G.R.I.T. - Goal-directed Resilience Intervention Training

Changes in pre-to-post scores among intervention versus control group as measured by the Clinician Administered PTSD Scale for DSM 5 (CAPS-5): clinician-administered, structured interview ideal for screening, differential diagnosis & confirmation of PTSD. Each item is scored on a scale of 0-4; the total composite score range is 0-212; Lower score = better outcome

Changes in pre-to-post scores among intervention versus control group as measured by the PTSD Checklist (PCL-5): 17-item self-report checklist of PTSD symptoms; General civilian version of the PCL will be used. Each item is scored on a scale of 0-4; the total composite score range is 0-80; Lower score = better outcome

Changes in pre-to-post scores among intervention versus control group as measured by the Posttraumatic Cognitions Inventory (PTCI): 36-item self-report measure assessing trauma-related thoughts and beliefs about self, others, and self-blame. Each item is scored on a scale of 1-7; the total composite score range is 33-231; Lower score = better outcome

Changes in pre-to-post scores among intervention versus control group as measured by the Difficulties in Emotion Regulation: 36-item self-report questionnaire designed to assess multiple aspects of emotion dysregulation. Each item is scored on a scale of 1-5; the total composite score range is 36-180; Lower score = better outcome

Changes in pre-to-post scores among intervention versus control group as measured by the Positive & Negative Affective Schedule (PANAS): 20-item self-report measure frequently used as a measure of general affective states. Each item is scored on a scale of 1-5; the total composite score range is 20-100; 1=very slightly or not at all; 5=extremely; measures positive and negative affect mood scales; higher scores on positive affective scale and lower scores on negative affective scale indicate better outcome

Changes in pre-to-post scores among intervention versus control group as measured by the Ryff Scales of Psychological Well-being: Measures aspects of psychological well-being across three selected subscales: Personal Growth, Positive Relations with Others, Purpose in Life; 9 items each. Each item is scored on a scale of 1-7; the total composite score range is 7-42; Higher score = better outcome

Changes in pre-to-post scores among intervention versus control group as measured by the Conner-Davidson Resilience Scale (CD-RISC): Unidimensional self-reported scale consisting of 10 items measuring resilience. Each item is scored on a scale of 0-4; the total composite score range is 0-100; Higher score = better outcome

Changes in pre-to-post scores among intervention versus control group as measured by the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS): Originally designed to identify and characterize mild and severe dementia in older adults, later modified to include younger adults. This study will focus on immediate memory, delayed memory, simple and complex attention subtests. In the Immediate memory subset the participant is asked to recall words from a list immediately after being read to her/him; More words remembered = better outcome. In the Delayed memory subset the participant asked to recall words from a list some time after being read to her/him; More words remembered = better outcome, In the Simple attention subset the participant is asked to repeat increasingly longer sequences of digits; More/longer sequences remembered = better outcome. In the Complex attention subset the participant matches symbols with numbers; More correct matches = better outcome.

Changes in pre-to-post scores among intervention versus control group as measured by the Delis-Kaplan Executive Function System (D-KEFS): Study focuses on two of nine subtests (Verbal Fluency and Color-Word Interference) assessing components of executive functioning. In the Verbal Fluency subset the participant says words that begin with a specified letter, belong to a designated semantic category, and alternate between saying words from two different semantic categories; More words participant can say per category = better outcome. In the Color-Word Interference subset the participant names color patches, reads words naming colors printed in black ink, names the ink color in which color words are printed in an incompatible ink color, and switches back and forth between naming the dissonant ink color and reading the conflicting words; More accurate = better outcome.

Changes in pre-to-post scores among intervention versus control group as measured by demographics: Collected demographic data will include age, gender, race, etc. Each item is scored on a scale of 0-3; the total composite score range is 0-66; Lower score=better outcome.

