Wyatt R. Evans

U.S. Department of Veterans Affairs | VA · Veterans Health Administration

The term moral injury has been coined to describe the suffering that may develop following a violation of deeply held moral beliefs and values and subsequent difficulties in functioning. Yet despite an increase in research and intervention approaches for this topic, the relationship between moral injury and mental health diagnoses such as Posttraum...

Objective: Potentially morally injurious events (PMIEs)-violations (perpetrated or witnessed) of one's deeply held beliefs or values-have been associated with several forms of psychological distress. The values violated by PMIEs are often influenced by one's religion/spirituality (r/s). Struggles with one's r/s beliefs and/or practices may also co...

Prolonged Exposure (PE) is a highly effective treatment for posttraumatic stress disorder (PTSD) across a variety of delivery formats and samples. However, for military service members, the treatment tends to be less effective than for civilians. One explanation for the reduced response to PE in military service members is the frequency, intensity,...

A Performance Improvement project conducted within Army Behavioral Medicine identified significant challenges associated with treating service members diagnosed with posttraumatic stress disorder (PTSD) including unavailability of frequent and consistent therapy, a low completion rate of evidence-based treatment, and a high non-response rate. In re...

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...

Recently, the legal landscape for sexual minorities in the United States has changed dramatically, prompting empirical research on lesbian, gay, and bisexual (LGB) couples and LGB service members. This study examined the relationship characteristics and mental health of LGB service members in couple relationships and compared partnered and single L...

In the current paper, we aim to expand the dialogue about applying psychological flexibility processes to moral injury-related spiritual suffering using Acceptance and Commitment Therapy (ACT). Psychological flexibility is the process of practicing present moment awareness and openness to experiences of emotions and thoughts, while also choosing to...

Community mental health providers play an essential role in delivering services to veterans who either have limited access to U.S. Department of Veterans Affairs (VA) facilities or who prefer to seek care outside of the VA. However, there are limited training opportunities in evidence-based treatments for posttraumatic stress disorder (PTSD) outsid...

Objective: Concern about symptom worsening with trauma-focused treatment may be one factor hindering the implementation of evidence-based treatments for PTSD, like cognitive processing therapy (CPT), despite evidence for their efficacy. Previous studies have examined the frequency and effect of symptom exacerbation, or temporary symptom increases,...

Purpose Current clinical practice guidelines for the treatment of post-traumatic stress disorder (PTSD) strongly recommend individual manualized trauma-focused therapy. However, it can be challenging for patients to complete a full course of treatment. There has been recent interest in modifying the format of evidence-based psychotherapies for PTSD...

Moral struggles involve internal conflict regarding inconsistencies between one’s higher values and the actions of the self and may include guilt, shame, contempt, disgust, and anger. Previous research in civilian populations revealed several factors that might predispose people to moral struggles. The current study sought to replicate and extend t...

Literature clearly elucidates the association between unit cohesion and service members’ well-being. Similarly, social support/acceptance of sexual identity is related to better mental health among LGB populations. No research exists examining the relation between perceived unit acceptance of LGB service members and LGB service members’ psychologic...

Combat-related posttraumatic stress disorder (PTSD) is the most common psychological health condition in military service members and veterans who have deployed to the combat theater since September 11, 2001. One of the highest research priorities for the Department of Defense and the Department of Veterans Affairs is to develop and evaluate the mo...

In the nascent literature on the sequelae of exposure to potentially morally injurious events (PMIEs), there has been little consideration of the possible associations between PMIE exposure and positive, growth-related outcomes. Broadly, trauma exposure is associated with negative changes in life satisfaction. However, posttraumatic growth (PTG) ha...

Over 15 years of combat deployments to Afghanistan, Iraq, and surrounding locations have increased the risk of posttraumatic stress disorder (PTSD) in active-duty military service members, significantly amplifying the need for effective treatments within the military health care system. While effective evidence-based treatments for PTSD exist, resu...

This study is among the first examining lesbian, gay, and bisexual (LGB) service members in the United States following the “Don’t Ask, Don’t Tell” policy repeal. Higher levels of outness predict better mental health among general LGB populations. The military environment, like other traditional/conservative settings, may alter this relation; howev...

Although advancements in attitudes of acceptance toward lesbian, gay, and bisexual (LGB) people have been well documented in the United States in policy and research, many forms of prejudice and discrimination toward this population still exist (Herek, 2009). This chapter addresses the emergence of specific clinical strategies designed to assist le...