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| Understanding Resilience and PTSD Through Behavior Analysis |
| Saturday, May 26, 2018 |
| 4:00 PM–4:50 PM |
| Manchester Grand Hyatt, America's Cup A-D |
| Area: CBM/CSS; Domain: Translational |
| Chair: Nicole C Groskreutz (University of Saint Joseph) |
| CE Instructor: Nicole C Groskreutz, Ph.D. |
| Abstract: Since the wars following September 11, 2001, our military service members have suffered from two hallmark wounds: post-traumatic stress disorder (PTSD) and traumatic brain injury (TBI). Chronic pain and substance abuse have also been common co-morbid conditions suffered by members of this community. While the rate of suicide among veterans of all wars continues to fluctuate between 20 and 22 per day, suicides in the military continue to remain above civilian rates. At no time in our country's history have the military or civilian communities sustained lower suicide rates despite their numerous programmatic and treatment efforts. Resilience is part of the answer to these problems; effective treatments are another. These three talks apply ABA theory to elucidate how resilience, PTSD and other conditions operate. By analyzing some of the evidence-based treatments for these conditions, the authors illustrate how ABA offers helpful explanations and additional solutions to the challenges faced by the military and veteran communities. |
| Instruction Level: Intermediate |
| Keyword(s): military veteran, PTSD, resilience, suicide |
| Target Audience: This is for members of the behavior analysis community who are interested in continuing education. |
| Learning Objectives: At the conclusion of the presentation, participants will be able to: 1) Use behavior analysis to explain the concept of resilience. 2) Describe cognitive processing therapy in behavior analytic terms. 3) Discuss the various effective treatments and a recommended general approach to addressing the common problems faced by the members of the military and veteran community. |
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| Toward a Behavioral Analysis of Resilience and Implications for Military Personnel |
| (Theory) |
| MARK P. GROSKREUTZ (Southern Connecticut State University), Nicole C Groskreutz (University of Saint Joseph) |
| Abstract: Military personnel described as less resilient are considered higher risk for a variety of challenges, including post-traumatic stress disorder (PTSD), substance abuse, and suicidality (Cornum, Matthews, & Seligman, 2011). In literature examining military personnel, resilience is typically considered as a complex construct related to psychological fitness and personality characteristics (e.g., Meredeth et al., 2011; Morgan & Garmon Bibb, 2011). Resilience encompasses an individual's experience of stress during event(s) and effectiveness in recovering from the event(s) over both the short- and long term. Researchers interested in resilience have historically targeted cognitive processes for assessment and intervention. From a behavior analytic perspective, resilience may alternatively be defined as a pattern of behavior characterized by the continued engagement in desirable behaviors despite behavioral disruptors (i.e., stressors). From this perspective, resilience would be expected to be influenced similar to other behaviors, i.e., by examining functional relations and developing behavior analytic interventions. To explore the potential effects of such an analysis, we will discuss specific topics from behavior analysis and how they may align well conceptually and practically with behavioral resilience and potential insights for supporting military personnel, including generalization, maintenance, resistance to change, relational frame theory (RFT), and acceptance and commitment therapy (ACT). |
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Cognitive Processing Therapy in Behavior Analytic Terms |
| (Service Delivery) |
| KOMLANTSE GOSSOU (Quebec Association for Behavior Analysis) |
| Abstract: Since 2001, American military service members have endured multiple deployments, some lasting up to 24-months in duration. Combat experiences leave many service members living with an unregulated, highly active sympathetic nervous system. For some service members, this degrades their job performance, while others experience sub-threshold or diagnosable sleeping problems, irritability, interpersonal conflicts, substance abuse, and post-traumatic stress symptoms (PSTD). Cognitive Processing Therapy (CPT) is one of only two efficacious treatments for treating combat-related Post Traumatic Stress Disorder (PTSD). CPT has been shown to be an effective manualized treatment in both the civilian and the military populations, and it has been endorsed as a best practice for the treatment of PTSD by the United States Departments of Veterans Affairs and Defense, as well as the International Society of Traumatic Stress Studies. Since it works, it must somehow operate via behavioral principles. However, our review of the literature indicates that it is difficult to find a behavior analytic conceptualization of CPT, or a behavior analytic explanation of its effectiveness. |
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| The Complexities of PTSD Co-Morbidities |
| (Service Delivery) |
| AMBER GROAT (California State University, Northridge) |
| Abstract: Veterans and active duty seeking treatments for PTSD often experience chronic pain, and develop habits that lead to substance abuse problems that may interfere with the effective treatment of PTSD symptoms. Treatment approaches vary in which symptoms to treat first. In this symposium we review current research on treatment practices for PTSD, substance abuse, and the comorbidity of PTSD and substance abuse. We identify which treatment approaches are emerging vs. established treatment approaches, and recommend research areas that behavior analyst can further explore and expand the treatment of PTSD and comorbid substance abuse. Furthermore, we bring behavior analytic terms and techniques into common treatment approaches currently evaluated in PTSD and comorbid substance abuse literature. We define some of the underlying contingencies that lead to the occurrence of comorbidity in veterans and active duty military with PTSD, and suggest future directions treatment providers might consider in addressing the complexities of PTSD comorbidities. |
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