Changes in pre-to-post scores among intervention versus control group as measured by the Beck Depression Inventory (BDI): reflects DSM criteria for depression, score indicates presence of minimal, mild, moderate, or severe depressive symptoms. Each item is scored on a scale of 0-3; the total composite score range is 0-66; Lower score=better outcome.

Changes in pre-to-post scores among intervention versus control group as measured by the Patient Health Questionnaire Depression Scale (PHQ-9): 9-item measure reflecting DSM criteria for depression. Each item is scored on a scale of 0-3; the total composite score range is 0-27; Lower score = better outcome.

Changes in pre-to-post scores among intervention versus control group as measured by the Alcohol Use Disorders Identification Test (AUDIT-C): brief alcohol screen used to identify persons who have active alcohol use disorders, including alcohol abuse or dependence. Each item is scored on a scale of 0-4; the total composite score range is 0-68; For each item, a score of 4 or more in men and 3 or more in women is considered positive, optimal for identifying hazardous drinking or active alcohol use disorders; Lower score = better outcome.

Changes in pre-to-post scores among intervention versus control group as measured by the SF-36 Health Measures: Multi-purpose, short-form health questionnaire of functional health and well-being scores. Over seven subsections, seven items are scored on a scale of 1-2 for a total composite score range of 7-14; ten items are scored on a scale of 1-3 for a total composite score range of 10-30; nine items are scored on a scale of 1-5 for a total composite score range of 9-45; and ten items are scored on a scale of 1-6 for a total composite score range of 10-60; Lower score = better outcome for 16 items; Higher score = better outcome for 20 items.

Changes in pre-to-post scores among intervention versus control group as measured by the Mini International Neuropsychiatric Interview (MINI): Short diagnostic structured interview designed to assess various psychiatric disorders according to DSM-IV and ICD-10 criteria. 98 items on a Yes/No scale with a skip pattern (i.e. not all 98 questions will necessarily be answered) and 49 qualitative questions; Fewer reported symptoms = better outcome.

Changes in pre-to-post scores among intervention versus control group as measured by the Berlin Questionnaire: self-reported questionnaire assessing snoring, sleepiness or fatigue, obesity and hypertension. Ten questions over three categories with non-uniform, symptom specific self-ratings; Positive (worse outcome) ranges are color-coded on the questionnaire.

Changes in pre-to-post scores among intervention versus control group as measured by the Pittsburgh Sleep Quality Index (PSQI): self-rated questionnaire that assesses sleep quality, latency, duration, efficiency, disturbances, sleep medication, and daytime dysfunction over a one-month time interval. Six qualitative questions, 17 questions rating symptoms from "Not during the past month" to "Three or more times a week"; More answers of "Not during the past month" = better outcome.

Changes in pre-to-post scores among intervention versus control group as measured by the Epworth Sleepiness Scale (ESS): self-report instrument on which respondents rate their chance of falling asleep in eight common daily situations. Each item is scored on a scale of 0-3; the total composite score range is 0-24; Lower score = better outcome.

Changes in pre-to-post scores among intervention versus control group as measured by the Short Form McGill Pain Questionnaire (SF-MPQ): 15 descriptors (11 sensory, 4 affective) rated on intensity scale (1=mild, 2=moderate, 3=severe, 4=none) the total composite symptomatic score range is 15-45; Lower symptomatic score = better outcome; 60 (no symptoms on any of the items)=best outcome.

Changes in pre-to-post scores among intervention versus control group as measured by the Structured Trauma Interview (STI): A non-invasive test that gathers specific information about trauma-related cognitive and physiological symptoms. A clinician administers qualitative questions to participants hooked up to machines that record physiological reactions (e.g. heart rate); Lower physiological response=better outcome.

Changes in pre-to-post measures among intervention versus control group as assessed by Actigraphy, a non-invasive approach to monitoring sleep/activity cycles that will collect five days of sleep data to assess sleep/wake behavior, circadian rhythm, and effectiveness of the intervention.