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Goal-Directed Resilience in Training (GRIT): A Biopsychosocial Model of Self-Regulation, Executive Functions, and Personal Growth (Eudaimonia) in Evocative Contexts of PTSD, Obesity, and Chronic Pain.

Kent M, Rivers CT, Wrenn G - Behav Sci (Basel) (2015)

Bottom Line: Existing models of attention, cognition, and physiology were sourced in combination with qualitative study findings in developing this resilience skills intervention.We used qualitative methods to uncover life skills that are most salient in cases of extreme adversity, finding that goal-directed actions that reflected an individual's values and common humanity with others created a context-independent domain that could compensate for the effects of adversity.Feasibility studies for groups with comorbid diagnoses, such as chronic pain and PTSD, also showed positive results, leading to the application of the GRIT intervention to other evocative contexts such as obesity and chronic pain.

View Article: PubMed Central - PubMed

Affiliation: Research Department R151, Phoenix VA Health Care System, 650 E. Indian School Rd., Phoenix, AZ 85012, USA. market@ix.netcom.com.

ABSTRACT
This paper presents a biopsychosocial model of self-regulation, executive functions, and personal growth that we have applied to Goal-Directed Resilience in Training (GRIT) interventions for posttraumatic stress disorder (PTSD), obesity, and chronic pain. Implications of the training for the prevention of maladaptation, including psychological distress and health declines, and for promoting healthy development are addressed. Existing models of attention, cognition, and physiology were sourced in combination with qualitative study findings in developing this resilience skills intervention. We used qualitative methods to uncover life skills that are most salient in cases of extreme adversity, finding that goal-directed actions that reflected an individual's values and common humanity with others created a context-independent domain that could compensate for the effects of adversity. The efficacy of the resilience skills intervention for promoting positive emotion, enhancing neurocognitive capacities, and reducing symptoms was investigated in a randomized controlled trial with a veteran population diagnosed with PTSD. The intervention had low attrition (8%) and demonstrated improvement on symptom and wellbeing outcomes, indicating that the intervention may be efficacious for PTSD and that it taps into those mechanisms which the intervention was designed to address. Feasibility studies for groups with comorbid diagnoses, such as chronic pain and PTSD, also showed positive results, leading to the application of the GRIT intervention to other evocative contexts such as obesity and chronic pain.

No MeSH data available.


Related in: MedlinePlus

Three contexts of obstacles within which people practice their goal-directed adaptive actions. The obstacle, trauma, challenge become the ‘stage’ or backdrop for goal-directed action that is played out on stage. Experiences of engagement as in interest, curiosity, appreciation or of social relatedness as in empathy, compassion, helping are enacted on these stages where obstacles are the backdrop or scenery and not the main actors. The stages can be: internal or Intrapersonal and represent states of mind and emotions or interoceptive body states such as pain; or Interpersonal such as conflict with another person; or Social as exemplified by experiences with larger groups, the community, or culture.
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behavsci-05-00264-f001: Three contexts of obstacles within which people practice their goal-directed adaptive actions. The obstacle, trauma, challenge become the ‘stage’ or backdrop for goal-directed action that is played out on stage. Experiences of engagement as in interest, curiosity, appreciation or of social relatedness as in empathy, compassion, helping are enacted on these stages where obstacles are the backdrop or scenery and not the main actors. The stages can be: internal or Intrapersonal and represent states of mind and emotions or interoceptive body states such as pain; or Interpersonal such as conflict with another person; or Social as exemplified by experiences with larger groups, the community, or culture.

Mentions: Through simulation activities, we sought to simulate adaptive responding (see Figure 1. We have dubbed the adaptive survival themes from the qualitative analysis as ‘life skills’ for the intervention. These skills are expected to be useful in challenging contexts because of: (a) their prospective, goal-directed qualities; (b) their independence from threatening context; and (c) the positive, affirming emotions accompanying them. Evidence suggests that these life skills activate prospective goal-directed cortical mechanisms and executive functions, while supporting deactivation of stress functions at cortical, endocrine, and physiological levels [14,114]. The effect is prospective goal-directed action and affective engagement that has an ameliorative effect on stress. Supporting work for disengagement of PTSD symptoms from executive functions is found in the work of Aupperle and colleagues [115]. Thus, we posit that these life skills are likely to be most helpful in environments or contexts that tend to strongly evoke emotional and physiological reactivity, such as: severe physical or social threat, interoceptive bodily contexts such as chronic pain, and chronic physical illnesses with a significant disease burden.


