Evaluation of a Brief Marriage Intervention for Internal Behavioral Health Consultants in Military Primary Care

Military couples face significant challenges to their relationships including demanding schedules, multiple deployments, and frequent moves. Despite the high costs of chronic marital distress, very few military (or civilian) couples seek marriage therapy. The military services and the VA system have implemented collaborative care models in primary care where internal behavioral health consultants are integrated into primary care. Integrated primary care can reduce the stigma of behavioral health services and may increase the odds that couples would seek help earlier. There are no established couple interventions designed for use in primary care. The purpose of this presentation is to describe a program of research focused on adapting and validating The Marriage Checkup (MC) for use in an integrated primary care clinic.https://corescholar.libraries.wright.edu/urop_celebration/1019/thumbnail.jp

The Scientist-Practitioner on the Front Line: Development and Formalization of Evidenced-Based Interventions on the Battlefield

Nathan (2005) and Petronko (2005) provide excellent commentaries on our three case studies (Cigrang, Peterson, & Schobitz, 2005) describing the use of prolonged imaginal exposure for the secondary prevention of Post-Traumatic Stress Disorder (PTSD). In this response, we note that future research should build upon the lessons and experiences of these cases and include larger sample sizes, additional measures (anxiety, depression, grief, quality of life, subjective units of distress ratings), the development of a flexible treatment manual, and formal measures of Acute Stress Disorder (ASD). Future research should also target process measures such as patient acceptability of the treatment and willingness to engage in the exposure sessions. Deployed military psychologists, in collaboration with civilian researchers, have the potential to further advance the scientific knowledge base on the assessment and treatment of combat-stress disorders through the use of innovative case studies. The potential importance of research and formalized treatments for individuals exposed to the significant psychological trauma related to terrorist attacks and bombings is highlighted

Readministration of the MMPI-2 Following Defensive Invalidation in a Military Job Applicant Sample

Job applicants whose response style on the Minnesota Multiphasic Personality Inventory-2 (MMPI-2; Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer) is excessively defensive create a dilemma for psychologists working in personnel selection settings. Clinical guidelines recommend the profile be considered uninterpretable, but the absence of usable testing data could lead to the elimination of otherwise qualified candidates. Readministering the MMPI-2 with altered instructions to reduce defensive responding has been suggested as an alternative. This option has lacked empirical support until recently. One study (Butcher, Morfitt, Rouse, & Holden, 1997) evaluated the effects of altered instructions on retest validity in a civilian job applicant sample, with the majority of participants obtaining valid and normal profiles on retest. The purpose of this study was to determine if these results would be replicated in a military job applicant sample. Participants were 97 military personnel who completed the MMPI-2 as part of application for selection to instructor duty. Forty-seven participants had obtained invalid profiles and retook the MMPI-2 after receiving instructions intended to reduce defensiveness. The results showed that 83% of retested participants obtained valid profiles on the second MMPI-2. The second test results were very similar in profile to those obtained from a comparison group of 50 participants whose initial MMPI-2 results were valid. The findings are discussed in terms of study limitations and future research directions

Biofeedback-Assisted Relaxation, Exposure, and Cognitive-Behavioral Treatment of Gastric Bypass Surgery Related Anxiety

An unusual case of a “food phobia,” which developed more than a year after the patient underwent a gastric bypass procedure, is described. A brief description of the normal digestive process and Roux-en-Y procedure is presented followed by a discussion of common surgical outcome, the patient’s presenting difficulties, assessment data, case conceptualization, and course of treatment. The case was challenging because, as with all clinical health psychology cases, it is often difficult to tease out the physical and psychological aspects of the problem. It was also difficult to establish an exposure hierarchy due to the satiation effect of food. Progress was made, however, by applying known principles of behavior change to this novel complaint. The case demonstrates the utility of a comprehensive functional analysis as well as the impact of incorporating the patient’s strengths into the treatment plan

Three American Troops in Iraq: Evaluation of a Brief Exposure Therapy Treatment for the Secondary Prevention of Combat - Related PTSD *

Relatively little research has been devoted to developing empirically-supported interventions for the secondary prevention of chronic post-traumatic stress disorder (i.e., for individuals who have developed PTSD symptoms but not the full PTSD disorder). One-session psychological debriefing has been routinely used as a primary preventive intervention for individuals exposed to trauma, but the appropriateness of this practice has been questioned. The authors describe an alternative, secondary prevention model of brief exposure- based treatment using three cases of military members seeking help at a forward-deployed medical clinic in Iraq for PTSD symptoms following combat -related traumas. Treatment involved repeated imaginal exposure and in vivo exposure conducted in four therapy sessions over a five-week period. Baseline measures on the PTSD Checklist were at a level that is considered to be in the range of PTSD. The results indicated that after four treatment sessions, PTSD symptoms were reduced by an average of 56%, and the final PTSD Checklist scores were within normal limits. The results suggest that prolonged exposure therapy may be a rapid individual treatment for the secondary prevention of combat-related PTSD

Readministration of the MMPI-2 Following Defensive Invalidation in a Military Job Applicant Sample

Job applicants whose response style on the Minnesota Multiphasic Personality Inventory-2 (MMPI-2; Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer) is excessively defensive create a dilemma for psychologists working in personnel selection settings. Clinical guidelines recommend the profile be considered uninterpretable, but the absence of usable testing data could lead to the elimination of otherwise qualified candidates. Readministering the MMPI-2 with altered instructions to reduce defensive responding has been suggested as an alternative. This option has lacked empirical support until recently. One study (Butcher, Morfitt, Rouse, & Holden, 1997) evaluated the effects of altered instructions on retest validity in a civilian job applicant sample, with the majority of participants obtaining valid and normal profiles on retest. The purpose of this study was to determine if these results would be replicated in a military job applicant sample. Participants were 97 military personnel who completed the MMPI-2 as part of application for selection to instructor duty. Forty-seven participants had obtained invalid profiles and retook the MMPI-2 after receiving instructions intended to reduce defensiveness. The results showed that 83% of retested participants obtained valid profiles on the second MMPI-2. The second test results were very similar in profile to those obtained from a comparison group of 50 participants whose initial MMPI-2 results were valid. The findings are discussed in terms of study limitations and future research directions