Barbara L. Niles

VA Boston Healthcare System U.S. Department of Veterans Affairs · National Center for PTSD VA Boston Healthcare System

The present study examined fluctuation over time in symptoms of posttraumatic stress disorder (PTSD) among 34 combat veterans (28 with diagnosed PTSD, 6 with subclinical symptoms) assessed every 2 weeks for up to 2 years (range of assessments = 13-52). Temporal relationships were examined among four PTSD symptom clusters (reexperiencing, avoidance,...

Objective To examine feasibility, qualitative feedback and satisfaction associated with a 4-session introduction to Tai Chi for veterans with post-traumatic stress symptoms. Design We observed and reported recruitment and retention rates, participant characteristics, adherence, and satisfaction across 2 cohorts. We also examined qualitative feedba...

Trauma-focused, evidence-based psychotherapies (TF-EBPs) for posttraumatic stress disorder (PTSD) have been widely promoted in the Veterans Health Administration to provide access to state-of-the-art treatments, but dropout rates may affect the impact of TF-EBPs. The current study summarizes findings from a program evaluation of 67 veterans assigne...

1 Objective To systematically review outcomes from randomized controlled trials (RCTs) of mind–body treatments for PTSD. 2 Methods Inclusion criteria based on guidelines for assessing risk of bias were used to evaluate articles identified through electronic literature searches. 3 Results Twenty‐two RCTs met inclusion standards. In most of the nin...

Objective: The aim of this study was to determine the efficacy of doxazosin, an α1-adrenergic antagonist, for the treatment of co-occurring posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD). Methods: This 12-week, double-blind, randomized controlled trial of doxazosin (16 mg/d) was conducted between June 2016 and December 2019 at...

Importance: Improved, efficient, and acceptable treatments are needed for combat-related posttraumatic stress disorder (PTSD). Objective: To determine the efficacy of 2 compressed prolonged exposure (PE) therapy outpatient treatments for combat-related PTSD. Design, setting, and participants: This randomized clinical trial was conducted among...

Background Many of the 700,000 American military personnel deployed to the Persian Gulf region in 1990 and 1991 have since reported health symptoms of unknown etiology. This cluster of symptoms has been labeled Gulf War Illness and include chronic musculoskeletal pain, fatigue, headaches, memory and attention difficulties, gastrointestinal complain...

Background The unified protocol (UP) is a promising transdisgnostic treatment for emotional disorders; limited data exists with trauma‐exposed populations. This study compared effectiveness of the UP, presented centered therapy (PCT), and treatment as usual (TAU) in trauma‐exposed veterans presenting to routine care. Method Trauma‐exposed veterans...

Background Trauma exposure and posttraumatic stress are highly prevalent and comorbid with health problems. Despite the apparent systemic nature of posttraumatic stress, recommended treatments neglect trauma's deleterious effects on health. Integrative mind-body treatments for posttraumatic stress, such as Tai Chi and Qigong (TCQ), may offer a prom...

The STRONG STAR Consortium (South Texas Research Organizational Network Guiding Studies on Trauma and Resilience) and the Consortium to Alleviate PTSD are interdisciplinary and multi-institutional research consortia focused on the detection, diagnosis, prevention, and treatment of combat-related posttraumatic stress disorder (PTSD) and comorbid con...

Clinicians in naturalistic settings regularly modify the delivery of trauma-focused treatments to enhance client engagement and retention. However, what types of modifications are made in clinical settings, why, and when, and their impact on client outcomes has seldom been examined. As an initial step to address this, the current study applied elem...

Extensive research has been conducted since 11 September 2001 to develop and evaluate evidence-based treatments for combat-related posttraumatic stress disorder (PTSD) in active duty United States military personnel treated in the combat theater and in garrison. This chapter reviews the results of 20 PTSD clinical trials funded by the United States...

Veterans with posttraumatic stress disorder (PTSD) report more aggression than civilians with PTSD. Because emotion regulation difficulties mediated the relationship between PTSD symptoms and impulsive aggression in veterans, we developed an intervention to increase emotion regulation skills. This pilot study tested the feasibility and acceptabilit...

Cognitive-behavioral conjoint therapy for posttraumatic stress disorder (CBCT for PTSD; Monson & Fredman, 2012) is efficacious in improving PTSD symptoms and relationship adjustment among couples with PTSD. However, there is a need for more efficient delivery formats to maximize engagement and retention and to achieve faster outcomes in multiple do...