Goal-Directed Resilience in Training (GRIT): A Biopsychosocial Model of Self-Regulation, Executive Functions, and Personal Growth (Eudaimonia) in Evocative Contexts of PTSD, Obesity, and Chronic Pain.

Kent M, Rivers CT, Wrenn G - Behav Sci (Basel) (2015)

Three contexts of obstacles within which people practice their goal-directed adaptive actions. The obstacle, trauma, challenge become the ‘stage’ or backdrop for goal-directed action that is played out on stage. Experiences of engagement as in interest, curiosity, appreciation or of social relatedness as in empathy, compassion, helping are enacted on these stages where obstacles are the backdrop or scenery and not the main actors. The stages can be: internal or Intrapersonal and represent states of mind and emotions or interoceptive body states such as pain; or Interpersonal such as conflict with another person; or Social as exemplified by experiences with larger groups, the community, or culture.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4493448&req=5

behavsci-05-00264-f001: Three contexts of obstacles within which people practice their goal-directed adaptive actions. The obstacle, trauma, challenge become the ‘stage’ or backdrop for goal-directed action that is played out on stage. Experiences of engagement as in interest, curiosity, appreciation or of social relatedness as in empathy, compassion, helping are enacted on these stages where obstacles are the backdrop or scenery and not the main actors. The stages can be: internal or Intrapersonal and represent states of mind and emotions or interoceptive body states such as pain; or Interpersonal such as conflict with another person; or Social as exemplified by experiences with larger groups, the community, or culture.
Mentions: Through simulation activities, we sought to simulate adaptive responding (see Figure 1. We have dubbed the adaptive survival themes from the qualitative analysis as ‘life skills’ for the intervention. These skills are expected to be useful in challenging contexts because of: (a) their prospective, goal-directed qualities; (b) their independence from threatening context; and (c) the positive, affirming emotions accompanying them. Evidence suggests that these life skills activate prospective goal-directed cortical mechanisms and executive functions, while supporting deactivation of stress functions at cortical, endocrine, and physiological levels [14,114]. The effect is prospective goal-directed action and affective engagement that has an ameliorative effect on stress. Supporting work for disengagement of PTSD symptoms from executive functions is found in the work of Aupperle and colleagues [115]. Thus, we posit that these life skills are likely to be most helpful in environments or contexts that tend to strongly evoke emotional and physiological reactivity, such as: severe physical or social threat, interoceptive bodily contexts such as chronic pain, and chronic physical illnesses with a significant disease burden.

Bottom Line: Existing models of attention, cognition, and physiology were sourced in combination with qualitative study findings in developing this resilience skills intervention.We used qualitative methods to uncover life skills that are most salient in cases of extreme adversity, finding that goal-directed actions that reflected an individual's values and common humanity with others created a context-independent domain that could compensate for the effects of adversity.Feasibility studies for groups with comorbid diagnoses, such as chronic pain and PTSD, also showed positive results, leading to the application of the GRIT intervention to other evocative contexts such as obesity and chronic pain.

View Article: PubMed Central - PubMed

Affiliation: Research Department R151, Phoenix VA Health Care System, 650 E. Indian School Rd., Phoenix, AZ 85012, USA. market@ix.netcom.com.

ABSTRACT
This paper presents a biopsychosocial model of self-regulation, executive functions, and personal growth that we have applied to Goal-Directed Resilience in Training (GRIT) interventions for posttraumatic stress disorder (PTSD), obesity, and chronic pain. Implications of the training for the prevention of maladaptation, including psychological distress and health declines, and for promoting healthy development are addressed. Existing models of attention, cognition, and physiology were sourced in combination with qualitative study findings in developing this resilience skills intervention. We used qualitative methods to uncover life skills that are most salient in cases of extreme adversity, finding that goal-directed actions that reflected an individual's values and common humanity with others created a context-independent domain that could compensate for the effects of adversity. The efficacy of the resilience skills intervention for promoting positive emotion, enhancing neurocognitive capacities, and reducing symptoms was investigated in a randomized controlled trial with a veteran population diagnosed with PTSD. The intervention had low attrition (8%) and demonstrated improvement on symptom and wellbeing outcomes, indicating that the intervention may be efficacious for PTSD and that it taps into those mechanisms which the intervention was designed to address. Feasibility studies for groups with comorbid diagnoses, such as chronic pain and PTSD, also showed positive results, leading to the application of the GRIT intervention to other evocative contexts such as obesity and chronic pain.

No MeSH data available.


Related in: MedlinePlus