An acceptance and commitment therapy intervention for combat veterans with posttraumatic stress disorder: Preliminary outcomes

Numerous clinical and epidemiologic studies have demonstrated an association between combat exposure and the development of posttraumatic stress disorder (PTSD). Studies regarding the psychological sequelae of war show a clear dose-response relationship, in which higher levels of combat exposure lead to a greater prevalence of PTSD among veterans. Posttraumatic stress disorder is prevalent across combat veteran cohorts, making the disorder a treatment priority within the Department of Veterans Affairs. The present study examined the preliminary effects of an Acceptance and Commitment Therapy (ACT) group intervention for combat veterans diagnosed with PTSD. The "pilot" ACT group was evaluated utilizing a nonequivalent control group design. This 2 (treatment versus control group) X 2 (pre- versus post-test) factorial design included repeat measures at Baseline and 12-Week Assessment. ACT aims to address human suffering through the reduction of experiential avoidance and cognitive entanglement, while encouraging individuals to pursue valued life directions. In the present study experiential avoidance significantly increased among veteran ACT group participants. However, when the three statistical outliers were removed from the analysis the change over time was no longer significant. There was also a significant increase in automatic thoughts in participants comprising the ACT group. No significant changes were evidenced by veteran participants in PTSD symptomatology, depressive symptoms, the believability of automatic thoughts, and life satisfaction. The control group endorsed no significant change over the course of 12 weeks. It is noteworthy that veteran participants significantly differed from the community sample control group on all measures at Baseline and 12-Week Assessment.