Menopausal Symptoms: Is Spirituality Associated with the Severity of Symptoms?

The aim of this study was to explore whether spirituality was associated with menopausal symptoms. Menopausal symptoms, spirituality, health and menopausal status, and socio-demographic variables were assessed in a community sample of 710 peri- and postmenopausal women. A structural model was explored using structural equation modeling. The results evidence spirituality as a significant contributor regarding the severity of most menopausal symptoms. Among others, spirituality had a significant weight in depressive mood (β = ?.414; p < .001), anxiety (β = ?.308; p < .001), cognitive impairment (β = ?.287; p < .001), aches/pain (β = ?.148; p < .001), vasomotor (β = ?.125; p = .005) and sexual symptoms (β = ?.211; p < .001). Some socio-demographic variables, as well as perceived health, also predicted the menopausal symptoms’ severity. Therefore, spirituality can have a positive impact on the menopausal symptoms’ reporting.     

Positive affect mediates the relationships between resilience,social support and posttraumatic growth of women with infertility

This study aims to explore the relationship between resilience, social support, positive affect and posttraumatic growth among Chinese women with infertility, and to examine the mediating role of positive affect. A convenience sample of 1733 women diagnosed with infertility was recruited from the infertility outpatient clinics at three reproductive hospitals in Shandong Province of China between May 2015 and April 2016. They completed a background questionnaire, the Posttraumatic Growth Inventory, the Perceived Social Support Questionnaire, the Connor-Davidson Resilience Scale, the Positive and Negative Affect Schedule. Individuals reported high levels of PTG (M = 64.81; SD = 16.20). Perceived social support (β = .11, p < .001), resilience (β = .18, p < .001) and positive affect (β = .46, p < .001) were related to PTG. Positive affect may play a mediating role in the relationships between resilience (.125, .201, p < .001), social support (.055, .121, p < .001) and PTG. This study examines the effects of resilience, social support, and positive affect on PTG among Chinese infertile women. Wherein, positive affect may play a mediating role in the relationships between resilience, social support and PTG.     

Acute Stress,Depression, and Anxiety Symptoms Among English and Spanish Speaking Children with Recent Trauma Exposure

A growing literature suggests the clinical importance of acute stress disorder symptoms in youth following potentially traumatic events. A multisite sample of English and Spanish speaking children and adolescents (N = 479) between the ages of 8–17, along with their caregivers completed interviews and self-report questionnaires between 2 days and 1 month following the event. The results indicate that children with greater total acute stress symptoms reported greater depressive (r = .41, p < .01) and anxiety symptoms (r = .53, p < .01). Examining specific acute stress subscales, reexperiencing was correlated with anxiety (r = .47, p < .01) and arousal was correlated with depression (r = .50, p < .01) and anxiety (r = .55, p < .01). Age was inversely associated with total acute stress symptoms (r = ?.24, p < .01), reexperiencing (r = ?.17, p < .01), avoidance (r = ?.27, p < .01), and arousal (r = ?.19, p < .01) and gender was related to total anxiety symptoms (Spearman’s ρ = .17, p < .01). The current study supports the importance of screening acute stress symptoms and other mental health outcomes following a potentially traumatic event in children and adolescents. Early screening may enable clinicians to identify and acutely intervene to support children’s psychological and physical recovery.     

Health-Related Quality of Life is Associated with Positive Affect in Patients with Coronary Heart Disease Entering Cardiac Rehabilitation

Health-related quality of life (QoL) is an important and widely used outcome measure in cardiac populations. We examined the relationship between positive affect and health-related quality of life, controlling for traditional cardiovascular risk factors, clinical variables and negative affect. We further investigated the role of gender in this relationship given the well-known gender differences in cardiovascular health. We enrolled 746 patients with coronary heart disease (CHD) before they entered outpatient cardiac rehabilitation. All patients completed the Global Mood Scale and the SF-36 Health Survey. Positive affect was independently associated with mental (p < .001) and physical QoL (p < .001) after controlling for control variables. Gender moderated the relationship between positive affect and physical QoL (p = .009) but not mental QoL (p = .60). Positive affect was positively associated with physical QoL in men (p < .001) but not in women (p = .44). The health-related QoL of patients with CHD is associated with a person’s level of positive affect.     

