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Behavioral Activation for Treatment of PTSD and Depression in an Iraqi Combat Veteran with Multiple Physical Injuries

Published online by Cambridge University Press:  07 April 2010

Aaron P. Turner*
Affiliation:
VA Puget Sound Health Care System and University of Washington, USA
Matthew Jakupcak
Affiliation:
VA Puget Sound Health Care System and University of Washington, USA
*
Reprint requests to Aaron P. Turner, VA Puget Sound Health Care System, Rehabilitation Care Service, S-117-RCS, 1660 S. Columbian Way, Seattle, WA 98108, USA. E-mail: [email protected]

Abstract

Background: Physical injury and psychological trauma associated with combat in the wars in Iraq and Afghanistan frequently lead to a constellation of symptoms including pain, post traumatic stress disorder (PTSD), and depression. Method: This single case study describes the application of a behaviorally-based psychotherapy known as behavioral activation for the treatment of post traumatic stress disorder (PTSD) and depressive symptoms in a recent combat veteran with multiple physical injuries sustained from a blast injury. Treatment was provided concurrently with other rehabilitation services and consisted of weekly individual sessions for 4 months, followed by monthly sessions for 4 months. Results: Clinically significant reductions in PTSD and depressive symptoms were noted between baseline and 1 year follow-up. Conclusion: Preliminary evidence from this case suggests that behavioral activation may be a promising treatment for PTSD and depression, and can be readily tailored to individuals with physical limitations such as pain and mobility restriction. Treatment can be provided in the context of concurrent interdisciplinary medical and rehabilitation care.

Type
Brief Clinical Reports
Creative Commons
This is a work of the U.S. Government and is not subject to copyright protection in the United States.
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2010. This is a work of the U.S. Government and is not subject to copyright protection in the United States.

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References

Beck, A. T., Rush, A. J., Shaw, B. F. and Emery, G. (1979). Cognitive Therapy of Depression. New York: Guilford.Google Scholar
Blanchard, E. B., Jones-Alexander, J., Buckley, T. C. and Forneris, C. A. (1996). Psychometric properties of the PTSD Checklist (PCL). Behaviour Research and Therapy, 34, 669673.CrossRefGoogle ScholarPubMed
Dimidjian, S., Hollon, S. D., Dobson, K. S., Schmaling, K. B., Kohlenberg, R. J., Addis, M. E., Gallop, R., McGlinchey, J. B., Markley, D. K., Gollan, J. K., Atkins, D. C., Dunner, D. L. and Jacobson, N. S. (2006). Randomized trial of behavioral activation, cognitive therapy, and antidepressant medication in the acute treatment of adults with major depression. Journal of Consulting and Clinical Psychology, 74, 658670.CrossRefGoogle ScholarPubMed
Jacobson, N. S., Dobson, K. S., Truax, P. A., Addis, M. E., Koerner, K., Gollan, J. K., Gortner, E. and Prince, S. E. (1996). A component analysis of cognitive-behavioral treatment for depression. Journal of Consulting and Clinical Psychology, 64, 295304.CrossRefGoogle ScholarPubMed
Jacobson, N. S. and Truax, P. (1991). Clinical significance: a statistical approach to defining meaningful change in psychotherapy research. Journal of Consulting and Clinical Psychology, 59, 1219.CrossRefGoogle ScholarPubMed
Jakupcak, M., Roberts, L. J., Martell, C., Mulick, P., Michael, S., Reed, R., Balsam, K. F., Yoshimoto, D. and McFall, M. (2006). A pilot study of behavioral activation for veterans with posttraumatic stress disorder. Journal of Traumatic Stress, 19, 387391.CrossRefGoogle ScholarPubMed
Kroenke, K., Spitzer, R. L. and Williams, J. B. (2001). The PHQ-9: validity of a brief depression severity measure. Journal of General Internal Medicine, 16, 606613.CrossRefGoogle ScholarPubMed
Lewinsohn, P. M. (Ed.) (1974). A Behavioral Approach to Depression. Oxford, UK: Wiley.Google Scholar
Martell, C. R., Addis, M. E. and Jacobson, N. S. (2001). Depression in Context: strategies for guided action. New York: Norton.Google Scholar
Otis, J. D., Keane, T. M. and Kerns, R. D. (2003). An examination of the relationship between chronic pain and post-traumatic stress disorder. Journal of Rehabilitation Research and Development, 40, 397405.CrossRefGoogle ScholarPubMed
Sayer, N. A., Chiros, C. E., Sigford, B., Scott, S., Clothier, B., Pickett, T. and Lew, H. L. (2008). Characteristics and rehabilitation outcomes among patients with blast and other injuries sustained during the Global War on Terror. Archives of Physical Medicine and Rehabilitation, 89, 163170.CrossRefGoogle ScholarPubMed
Seal, K. H., Bertenthal, D., Maguen, S., Gima, K., Chu, A. and Marmar, C. R. (2008). Getting beyond “Don't ask; don't tell”: an evaluation of US Veterans Administration postdeployment mental health screening of veterans returning from Iraq and Afghanistan. American Journal of Public Health, 98, 714720.CrossRefGoogle ScholarPubMed
Seal, K. H., Bertenthal, D., Miner, C. R., Sen, S. and Marmar, C. (2007). Bringing the war back home: mental health disorders among 103788 US veterans returning from Iraq and Afghanistan seen at Department of Veterans Affairs facilities. Archives of Internal Medicine, 167, 476482.CrossRefGoogle Scholar
Skolasky, R. L., Mackenzie, E. J., Wegener, S. T. and Riley III, L. H. (2008). Patient activation and adherence to physical therapy in persons undergoing spine surgery. Spine, 33, E784791.CrossRefGoogle ScholarPubMed
Taylor, S., Fedoroff, I. C., Koch, W. J., Thordarson, D. S., Fecteau, G. and Nicki, R. M. (2001). Posttraumatic stress disorder arising after road traffic collisions: patterns of response to cognitive-behavior therapy. Journal of Consulting and Clinical Psychology, 69, 541551.CrossRefGoogle ScholarPubMed
Wagner, A., Zatzick, D., Ghesquiere, A. and Jurkovich, G. (2007). Behavioral activation as an early intervention for posttraumatic stress disorder and depression among physically injured trauma survivors. Cognitive and Behavioral Practice, 14, 341349.CrossRefGoogle Scholar
Weathers, F. W., Litz, B. T., Herman, D. S., Huska, J. A. and Keane, T. M. (1993). The PTSD checklist: reliability, validity, and diagnostic utility. Paper presented at the Annual Meeting of the International Society for Traumatic Stress Studies, San Antonio, TX.Google Scholar
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