christopher G. Engeland, Galena K. Rhoades, Scott M. Stanley, Alexandra Macdonald, Katherine A. Dondanville, Daniel J. Taylor, Kristi E. Pruiksma, Brett T. Litz, Stacey Young-McCaughan, Jeffrey S. Yarvis, Terence M. Keane and Alan L. Petersonadd Show full author list remove Hide full author list
Behav. Sci. 2025, 15(4), 537; https://doi.org/10.3390/bs15040537 - 16 Apr 2025
Viewed by 662
Abstract
Black/African American individuals experience high rates of posttraumatic stress disorder (PTSD), which is frequently chronic and undertreated in this population. Intimate relationships are a salient resource for Black/African American adults’ psychological well-being. To help advance health equity, this study serves as an initial, [...] Read more.
Black/African American individuals experience high rates of posttraumatic stress disorder (PTSD), which is frequently chronic and undertreated in this population. Intimate relationships are a salient resource for Black/African American adults’ psychological well-being. To help advance health equity, this study serves as an initial, proof-of-concept investigation of patient outcomes among Black/African American adults who received a disorder-specific couple therapy for PTSD. Participants were a subsample of seven Black/African American adults (mean age = 40.56 years, SD = 10.18; 85.7% male) who participated in an uncontrolled trial of an abbreviated, intensive, multi-couple group version of cognitive-behavioral conjoint therapy for PTSD with 24 military dyads. Treatment was delivered over 2 days in a weekend retreat format. Assessments were administered at baseline, 1 month post-retreat, and 3 months post-retreat. There were large and significant decreases in patients’ PTSD symptoms based on clinicians’ and patients’ ratings (ds −1.37 and −1.36, respectively) by the 3-month follow-up relative to baseline. There were also large and significant decreases in patients’ depressive, anxiety, and anger symptoms (ds −1.39 to −1.93) and a large, marginally significant decrease in patients’ insomnia (d = −0.85; p = 0.083). Patients reported a medium, non-significant increase in relationship satisfaction (d = 0.68; p = 0.146) and a large, marginally significant increase in joint dyadic coping (d = 0.90; p = 0.069). Findings offer preliminary evidence that treating PTSD within a couple context is a relevant strategy to reduce PTSD and comorbid symptoms among partnered Black/African American adults and a promising approach to enhance relationships. Full article
(This article belongs to the Special Issue Innovations for Addressing Posttraumatic Stress and Co-occurring Conditions)
9 pages, 210 KiB  
Article
Examining Virtual Delivery of Strength at Home for Intimate Partner Violence Perpetration
by Casey T. Taft, Justin K. Benzer, Megan Kopitsky and Suzannah K. Creech
Behav. Sci. 2024, 14(12), 1127; https://doi.org/10.3390/bs14121127 - 25 Nov 2024
Viewed by 941
Abstract
This study examined the effectiveness of the virtual delivery of the Strength at Home (SAH) intervention program for intimate partner violence in a sample of 605 military veterans across 69 Veterans Affairs (VA) Medical Centers through a national implementation of the program. Outcome [...] Read more.
This study examined the effectiveness of the virtual delivery of the Strength at Home (SAH) intervention program for intimate partner violence in a sample of 605 military veterans across 69 Veterans Affairs (VA) Medical Centers through a national implementation of the program. Outcome measures included physical IPV, psychological IPV, coercive control behaviors, post-traumatic stress disorder (PTSD) symptoms, and alcohol misuse. Significant pre-intervention to post-intervention reductions were found for all the outcomes, with similar effect size estimates relative to a prior investigation of in-person-delivered SAH through the same national VA implementation. Study findings suggest that the virtual delivery of SAH may be as effective as in-person delivery which has important implications for program access and impact. Full article
(This article belongs to the Special Issue Innovations for Addressing Posttraumatic Stress and Co-occurring Conditions)
14 pages, 233 KiB  
Article
Intensive Treatment of Chronic Pain and PTSD: The PATRIOT Program
by John D. Otis, Jonathan S. Comer, Terence M. Keane, Erica Checko (Scioli) and Donna B. Pincus
Behav. Sci. 2024, 14(11), 1103; https://doi.org/10.3390/bs14111103 - 16 Nov 2024
Cited by 3 | Viewed by 1745
Abstract
Military combat can result in the need for comprehensive care related to both physical and psychological trauma, most commonly chronic pain and post-traumatic stress disorder (PTSD). These conditions tend to co-occur and result in high levels of distress and interference in everyday life. [...] Read more.