Resilience to Interpersonal Trauma and Decreased Risk for Psychopathology in an Epidemiologic Sample

Quantitative measures of psychological resilience related to discrete stressors, such as interpersonal (IP) trauma, are lacking. The current study examined whether a novel, quantitative measure of resilience was related to decreased risk for a broad range of lifetime DSM-IV axis I disorders in an epidemiologic sample. Resilience was defined as the residual resulting from the difference between the individual’s predicted and observed PTSD symptom count, based on their cumulative exposure to IP traumatic events. Participants were 6288 adults (59.5% women; M _age  = 46.9, SD = 14.5) from the National Epidemiologic Study on Alcohol and Related Conditions endorsing at least one lifetime IP traumatic event. Logistic regressions were conducted to examine the relationship between resilience and axis I diagnoses, covarying for age, sex, education level, social support, and recent stressful life events. Greater resilience scores were associated with decreased likelihood of major depression (OR = .64, p < .001), generalized anxiety disorder (OR = .65, p < .001), social anxiety disorder (OR = .74, p < .001), panic disorder (OR = .65, p <. 001), and alcohol dependence (OR = .85, p < .001). Discrepancy between expected and observed PTSD symptom severity based on IP trauma load may represent a useful, quantitative measure of resilience.     

Exploring correlations between positive psychological resources and symptoms of psychological distress among hematological cancer patients: a cross-sectional study

Hematological cancer patients experience high levels of psychological distress during diagnoses and intensive treatments. The aim of the present study is to explore the effects of positive psychological resources on depressive and anxiety symptoms in hematological cancer patients. This survey was conducted in a hospital during the period from July 2013 to April 2014. A total of 300 inpatients were recruited and finally 227 of them completed the questionnaires. Questionnaires included demographic and clinical variables, the Center for Epidemiologic Studies Depression Scale, the Self-Rating Anxiety Scale, the Life Orientation Scale-Revised, the General Perceived Self-Efficacy Scale, and the Resilience Scale-14. Results showed that the prevalence of depressive and anxiety symptoms was 66.1 and 45.8%, respectively. Both optimism (β = ?.479, p < .001) and resilience (β = ?.174, p < .05) were negatively associated with depressive symptoms, and optimism (β = ?.393, p < .001) was negatively associated with anxiety symptoms. However, resilience (β = ?.133, p > .05) was not significantly associated with anxiety symptoms, and self-efficacy was not significantly associated with depressive (β = ?.032, p > .05) or anxiety symptoms (β = ?.055, p > .05). The results suggest that hematological cancer patients who possess high levels of positive psychological resources may have fewer symptoms of psychological distress. The findings indicate that enhancing positive psychological resources can be considered in developing intervention strategies for decreasing depressive and anxiety symptoms.     

The relationships of change in work climate with changes in burnout and depression: a 2-year longitudinal study of Chinese mental health care workers

Mental health care workers face heavy emotional demand and are prone to work burnout. Work burnout has been associated with poor mental health and work climate, which refers to individual perceptions about work setting. The purpose of this study was to examine whether intra-individual changes in work climate were associated with intra-individual changes in burnout and depression over two years. The present sample included Chinese mental health care workers (N = 312; mean age = 38.6, SD = 9.9) working in a psychosocial rehabilitation institution. The participants completed questionnaires on work climate, work burnout and depression at seven time points across two years. Parallel process latent growth modeling was used to analyze the associations of change between work climate and burnout and depression. Work climate displayed a logarithmic decreasing trend while burnout and depression displayed logarithmic increasing trends over two years. Baseline levels of work climate were negatively and moderately associated with baseline levels of burnout and depression (r = ?.44 to ?.60, p < .01). Changes in work climate were negatively and moderately associated with change in burnout (r = ?.43, p < .01) and change in depression (r = ?.31, p < .05). Change in burnout was positively and strongly associated (r = .58, p < .01) with change in depression. The current results support temporal relationships among changes in work climate, burnout and depression across time. Practical implications for future preventive work in burnout interventions were discussed within this population.     

Stress-Related Growth in Japanese Adolescents Experiencing High School Entrance Examinations

High school entrance examinations and preparation for them have become a highly stressful experience for many Japanese adolescents. This study examined the relationship between stress-related growth (SRG) and distress resulting from these exams from the perspective of positive meaning-making. Ninth graders (N = 183, 87 females, aged 14–15 years) of a public school in Tokyo participated in the study by responding to a questionnaire survey. Results indicated that meaning-making was positively correlated with SRG (r = .58, p < .001), whereas it was negatively correlated with distress (r = ?.20, p = .006). Moreover, SRG was negatively correlated with distress (r = ?.34, p < .001). Mediation analysis demonstrated that SRG positively mediates the relationship between meaning-making and distress, while distress negatively mediates the relationship between meaning-making and SRG. These results have implications for understanding the causal relationships between SRG and distress, from the perspective of positive meaning-making regarding high school entrance examinations in Japan.     

