Amy E. Naugle

Intimate partner violence theoretical considerations: Moving towards a contextual framework

Several theories have been developed to provide a conceptual understanding of intimate partner violence (IPV) episodes. Although each of these theories has found some degree of empirical support, they are limited in their explanatory power of IPV episodes and their ability to significantly impact the efficacy of IPV prevention and treatment programs. The current paper provides a review and critique of current IPV theories and highlights strategies for improving upon these theories. An alternative theoretical conceptualization is introduced that incorporates existing IPV and functional analytic literature into a contextual framework for conceptualizing IPV episodes. Components of the IPV contextual framework include distal, static and proximal antecedents; motivating factors; behavioral repertoire; discriminative stimuli (i.e. environmental cues/signals); verbal rules; and IPV consequences. The proposed theoretical framework offers two primary advantages over former IPV theories. First, it provides a comprehensive conceptualization of IPV by integrating components of previous IPV theories and their related empirical findings into one, cohesive conceptual framework. Additionally, it allows for a more fine-grained analysis of more proximal variables potentially related to discrete IPV episodes. A discussion of how the proposed theoretical framework may influence future IPV research and clinical practice is provided.

Effects of social desirability on students' self-reporting of partner abuse perpetration and victimization

Little is still known about the degree to which social desirability affects reports of partner abuse. The current study builds on existing research exploring the relationship between social desirability and partner abuse reports by analyzing 49 male and 155 female students’ responses to the Revised Conflict Tactics Scale (CTS2) and the Marlowe-Crowne Social Desirability Scale (MCSDS). Sex differences were not associated with partner abuse rates, regardless of type, severity, and violence role. Women had significantly higher social desirability scores than men, and women’s MCSDS scores were negatively correlated with partner abuse perpetration and victimization rates. Social desirability was a significant predictor of psychological abuse perpetration, whereas gender was a significant predictor of sexual coercion perpetration. In all partner abuse cases, however, social desirability and gender accounted for less than 10% of the variance in partner abuse reports.

Behavioral Activation for Comorbid PTSD and Major Depression: A Case Study.

The present investigation details the assessment and use of Behavioral Activation (BA) therapy to treat a 37-year-old male police officer/military veteran suffering from posttraumatic stress disorder (PTSD) and major depressive disorder (MDD). This case study is an attempt to expand empirical knowledge regarding BA, comorbid PTSD and MDD, and treatment outcome research specifically relevant to these comorbid diagnoses. The BA treatment consisted of 11 sessions, which occurred on a weekly basis. Self-report data were gathered at each session and again at midpoint between each session. At posttreatment assessment, self-report and observer-rated data indicated that the client no longer met criteria for either PTSD or MDD. Results at 1-month follow-up suggested that the therapeutic gains were not only maintained, but that the client continued to improve. It is argued that BA may be an effective treatment for comorbid PTSD and MDD and the theoretical rationale is provided.

Child sexual abuse and adulthood sexual assault among military veteran and civilian women

The purpose of this study was to investigate childhood sexual abuse (CSA), adulthood sexual victimization (ASV), and adulthood sexual assault experiences in a comparison sample of female military veterans (n = 142) and civilian community members (n = 81). Women veterans were significantly more likely than civilian women to report adult sexual assault. Although comparable rates of CSA and ASV were found across groups, veterans more frequently reported having been sexually abused by a parental figure, reported longer durations of CSA, and significantly greater severity of ASV than civilians. Implications for mental health professionals providing sexual trauma services to female military personnel and veterans are discussed.

Ethics of Asking Trauma-Related Questions and Exposing Participants to Arousal-Inducing Stimuli

ABSTRACT This study examined ethical concerns related to exposing participants with childhood victimization histories to both trauma-specific and non-trauma-specific stimuli. We asked participants questions about childhood victimization experiences and exposed participants to a negatively-arousing experimental condition. Following each of these procedures and at a one-week follow-up session, participants completed a measure designed to asses their reactions to participation. The measure included several questions to assess reactions including questions about distress, benefit, and willingness to participate in the study again. Overall, participants reported low levels of distress and described their participation experience as interesting, enjoyable, and somewhat beneficial. Participants also indicated that they would be willing to participate in the study again with the knowledge of what participation was actually like. Participants with childhood trauma histories and PTSD symptoms reported more distress during the childhood maltreatment screening compared to other participants. However, the level of distress they experienced was mild and transitory. Our findings add to the emerging data indicating that individuals find their participation in trauma-related research to be a positive experience overall, rather than a harmful one.

