Trial reportJournal of consulting and clinical psychology2024
A controlled trial of adaptive disclosure-enhanced to improve functioning and treat posttraumatic stress disorder.
Trial report in Journal of consulting and clinical psychology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 12 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Psychosocial Rehabilitation After Moral Injury and Loss With Adaptive Disclosure
Comparing Two Moral Injury Treatments: Acceptance and Commitment Therapy for Moral Injury and Present Centered Therapy for Moral Injury
Who cites it
12 citing papers in PubMed.
- Acceptance and commitment therapy for moral injury (ACT-MI) and present-centered therapy for moral injury (PCT-MI): Results from a randomized controlled pilot trial with war zone deployed veterans.Psychotherapy (Chicago, Ill.) · 2026Trial
- Integrative Rehabilitation for War-Related Polytrauma: A Narrative Review of Multidimensional Strategies and Implementation Challenges.Healthcare (Basel, Switzerland) · 2026Review
- Moral Injury as a Wound of Meaning and Conscience: An Introductory Synthesis of Conceptual Foundations, Spiritual Dimensions, and Clinical Implications.Journal of religion and health · 2026Article
- Moral Injury in Elite Sport: Trauma in the Failure of the Athlete's Quest.Journal of religion and health · 2026Article
- Acceptance and commitment therapy for moral injury: conceptualizing and intervening on moral injury through the lens of contextual behavioral science.Frontiers in psychiatry · 2026Article
- Depth-oriented group psychotherapy for moral injury with military veterans: relational psychoanalytic and psychodynamic theory, mechanisms of action, and clinical implications.Frontiers in psychiatry · 2026Article
- Moral injury research at a crossroads: assumptions, limitations, and the promise of relational reorientation.Frontiers in psychiatry · 2026Article
- The therapeutic role of self-transcendence in moral injury recovery:Frontiers in psychiatry · 2026Article
- Service members' exposure to potentially morally injurious events: Intimate partner knowledge and response.Military psychology : the official journal of the Division of Military Psychology, American Psychological Association · 2026Article
- Moral injury prevention and intervention.European journal of psychotraumatology · 2025Review
- The prevalence of moral distress and moral injury among U.S. veterans.Journal of psychiatric research · 2025Article
- Fallout: the psychosocial harms of negative military discharge experiences.Frontiers in psychology · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors.
Funding
Abstract
objectiveThis is a randomized controlled trial (NCT03056157) of an enhanced adaptive disclosure (AD) psychotherapy compared to present-centered therapy (PCT; each 12 sessions) in 174 veterans with posttraumatic stress disorder (PTSD) related to traumatic loss (TL) and moral injury (MI). AD employs different strategies for different trauma types. AD-Enhanced (AD-E) uses letter writing (e.g., to the deceased), loving-kindness meditation, and bolstered homework to facilitate improved functioning to repair TL and MI-related trauma.
methodThe primary outcomes were the Sheehan Disability Scale (SDS), evaluated at baseline, throughout treatment, and at 3- and 6-month follow-ups (Brief Inventory of Psychosocial Functioning was also administered), the Clinician-Administered PTSD Scale (CAPS-5), the Dimensions of Anger Reactions, the Revised Conflict Tactics Scale, and the Quick Drinking Screen.
resultsThere were statistically significant between-group differences on two outcomes: The intent-to-treat (ITT) mixed-model analysis of SDS scores indicated greater improvement from baseline to posttreatment in the AD-E group (d = 2.97) compared to the PCT group, d = 1.86; -2.36, 95% CI [-3.92, -0.77], t(1,510) = -2.92, p < .001, d = 0.15. Twenty-one percent more AD-E cases made clinically significant changes on the SDS than PCT cases. From baseline to posttreatment, AD-E was also more efficacious on the CAPS-5 (d = 0.39). These differential effects did not persist at follow-up intervals.
conclusionThis was the first psychotherapy of veterans with TL/MI-related PTSD to show superiority relative to PCT with respect to functioning and PTSD, although the differential effect sizes were small to medium and not maintained at follow-up. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.