Association of Stress Management Skills and Perceived Stress with Physical and Emotional Well-Being Among Advanced Prostrate Cancer Survivors Following Androgen Deprivation Treatment

Advanced prostate cancer (APC) is associated with disruptions that compromise health related quality of life (HRQOL). Treatment often includes androgendeprivation therapy (ADT), which results in a range of side effects (e.g., fatigue, urinary dysfunction) that further impact HRQOL. Despite these challenges, there are limited evaluations of the impact of stress and stress management skills on HRQOL among APC survivors on ADT. This study evaluated relationships among stress, stress management skills, and HRQOL, and it was hypothesized that better stress management skills would relate to greater physical and emotional well-being by mitigating perceived stress levels. Participants (N = 77) were 69.7 years old (SD = 9.8), 18.6 months post-treatment (SD = 17.5), and ethnically diverse (65 % Non-Hispanic White, 13 % Hispanic, 21 % African-American). Measures included the Measure of Current Status for stress management skills, the Perceived Stress Scale for perceived stress, and the Medical Outcomes Study—Short Form (MOS SF-36; physical functioning and emotional well-being subscales) for HRQOL. Direct effects and mediation models were evaluated to determine the relationships between perceived stress, stress management skills, and HRQOL domains, controlling for relevant covariates. Stress management skills and perceived stress were significantly associated with physical functioning (β = .24, p < .05 and β = ?.43, p < .01, respectively) and emotional well-being (β = .35, p < .01 and β = ?.64, p < .01, respectively). Regression analyses supported the hypothesis that reduced perceived stress mediated the relationship between stress management skills and both physical functioning and emotional well-being. These results demonstrate that one way stress management skills may impact HRQOL is by lessening ongoing perceptions of stress.     

Physician Burnout and Patient Satisfaction with Consultation in Primary Health Care Settings: Evidence of Relationships from a one-with-many Design

Physician burnout, as a prolonged response to chronic emotional and interpersonal stressors on the job, has been associated with suboptimal patient care and deterioration in the patient?Cprovider relationship. Although prior studies have identified a range of factors associated with decreased patient satisfaction, most have been conducted in tertiary care settings, with staff burnout examined at the hospital unit-level. To examine the impact of physician burnout on patient satisfaction from consultation in the primary care setting, a cross-sectional survey was conducted in Western Greece. Using a one-with-many design, 30 physicians and 300 of their patients, randomly selected, responded to the survey. Results showed that patient satisfaction correlated significantly with physician emotional exhaustion (r = ?.636, p < .01) and physician depersonalization (r = ?.541, p < .01). Mixed-effects multilevel models indicated that 34.4% of total variation in patients?? satisfaction occurred at the physician level, after adjustment for patients?? characteristics. Moreover, physician emotional exhaustion and depersonalization remained significant factors associated with patient satisfaction with consultation, after controlling for patient and physician characteristics. Patients of physicians with high-exhaustion and high-depersonalization had significantly lower satisfaction scores, compared with patients of physicians with low-exhaustion and low-depersonalization, respectively. Future studies need to explore the mechanisms by which physician burnout affects patient satisfaction.     

Monitoring stress among internal medicine residents: an experience-driven,practical and short measure

Residents experience severely high levels of stress, depression and burnout, leading to perceived medical errors, as well as to symptoms of impairment, such as chronic anger, cognitive impairment, suicidal behavior and substance abuse. Because research has not yet provided a psychometrically robust population-specific tool to measure the level of stress of medicine residents, we aimed at building and validating such a measure. Using an inductive scale development approach, a short, pragmatic measure was built, based on the interviews of 17 medicine residents. The Internal Medicine Residency Stress Scale (IMRSS) was then administered in a sample of 259 internal medicine residents (199 females, 60 males, M_Age = 25.6) along with the Hospital Anxiety and Depression Scale, Maslach Burnout Inventory, Satisfaction With Life Scale and Ways of Coping Checklist. The IMRSS showed satisfactory internal reliability (Cronbach’s α = .86), adequate structural validity – studied through Confirmatory Factor Analysis (χ²/df = 2.51, CFI = .94; SRMR = .037, RMSEA = .076) – and good criterion validity – the IMRSS was notably strongly correlated with emotional exhaustion (r = .64; p < .001) and anxiety (r = .57; p < .001). Because of its short length and robust psychometric qualities, the use of the IMRSS is recommended to quickly and frequently assess and monitor stress among internal medicine residents.     