Military combat can result in the need for comprehensive care related to both physical and psychological trauma, most commonly chronic pain and post-traumatic stress disorder (PTSD). These conditions tend to co-occur and result in high levels of distress and interference in everyday life. Thus, it is imperative to develop effective, time-efficient treatments for these conditions before they become chronic and resistant to change. We developed and pilot-tested the Pain and Trauma Intensive Outpatient Treatment (PATRIOT) Program, a brief, intensive (3 weeks, six sessions) integrated chronic pain and PTSD treatment. An overview and session-by-session outline of the PATRIOT Program is provided, followed by results from the first pilot evaluation of the PATRIOT Program’s feasibility, acceptability, and preliminary efficacy in a sample of eight participating Veterans with comorbid chronic pain and PTSD. There were no treatment dropouts. At post-treatment, there were significant reductions in PTSD symptoms based on the Clinician-Administered Assessment of PTSD (CAPS). Pain and catastrophic thinking also decreased from pre- to post-treatment. With continued investigations and support, the PATRIOT Program may offer a brief, cost-effective, and more easily accessible treatment option for individuals who could benefit from learning skills to manage pain and PTSD more effectively. Full article
(This article belongs to the Special Issue Innovations for Addressing Posttraumatic Stress and Co-occurring Conditions)
14 pages, 296 KiB  
Article
Optimizing Allocation to Telehealth and In-Person Prolonged Exposure for Women Veterans with Military Sexual Trauma: A Precision Medicine Approach
by Evangelia Argyriou, Daniel F. Gros, Melba A. Hernandez Tejada, Wendy A. Muzzy and Ron Acierno
Behav. Sci. 2024, 14(11), 993; https://doi.org/10.3390/bs14110993 - 24 Oct 2024
Viewed by 1420
Abstract
Military sexual trauma-related post-traumatic stress disorder (PTSD) is highly prevalent and costly among women veterans, making the need for effective and accessible treatment of critical importance. Access to care is a key mechanism of mental health disparities and might affect differential response to [...] Read more.
Military sexual trauma-related post-traumatic stress disorder (PTSD) is highly prevalent and costly among women veterans, making the need for effective and accessible treatment of critical importance. Access to care is a key mechanism of mental health disparities and might affect differential response to treatment. The goal of this study was to estimate an individualized treatment rule based on readily available individual characteristics related to access to care to optimize allocation to in-person vs. telehealth delivery of prolonged exposure for PTSD in military sexual trauma survivors. The following variables were used as prescriptive factors: age, race, disability status, socioeconomic status, rural vs. urban status, and baseline PTSD level. The rule was estimated using a machine-learning approach, Outcome Weighted Learning. The estimated optimal rule outperformed a one-size-fits-all rule where everyone is universally assigned to telehealth; it led to markedly lower mean PTSD levels following 6 months from treatment (Vdopt − VTelehealth = −14.55, 95% CI: −27.24, −1.86). However, the rule did not significantly discriminate for in-person therapy (Vdopt − VIn-person = −11.86, 95% CI: −25.83, 2.12). Upon further validation with larger and more diverse samples, such a rule may be applied in practice settings to aid clinical decision-making and personalization of treatment assignment. Full article
(This article belongs to the Special Issue Innovations for Addressing Posttraumatic Stress and Co-occurring Conditions)

Other

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12 pages, 604 KiB  
Perspective
Overcoming Implementation Barriers of Concurrent Treatment for Eating Disorders and Posttraumatic Stress Disorder: Two Novel and Feasible Approaches
by Kathryn Trottier, Sara Bartel and Aaron Keshen
Behav. Sci. 2025, 15(6), 749; https://doi.org/10.3390/bs15060749 - 30 May 2025
Viewed by 295
Abstract
Eating disorders (EDs) and posttraumatic stress disorder (PTSD) frequently co-occur and share a functional relationship. Evidence suggests benefits of integrated and/or concurrent treatment; however, implementation is hindered by clinician training burden and the challenges of delivering two treatments simultaneously. This paper explores two [...] Read more.
Eating disorders (EDs) and posttraumatic stress disorder (PTSD) frequently co-occur and share a functional relationship. Evidence suggests benefits of integrated and/or concurrent treatment; however, implementation is hindered by clinician training burden and the challenges of delivering two treatments simultaneously. This paper explores two novel and feasible approaches to addressing ED-PTSD. The first is a clinician-guided cognitive behavioural workbook intervention delivered concurrently with ED treatment. It involves psychoeducation, addresses dissociation, and encourages approach (versus avoidance) practices. The second involves combining Written Exposure Therapy (WET) with ED treatment at both outpatient and day hospital levels of care. Both interventions have a low training burden and are feasible in routine clinical practice, making concurrent approaches available to those who need them. Full article
(This article belongs to the Special Issue Innovations for Addressing Posttraumatic Stress and Co-occurring Conditions)
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