Psychiatry - Research Publications

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Author: Bryant, Richard × Author: McFarlane, Alexander × Author: Varker, Tracey × Start date: 2009 ×

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    Attention-control training as an early intervention for veterans leaving the military: A pilot randomized controlled trial
    Metcalf, O ; O'Donnell, ML ; Forbes, D ; Bar-Haim, Y ; Hodson, S ; Bryant, RA ; McFarlane, AC ; Morton, D ; Poerio, L ; Naim, R ; Varker, T (WILEY, 2022-08)
    Transitioning out of the military can be a time of change and challenge. Research indicates that altered threat monitoring in military populations may contribute to the development of psychopathology in veterans, and interventions that adjust threat monitoring in personnel leaving the military may be beneficial. Australian Defence Force personnel (N = 59) transitioning from the military were randomized to receive four weekly sessions of either attention-control training or a placebo attention training. The primary outcome was symptoms of posttraumatic stress disorder (PTSD), as measured using the PTSD Checklist for DSM-5 (PCL-5) at posttreatment. Following training, participants who received attention-control training reported significantly lower levels of PTSD symptoms, Hedges' g = 0.86, 95% CI [0.37, 1.36], p = .004, and significantly improved work and social functioning, Hedges' g = 0.93, 95% CI [0.46, 1.39], p = .001, relative to those in the placebo condition. Moreover, no participants who received attention-control training worsened with regard to PTSD symptoms, whereas 23.8% of those who received the placebo attention training experienced an increase in PTSD symptoms. The preliminary findings from this pilot study add to a small body of evidence supporting attention-control training as a viable indicated early intervention approach for PTSD that is worthy of further research.
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    Dropout from guideline-recommended psychological treatments for posttraumatic stress disorder: A systematic review and meta-analysis
    Varker, T ; Jones, KA ; Arjmand, HA ; Hinton, M ; Hiles, SA ; Freijah, I ; Forbes, D ; Kartal, D ; Phelps, A ; Bryant, RA ; McFarlane, A ; Hopwood, M ; O'Donnell, M (Elsevier BV, 2021-04-01)
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    Defining post-traumatic stress disorder recovery in veterans: Benchmarking symptom change against functioning indicators
    Hinton, M ; O'Donnell, M ; Cowlishaw, S ; Kartal, D ; Metcalf, O ; Varker, T ; McFarlane, AC ; Hopwood, M ; Bryant, RA ; Forbes, D ; Howard, A ; Lau, W ; Cooper, J ; Phelps, AJ (WILEY, 2021-08)
    Improved metrics of Post-traumatic stress disorder (PTSD) treatment response that extend beyond a focus on symptom reduction to incorporate meaningful, patient-centred indicators of functioning are needed in veteran populations. The aim of this study was to extend previous research by investigating whether indicators of functioning can successfully distinguish against symptom response categories derived from the Post-Traumatic Stress Disorder Checklist (PCL-5) pre- and post- PTSD treatment. Participants were 472 veterans receiving hospital-based treatment for PTSD. In addition to the PCL-5, measures included quality of life, social relationships, physical health and psychological distress. Four mutually exclusive, progressive response categories were used to define treatment response including: No Response, Response, Response and Below Threshold, and Remission. PTSD symptom reductions were associated with corresponding improvements in broader indicators of functioning. However, it was only when the magnitude of symptom reduction placed the individual in the 'Response and Below Threshold' category that improvement on functioning measures achieved levels indicative of a good end state. Traditional metrics of treatment 'response' in PTSD treatment do not necessarily indicate recovery on important functioning indicators. Only when an individual both responds to treatment and drops below threshold for probable disorder are they likely to report having meaningful levels of functioning.