Developmentally Adapted Cognitive Processing Therapy for Adolescents Suffering from Posttraumatic Stress Disorder after Childhood Sexual or Physical Abuse: A Pilot Study

Although childhood sexual abuse and childhood physical abuse (CSA and CPA) have severe psychopathological consequences, there is little evidence supporting psychotherapeutic interventions for adolescents who have experienced CSA or CPA. To provide a treatment tailored to the specific needs of adolescents suffering from abuse-related posttraumatic stress disorder (PTSD), we modified Cognitive Processing Therapy (CPT) by adding new treatment modules and changing the therapy setting. To evaluate the feasibility and efficacy of Developmentally Adapted CPT (D-CPT), we treated 12 adolescents suffering from PTSD secondary to CSA or CPA. Patients were assessed prior to treatment (t0), post-treatment (t1), and 6 weeks after treatment (t2). Assessments included the Clinician-Administered PTSD Scale (CAPS), the UCLA PTSD Index (UCLA), the Children’s Depression Inventory (CDI), the Adolescent Dissociative Experiences Scale (A-DES), and the Borderline Symptom List (BSL-23). MANOVAs revealed that posttraumatic stress measurements and associated symptom measurements significantly differed across time points. When comparing t0 with t2, Cohen’s d was large with respect to the CAPS scores (d = 1.45, p < .001) and the UCLA scores (d = 1.91, p < .001). Cohen’s d had a medium magnitude with respect to the CDI scores (d = .78, p < .001), the A-DES scores (d = 0.64, p < .05), and the BSL-23 scores (d = 0.74, p < .01). D-CPT has the potential to reduce PTSD symptoms and comorbid psychopathology in adolescents with histories of CSA or CPA.     

A computerized test for the assessment of mild cognitive impairment subtypes in sentence processing

This study examines thesentence processing ability of mild cognitive impairment (MCI) subtypes. In addition to standard MCI neuropsychological tests, an experimental approach was applied to assess language. 133 people (93 MCI/40 controls) participated in novel computerized sentence processing tasks. Results presented statistically significant differences between MCI/controls andMCI subtypes (ANOVA):(a) duration F(2,92) = 19.259,p < .001) in sentence construction; (b) correct answers (F(2, 89) = 8.560,p < .001) and duration (F2,89) = 15.525,p < .001)in text comprehension; (c) correct answers (F(2, 92) = 8.975,p < .001) andduration (F(2, 92) = 4.360,p = .016) in metaphoric sentences comprehension; (d) correct answers (F(2, 92) = 12.836,p < .001) andduration (F(2, 92) = 10.974,p < .001) in verb form generation. Subtle changes in MCIsubtypes could affect sentence processing and provide useful information for cognitive decline risk estimation and screening purposes.     

Relations between symptom severity,illness perceptions,visceral sensitivity,coping strategies and well-being in irritable bowel syndrome guided by the common sense model of illness

Irritable Bowel Syndrome (IBS) is a common condition affecting around 10–20% of the population and associated with poorer psychological well-being and quality of life. The aim of the current study was to explore the efficacy of the Common Sense Model (CSM) using Structural Equation Modelling (SEM) in an IBS cohort. One hundred and thirty-one IBS patients (29 males, 102 females, mean age 38 years) participating in the IBSclinic.org.au pre-intervention assessment were included. Measures included IBS severity (Irritable Bowel Syndrome Severity Scoring System), coping patterns (Carver Brief COPE), visceral sensitivity (Visceral Sensitivity Index), illness perceptions (Brief Illness Perceptions Questionnaire), psychological distress (Depression, Anxiety and Stress Scale), and quality of life (IBS Quality of Life scale; IBS-QoL). Using SEM, a final model with an excellent fit was identified (χ² (8) = 11.91, p = .16, χ²/N = 1.49, CFI > .98, TLI > .96, SRMR < .05). Consistent with the CSM, Illness perceptions were significantly and directly influenced by IBS severity (β = .90, p < .001). Illness perceptions in turn directly influenced maladaptive coping (β = .40, p < .001) and visceral sensitivity (β = .70, p < .001). Maladaptive coping and visceral sensitivity were significantly associated with psychological distress (β = .55, p < .001; β = .22, p < .01) and IBS-QoL (β = –.28, p < .001; β = –.62, p < .001). Based on these findings, we argue that to augment the adverse impact of IBS severity on IBS-QoL and psychological distress, psychological interventions will be best to target the mediating psychological processes including illness beliefs, visceral sensitivity and maladaptive coping.     

