Candidate: Theodore P. Wright

Degree of: Doctor of Philosophy

Department: Psychology

Title: The Effectiveness of Behavioral Activation Group therapy: Treating Comorbid Depression on a Specialized Impatient Posttraumatic Stress Disorder Unit for Combat Veterans

Committee:
Dr. C. Richard Spates, Chair
Dr. Galen Alessi
Dr. Lester Wright
Dr. Rita Kenyon-Jump

Date: November 6, 2002, Wednesday, 10:00 a.m.-12:00 p.m.
3715 Wood

Abstract:
The comorbidity of depression and PTSD has been shown to be relatively prevalent. Researchers have found a 70% lifetime prevalence of comorbid PTSD and depression among combat veterans. Many combat veterans are treated for PTSD at specialized programs in VA hospitals across the country, including the Battle Creek Veterans Affairs Medical Center (BCVAMC). The specialized inpatient PTSD treatment program at the BCVAMC utilized many different therapeutic and psychoeducational treatment modalities to assist veterans in understanding and managing PTSD symptoms. However, there was no psychotherapeutic treatment modality in the program that directly and systematically addressed depressive symptoms. Given the relatively high comorbidity between PTSD and depression in this particular population, the possible utility of a treatment modality focused on alleviating depressive symptoms became of interest. Recent dismantling studies have found that one component of the cognitive-behavioral individual treatment protocol for depression produces positive results consistent with the administration of the entire treatment. This component, behavioral activation (BA), has been suggested for use in treating depression due to its parsimony in relation to time and complexity. Positive results have been demonstrated when behavioral activation has been used in group therapy settings with community mental health outpatients. This study examined the effectiveness of the BA
treatment when administered to combat veterans with PTSD in the residential treatment program at the BCVAMC. Forty-five veterans participated in the study. Twenty-four veterans participated in a BA treatment group while in the treatment program. Twenty-one veterans attended the treatment program, but did not participate in BA treatment group and served as a comparison group. All of the participants completed a battery of assessments upon admission, at discharge, one month after discharge, and two months after discharge. It was hypothesized that veterans participating in the BA group would evidence a greater reduction in depressive and PTSD symptoms than those in the comparison group at the post-treatment and two follow-up assessments. Veterans in the BA group evidenced mild reductions of depressive symptoms, but no changes in PTSD symptoms. The comparison group evidenced no reductions in depressive or PTSD symptoms. Factors associated with changes in symptoms were also explored.

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