Background: Although there are effective evidence-based treatments for posttraumatic stress disorder (PTSD), many individuals drop out or do not benefit from treatment. There is a need for new treatments, including approaches that are nontrauma focused. Objective: The purpose of this program evaluation was to investigate the acceptability of a W...

Gulf War illness (GWI) is a chronic and multisymptom disorder affecting military veterans deployed to the 1991 Persian Gulf War. It is characterized by a range of acute and chronic symptoms, including but not limited to, fatigue, sleep disturbances, psychological problems, cognitive deficits, widespread pain, and respiratory and gastrointestinal di...

Objective: Examine initial levels and pattern of change of alliance in group treatment for posttraumatic stress disorder (PTSD) for veterans. Method: One hundred and seventy-eight male veterans with PTSD were recruited for this study. Participants were randomly assigned to either group cognitive behavioral therapy (GCBT) or to group present-cent...

This review assessed the concordance of the literature on recovery with the definition and components of recovery developed by the Substance Abuse and Mental Health Services Administration (SAMHSA). Each SAMHSA identified recovery component was first explicated with synonyms and keywords and made mutually exclusive by authors. Inter-rater reliabili...

In recent years, mindfulness and meditation-based processes and interventions have received increasing clinical and scholarly attention in the trauma field due to their theoretical and clinical relevance to the etiology, maintenance, and treatment of posttraumatic stress disorder (PTSD). Indeed, there has been a proliferation of literature document...

Recruiting sufficient numbers of participants for physical activity trials for individuals with diabetes can be difficult because there are often many behavioral demands for participants, and inclusion and exclusion criteria can be extensive. This study examined the recruitment strategies used for a randomized, controlled trial designed to investig...

Objective This study explored possible mechanisms through which symptoms of posttraumatic stress disorder (PTSD) were reduced in a randomized controlled trial comparing the effect of a yoga intervention with an assessment control.Method We examined whether changes in psychological flexibility, mindfulness, and emotion regulation strategies (express...

Posttraumatic stress disorder (PTSD) is a debilitating condition that affects approximately 10% of women in the United States. Although effective psychotherapeutic treatments for PTSD exist, clients with PTSD report additional benefits of complementary and alternative approaches such as yoga. In particular, yoga may downregulate the stress response...

The primary objective of this pilot study was to develop and implement a telephone intervention for veterans with diabetes and posttraumatic stress symptoms (PTSS). Additional objectives were to evaluate study feasibility and to conduct exploratory analyses of the influence of the intervention on diabetic self-care, quality of life, treatment adher...

The goal of this pilot study was to examine changes in self-reported levels of mindfulness in the context of an 8-week mindfulness telehealth intervention for military veterans with combat-related posttraumatic stress disorder (PTSD). Participants were 24 male veterans with PTSD aged 23 to 66 (M = 55.2). Participants were randomized to either a min...

The present investigation evaluated the main and interactive effects of distress tolerance and negative affect intensity in relation to posttraumatic stress disorder (PTSD) symptom severity and symptom cluster severity. Participants were 190 trauma-exposed adults (52.6 % women; M age = 25.3 years, SD = 11.4) recruited from the community. Distress t...

This pilot study examined two telehealth interventions to address symptoms of combat-related posttraumatic stress disorder (PTSD) in veterans. Thirty-three male combat veterans were randomly assigned to one of two telehealth treatment conditions: mindfulness or psychoeducation. In both conditions, participants completed 8 weeks of telehealth treatm...

The goal of this study was to explore sleep quality as a potential mediator between depression symptoms and diabetes quality of life (DQOL), and anxiety symptoms and DQOL. Participants were 83 male and 3 female veterans with type 2 diabetes (Mage = 62.4). Self-report measures were completed during the baseline assessment of a larger intervention st...

“Health is the vital principle of bliss, and exercise, of health.” —James Thomson, 18th century Scottish poet Exercise is considered a crucial component of disease management for individuals with type 2 diabetes, and it is associated with extensive health and mental health benefits. Although the benefits of exercise are well established, most peopl...