Therapist Training in Empirically Supported Treatments: A Review of Evaluation Methods for Short- and Long-Term Outcomes

Therapist training efforts have been assessed using several outcomes. A model for evaluating therapist training in empirically supported treatments is presented, adapted from Kirkpatrick’s (in: Craig and Bittel (eds.) Training and development handbook, 1967) training evaluation model. The adapted framework includes short-term outcomes, such as reactions to training and changes in attitude, knowledge, or skills, and longer-term outcomes, such as changes in therapist behavior in practice or client outcomes. Evaluation methods for these outcomes are reviewed, with information on their validity, reliability, and feasibility. An agenda for further research to improve therapist training evaluation is presented, with discussion of how evaluation can inform other areas of the field.

Immediate Intervention for Sexual Assault: A Review with Recommendations and Implications for Practitioners

Rape crisis centers provide vital early intervention services to sexual assault survivors. The history and current status of these services are reviewed in light of the current literature on early trauma intervention. The authors suggest approaches for rape crisis centers that are likely to be most effective and identify supporting evidence for these practices from the available literature. The role of other mental health practitioners in early sexual assault intervention is discussed, with recommendations for how practitioners may work with rape crisis services to coordinate delivery of the best service. Finally, a collaborative research agenda is proposed to further our knowledge and expertise in coordinating the delivery of immediate intervention for sexual assault.

Cognitive-behavioral psychology: implications for disaster and terrorism response

Given the personal and societal costs associated with acute impairment and enduring post-traumatic stress disorder (PTSD), the mental health response to disasters is an integral component of disaster response planning. The purpose of this paper is to explore the compatibility between cognitive-behavioral psychology and the disaster mental health model, and explicate how cognitive-behavioral perspectives and intervention methods can enhance the effectiveness of disaster mental health services. It is argued that cognitive-behavioral methods, if matched to the contexts of the disaster and the needs of individuals, will improve efforts to prevent the development of PTSD and other trauma-related problems in survivors of disaster or terrorist events. First, the similarities between models of care underlying both disaster mental health services and cognitive-behavioral therapies are described. Second, examples of prior cognitive-behavioral therapy-informed work with persons exposed to disaster and terrorism are provided, potential cognitive-behavioral therapy applications to disaster and terrorism are explored, and implications of cognitive-behavioral therapy for common challenges in disaster mental health is discussed. Finally, steps that can be taken to integrate cognitive-behavioral therapy into disaster mental health are outlined. The aim is to prompt disaster mental health agencies and workers to consider using cognitive-behavioral therapy to improve services and training, and to motivate cognitive-behavioral researchers and practitioners to develop and support disaster mental health response.

Depression and a Stepped Care Model

Given the public health significance of depression and the limited resources available for providing evidence-based treatment, there is a need to develop effective models of care to reduce the personal and societal costs of the disorder. Within stepped care service provisions, all patients presenting with symptoms of depression generally are first offered the lowest intensity and least intrusive intervention deemed necessary following assessment and triage. Only when patients do not show improvement do they move to higher, more intensive levels of care. However, stepped care models also provide information to aid clinicians in decision making regarding selection of treatment strategies that are most appropriate for an individual patient. For some individuals, lower levels of care would never be appropriate or may not be preferred by the consumer. Thus, stepped interventions offer a variety of treatment options to match the intensity of the patient’s presenting problem as well as potential patient preference.

Disaster and terrorism: Cognitive-behavioral interventions

The mental health effects of disaster and terrorism have moved to the forefront in the recent past following the events of 11 September 2001 in the United States. Although there has been a protracted history by mental health researchers and practitioners to study, understand, prevent, and treat mental health problems arising as a result of disasters and terrorism, there still is much to learn about the effects and treatment of trauma. Continued communication among disaster workers, first-response medical personnel, and mental health professionals is part of this process. This paper outlines current knowledge regarding the psychological effects of trauma and best cognitive-behavioral practices used to treat trauma reactions. More specifically, the information presented is a summary of Cognitive-Behavioral Therapy (CBT) interventions that are relevant for responding to and dealing with the aftermath of disasters.