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Date of Award


Degree Type

Dissertation (On-Campus Access Only)

Degree Name

Doctor of Psychology (PsyD)

Committee Chair

Lisa Christiansen, Psy.D.

Second Advisor

James B. Lane, Ph.D.


Combat veterans are at risk for a variety of mental health concerns, in particular namely Posttraumatic stress disorder (PTSD). Previous research has revealed low treatment adherence rates among veterans who do utilize services. Family and social supports have been identified as potential protective factors, reducing the deleterious effects of war exposure. Recent research has identified that Vietnam veterans attend more, and a greater proportion of sessions than Operation Iraqi Freedom/Enduring Freedom (OIF/EF) veterans. This finding may be more meaningful if it is determined OIF/EF veterans are discontinuing treatment prior to clinical recommendations, but there are no clear indicators of how many sessions are appropriate to treat PTSD utilizing Cognitive Behavioral Therapy (CBT). This study explored whether the involvement of family, or other close social supports, in treatment was associated with better treatment adherence and outcomes among combat veterans with a primary diagnosis of PTSD. The study also examined whether pre-treatment social adjustment was related to treatment outcomes or support involvement in treatment. This study explored the relationship between treatment duration and clinical improvement as well as compared treatment duration and adherence among Vietnam and OEF/IF veterans. Results revealed that, on average, cases with no support involvement attended fewer sessions, had higher levels of distress at the end of treatment and exhibited less clinical improvement compared to cases with substantial involvement. This difference may be more attributable to cases with no support involvement exhibiting poor progress, rather than the improvement of cases with substantial involvement. Baseline social functioning was not related to the amount of support involvement. OEF/IF veterans were more likely to attend more sessions than Vietnam veterans. Despite this, the number of sessions attended was not related to clinically significant change. Greater pre-treatment distress was associated with more clinically significant improvement. Cases exhibiting clinically significant improvement were also more likely to endorse greater pre-treatment interpersonal relationship distress compared to cases that exhibited no reliable change.


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