How might a practice that has its roots in contemplative traditions, seeking heightened awareness through meditation, apply to trauma-related mental health struggles among military veterans? In recent years, clinicians and researchers have observed the increasing presence of mindfulness in Western mental health treatment programs. Mindfulness is ab...

Mindfulness is increasingly conceptualized in terms of its regulatory function with research suggesting that mindfulness may have a salutary effect on psychological well-being. The present cross-sectional study of 514 college students (84% Caucasian and 62% females), using self-report questionnaires, tested a proposed model for understanding the re...

Using multilevel modeling, the authors examined the impact of antisocial personality characteristics on the effectiveness of cognitive behavioral anger management group treatment among 86 veterans with posttraumatic stress disorder. A wide range of forms of anger, as well as use of physical aggression, decreased during treatment. As predicted, anti...

The psychometric properties of the PTSD Checklist (PCL) were investigated in a sample of treatment-seeking and community-dwelling male veterans. In conjunction with previous reports, results from the present study indicate that the PCL possesses strong, robust psychometric properties. The current investigation suggests a cutoff score of 60-higher t...

Prior research has revealed heightened aggressive behavior among veterans with PTSD. This study tested a model examining the interrelationships among combat exposure, posttraumatic stress disorder (PTSD) symptoms, dysphoric symptoms, and anxiety symptoms in predicting aggressive behavior in a sample of 265 male combat veterans seeking diagnostic as...

Identifying and treating depression has been a major focus in primary care over the last decade. Unfortunately, treatments have not been as successful as originally hoped. The current study investigated factors that may contribute to poor outcomes in a sample of VA primary care patients. Results indicate that 15.5% of the patients in this investiga...

Despite the prevalence of psychiatric disorders in medical settings, mental health problems often go undetected and patients do not receive appropriate treatment. The main goal of this study is to provide additional information about the Beck Anxiety Inventory – Primary Care (BAI–PC), a brief instrument that screens for patients with anxiety. This...

Despite the burgeoning literature on the assessment, diagnosis, and treatment of posttraumatic stress disorder, there are few empirical findings to guide clinicians and researchers in anticipating how individuals with PTSD will fare over a time span of years. This chapter first briefly overviews current findings about the course of PTSD and then id...

All practicing psychologists with an active caseload occasionally encounter a patient or client whom they consider to be a suicidal emergency. Few psychologists, however, have had education or training focused on managing such cases. The current article conceptualizes what a "behavioral emergency" is, gives recommendations for containing the emerge...

All practicing psychologists with an active caseload occasionally encounter a patient or client whom they consider to be a suicidal emergency. Few psychologists, however, have had education or training focused on managing such cases. The current article conceptualizes what a "behavioral emergency" is, gives recommendations for containing the emerge...

In this book (see record 1993-98489-000 ), Solomon's integration of clinical anecdote, empirical findings, and theory will appeal to trauma specialists and nonspecialists alike. Her clear presentation of the phenomena of combat stress reaction (CSR) will easily educate those unfamiliar with the psychological aftermath of traumatic events. She illus...

Disorders of extreme stress (DES), previously referred to as disorders of extreme stress not otherwise specified and/or complex posttraumatic stress disorder, is a proposed diagnosis designed to describe the symptom presentation of those repeatedly exposed to traumatic stressors. Little is known, however, about the applicability of DES to combat ve...

Immediately following exposure to high-magnitude, life-threatening Stressors (i.e., a traumatic event), most people develop an acute stress response that might include symptoms of arousal, anxiety, sadness, grief, agitation, irritability, sleep disturbance, and a host of psychophysiologic complaints (e.g., headaches, pains, stomach problems). For m...

Three hundred and six adult medical and family practice inpatients at a university-affiliated teaching hospital were assessed for problem drinking using: (1) a short questionnaire containing the CAGE (a 4-question, self-report screening measure), and (2) a standardized review of medical records (an examination of specific blood chemistries and the...

We compared cognitive-behavior therapy (CBT) with and without exposure and response prevention (ERP) in the treatment of eating disorder patients who both binged and purged, and reported abnormal attitudes concerning body weight and shape. Both treatments produced significant and comparable reductions in binge-eating and purging, eating patterns, a...

Typescript (photocopy). "Graduate Program in Psychology." Thesis (M. Sc.)--Rutgers University, 1988. Includes bibliographical references (leaves 52-57).