Higher chronic psychological stress is associated with blunted affective responses to strenuous resistance exercise: RPE,pleasure, pain

The aim of this study was to determine whether mental stress moderates perceptions of muscular pain, exertion, pleasure and arousal during a bout of strenuous resistance exercise. Two hundred and ten undergraduate students recruited from resistance exercise classes were screened with the Perceived Stress Scale (PSS). Fifty-seven individuals (age = 20.1 ± 1.2 y) were invited to complete the Undergraduate Stress Questionnaire (USQ), a measure of life event stress, and fitness testing. They later performed a two-phase, acute heavy-resistance exercise protocol: first phase: 10-repetition maximum (RM) leg press test; second phase: six sets at 80–100% of 10-RM. During exercise, participants responded to the Feeling Scale (pleasure), Felt Arousal Scale, Omni-RPE and the Pain Intensity Scale. Affective responses and heart rate were analyzed with a hierarchical linear modeling (HLM) growth curve analysis. USQ moderated the trajectories of affective responses and heart rate during exercise. Higher stress (USQ) levels were significantly related to lower rise in RPE (time², p = .002; time³, p < .001) and heart rate (time², p < .001; time³, p < .001). USQ had a main effect on pleasure and arousal (p values < .001), in which higher levels of stress were related to less affect. Models using the PSS scale produced similar results. PSS, but not USQ, interacted with time to predict pain (time², p = .048; time³, p = .024). Relationships held even after adjusting for covariates, such as depression. Future research should determine if differential responses to exercise by stress have implications for behavioral interventions and mental health outcomes.     

Episodes of momentary resilience in daily life are associated with HRV reductions to stressful operations in firefighters: an ambulatory assessment approach using bayesian multilevel modeling

ABSTRACT

Background: Resilience is discussed to constitute a protective buffer against stress, thus fostering health. Methods: This study aimed to assess resilience both via traditional questionnaire and in everyday life on a momentary basis, and to relate these measures to autonomic functioning (heart rate variability, HRV) in 38 male firefighters during a weekday. Stressful operations, non-stressful operations and routine work at the firestation were coded during 24 hours. Momentary negative affect, feelings of resilience, and HRV were recorded via ecological momentary assessment. Findings: Questionnaire-assessed resilience was significantly positively associated with aggregated momentary resilience (r = .58, p < .001), but unrelated to HRV. However, controlling for multiple confounders (e.g., age, smoking, bodily movement, waist-to-height ratio) momentary resilience was associated with attenuated HRV and lower negative affect during stressful encounters only. Discussion: The findings suggest that momentary feelings of resilience are accompanied by vagal withdrawal to stress, possibly indicating psychological flexibility and adaptive responding to stress.     

Association of Burnout with Emotional Coping Strategies,Friendship, and Institutional Support Among Internal Medicine Physicians

Physician burnout influences physician mental health, staff stress, safety events, and patient outcomes. The association of burnout with compassion satisfaction, secondary stress, emotional coping strategies and many psychosocial variables, such as institutional support, friendship, and spirituality, have not been well studied. A convenience sample of internal medicine physicians was emailed a survey using validated instruments to explore these associations. The response rate was 337/1021 (33%), with a burnout prevalence of 175/337 (52%). Grit, acceptance, active coping, positive reframing, and strategy planning were associated with lower burnout domains and greater compassion satisfaction. Certain emotional coping strategies such as denial, disengagement, self-blame, substance abuse, and venting were associated with greater burnout and lower compassion satisfaction. Greater institutional support was associated with lower burnout (r?=????.35, p?<?.001), secondary stress (r?=????.14, p?<?.05), and compassion satisfaction (r?=?.28, p?<?.0001). Friendship was associated with lower burnout (r?=????.25, p?<?.0001) and greater compassion satisfaction (r?=?.28, p?<?.0001). This study suggests that amelioration of burnout requires both intrinsic strategies that emphasize physician coping skills as well as extrinsic strategies that address institutional support.

