The interactions between patient preferences, expectancies, and stigma contribute to posttraumatic stress disorder treatment outcomes.

Cognitive processing therapy (CPT) is an effective treatment for posttraumatic stress disorder (PTSD); however, some patients do not improve to the same extent as others. It is important to understand potential factors that can be modified for better patient outcomes. This clinical trial implemented a three-arm, equipoise-stratified randomization design to allow for the accommodation of patient preference before randomization to one of three CPT treatment modalities: in-home, in-office, or telehealth. This study examined whether satisfaction with the modality, perceived stigma, expectations of therapy, and credibility of the therapist differed between modalities and whether these factors impacted treatment outcomes. We hypothesized that the contributions of these variables would depend upon whether participants opted out of any treatment arms and that these factors would predict treatment outcomes. Participants who endorsed less perceived stigma demonstrated larger reductions in PTSD symptom severity than those with similar levels of perceived stigma in the telehealth and in-office conditions, η2 = .12-.18. Participants who endorsed lower satisfaction with their treatment modality and were assigned to the in-home condition experienced larger PTSD symptom reductions than those with similar dissatisfaction in the telehealth and in-office conditions, η2 = .20. The results show the robustness of evidence-based therapies for PTSD given that dissatisfaction did not impede treatment success. In addition, they demonstrate that it is important for clinicians to address stigma before initiating evidence-based therapies for PTSD. Strategies to address these factors are discussed.

Criterion Validity of Protective Behavioral Strategies for Alcohol Consumption among College Students: Comparison across Two Measures.

BACKGROUND: Protective behavioral strategies (PBS), or behaviors used to reduce harm associated with alcohol use, are often associated with lower levels of alcohol consumption, lower engagement in high-risk drinking behaviors, and fewer alcohol-related consequences. Although the majority of studies have found significant associations between higher PBS use and lower consumption or consequences, some studies have found nonsignificant or even positive associations. One explanatory hypothesis is that the mixed findings are due to differential content in PBS measures. OBJECTIVES: The current study examined the criterion validity of two widely-used PBS measures, the PBSS and the SQ. In a multi-institution online study assessing alcohol outcomes, college drinkers were randomly assigned to complete one PBS measure. Both measures had the same response options to standardize assessment and focus on content. RESULTS: Findings suggest both measures of PBS are consistently predictive of alcohol outcomes among college drinkers, across multiple subpopulations (i.e., strength of association was not moderated by sex, race, or drinking level). CONCLUSIONS/IMPORTANCE: Some PBS subscales were more impactful than others, suggesting researchers may want to choose which PBS scale to use based on outcomes of interest, or after determining if alternatives to drinking is an important facet of PBS for the research questions being examined. Moreover, the differential findings for subscales suggest that prevention and intervention programs incorporating PBS should focus on strategies that avoid high-risk scenarios (e.g., avoiding shots or drinking games), rather than general strategies of self-pacing.

Data Quality and Study Compliance Among College Students Across 2 Recruitment Sources: Two Study Investigation.

BACKGROUND: Models of satisficing suggest that study participants may not fully process survey items and provide accurate responses when survey burden is higher and when participant motivation is lower. Participants who do not fully process survey instructions can reduce a study's power and hinder generalizability. Common concerns among researchers using self-report measures are data quality and participant compliance. Similarly, attrition can hurt the power and generalizability of a study. OBJECTIVE: Given that college students comprise most samples in psychological studies, especially examinations of student issues and psychological health, it is critical to understand how college student recruitment sources impact data quality (operationalized as attention check items with directive instructions and correct answers) and retention (operationalized as the completion of follow-up surveys over time). This examination aimed to examine the following: whether data quality varies across recruitment sources, whether study retention varies across recruitment sources, the impact of data quality on study variable associations, the impact of data quality on measures of internal consistency, and whether the demographic qualities of participants significantly vary across those who failed attention checks versus those who did not. METHODS: This examination was a follow-up analysis of 2 previously published studies to explore data quality and study compliance. Study 1 was a cross-sectional, web-based survey examining college stressors and psychological health (282/407, 69.3% female; 230/407, 56.5% White, 113/407, 27.8% Black; mean age 22.65, SD 6.73 years). Study 2 was a longitudinal college drinking intervention trial with an in-person baseline session and 2 web-based follow-up surveys (378/528, 71.6% female; 213/528, 40.3% White, 277/528, 52.5% Black; mean age 19.85, SD 1.65 years). Attention checks were included in both studies to assess data quality. Participants for both studies were recruited from a psychology participation pool (a pull-in method; for course credit) and the general student body (a push-out method; for monetary payment or raffle entry). RESULTS: A greater proportion of participants recruited through the psychology pool failed attention checks in both studies, suggesting poorer data quality. The psychology pool was also associated with lower retention rates over time. After screening out those who failed attention checks, some correlations among the study variables were stronger, some were weaker, and some were fairly similar, potentially suggesting bias introduced by including these participants. Differences among the indicators of internal consistency for the study measures were negligible. Finally, attention check failure was not significantly associated with most demographic characteristics but varied across some racial identities. This suggests that filtering out data from participants who failed attention checks may not limit sample diversity. CONCLUSIONS: Investigators conducting college student research should carefully consider recruitment and include attention checks or other means of detecting poor quality data. Recommendations for researchers are discussed.