     

Is the Association of ADHD with Socio-Economic Disadvantage Explained by Child Comorbid Externalizing Problems or Parent ADHD?

It has been unclear whether an associations of child ADHD with socio-economic disadvantage (SES) could be accounted for by (a) parental ADHD explaining both low SES and child ADHD, and/or (b) the joint overlap of ODD or CD with low SES and ADHD. Study 1 used a community-recruited case-control sample with detailed evaluation of SES indicators, child ADHD, child externalizing, and parent ADHD symptoms (n = 931 children, 521 ADHD, 577 boys, 354 girls) in a path modeling analysis with latent variables. Study 2 evaluated ADHD and externalizing behavior in a regression model using a poverty index for SES, in 70,927 children (48.2% female) aged 5–17 years from the US 2011–2012 National Survey of Children’s Health (NSCH). In Study 1, lower SES was related to the ADHD latent variable, β = ?.18, p < .001; 95%CI [?.25,-.12]. This effect held when parent ADHD and child ODD and CD were in the model, β = ?.11, p < .01, 95% CI [?.09,-.03], equivalent to OR = 1.50, 95% CI[1.12–2.04]). In Study 2, these results replicated. Adjusting only for age and sex, children from families who were below 200% of the federal poverty line were more likely to have moderate or severe ADHD than no ADHD, versus children above that line, OR = 2.13, 95% CI[1.79,2.54], p < .001. The effect held after adjusting for disruptive/externalizing problems, OR = 1.61, p < .01, 95%CI [1.32,1.96]. The effect size for comparable models was similar across both studies, lending higher confidence to the results. It is concluded that the SES association with child ADHD is not explained by artifact and requires a mechanistic explanation.     

Trauma history as a resilience factor for patients recovering from total knee replacement surgery

Research concerning the impact of trauma history on individuals' ability to cope with subsequent events is mixed. While many studies find that trauma history increases vulnerability for conditions such as post-traumatic stress disorder and chronic pain, others reveal that there are benefits associated with moderate levels of stress (e.g. development of coping skills).

Objective: The present study investigated whether the experience of prior traumatic stressors would serve as a risk or resilience factor based on physical and emotional outcomes among patients recovering from total knee replacement surgery (TKR).

Design: 110 patients undergoing unilateral, TKR completed surveys before surgery, as well as one and three months following the procedure.

Results: Contrary to hypotheses, patients who reported more prior traumas experienced less severe pain and functional limitations at one- (β = ?.259, p = .006) and three-month follow-up assessments (β = ?.187, p = .04). A similar pattern emerged when specific types of traumas (e.g. interpersonal) were examined in relation to physical recovery. Further, patients’ trauma history was negatively related to symptoms of post-traumatic stress three-months following surgery (e.g. Avoidance: β = ?.200, p = .037).

Conclusion: Trauma history represents a source of resilience, rather than vulnerability, within the context of arthroplastic surgery.     

Efficacy of Telehealth Treatments for Posttraumatic Stress-Related Symptoms: A Meta-Analysis

This meta-analysis summarizes the findings of outcome research on the degree to which telehealth treatments reduce posttraumatic stress disorder (PTSD)-related symptoms. In a search of the literature, 13 studies were identified for inclusion in the meta-analysis and were coded for relevant variables. A total of 725 participants were included. Results indicate that telehealth treatments are associated with significant pre- to postreduction in PTSD symptoms (d = 0.99, 95% confidence interval [CI]: 0.87–1.11, p < .001), and result in superior treatment effects relative to a wait-list comparison condition (d = 1.01, 95% CI: 0.76–1.26, p < .001). However, no significant findings were obtained for telehealth intervention relative to a supportive counseling telehealth comparison condition (d = 0.11, 95% CI: ? 0.38 to 0.60, p = .67), and telehealth intervention produced an inferior outcome relative to a face-to-face intervention (d = ? 0.68, 95% CI: ? 0.39 to ? 0.98, p < .001). Findings for depression symptom severity outcome were generally consistent with those for PTSD outcome. Telehealth interventions produced a significant within-group effect size (d = 0.98, 95% CI: 0.86 to 1.10, p < .001) and superior effect relative to wait-list comparison condition (d = 0.80, 95% CI: 0.56–1.05, p < .001). Relative to face-to-face interventions, telehealth treatments produced comparable depression outcome effects (d = 0.13, 95% CI: ? 0.55 to 0.28, p = .53). Taken together, these findings support the use of telehealth treatments for individuals with PTSD-related symptoms.