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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

Schematic representation of goal-directed actions transforming stimulus-based responding. These two basic modes of interacting with the environment become visible in extreme situations where adaptive responses are goal-directed actions and trauma is expressed as stimulus based reaction. During resilience training, goal-directed actions are taken into past experiences of trauma, as indicated by the prominent forward arrow leading from the goal-directed pole to stimulus-based pole as experienced in trauma. The transformation is brought about by the qualities of goal-directed action: the person is an actor rather than reactor or object being acted upon by the environment, the action is independent of the environment, and the person changes how he/she experiences the environment or changes the environment itself. In this way, the person no longer is reactive to the environment, is no longer changed by the environment but is an agent, goal-directed in his/her actions, and affects changes related to the environment, as indicated by the reverse arrow.
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behavsci-05-00264-f002: Schematic representation of goal-directed actions transforming stimulus-based responding. These two basic modes of interacting with the environment become visible in extreme situations where adaptive responses are goal-directed actions and trauma is expressed as stimulus based reaction. During resilience training, goal-directed actions are taken into past experiences of trauma, as indicated by the prominent forward arrow leading from the goal-directed pole to stimulus-based pole as experienced in trauma. The transformation is brought about by the qualities of goal-directed action: the person is an actor rather than reactor or object being acted upon by the environment, the action is independent of the environment, and the person changes how he/she experiences the environment or changes the environment itself. In this way, the person no longer is reactive to the environment, is no longer changed by the environment but is an agent, goal-directed in his/her actions, and affects changes related to the environment, as indicated by the reverse arrow.

Mentions: In the above exercise, participants complete the above stage simulation with examples from their own lives. For example, an explosion in a market in Baghdad is the stage or scenery and selling toys on the sidewalk from a childhood is the action in the Baghdad scenery. Participants are also provided with readings that illustrate challenges and responses in the intrapersonal context, the interpersonal context, and the context of the social environment. For example, Helen Keller is identified as someone responding to the intrapersonal physical context of impairments in hearing, vision, and speech. For her these had severe consequences until she learned the goal-directed skill of signing and communicating. Rosa Parks is someone who faced the external social environment of threats from racial discriminatory practices. Both individuals created opportunities for their development out of and despite the barriers in these different contexts. The transformation of stimulus-based responding to goal-directed action is summarized in Figure 2 below.


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)

Schematic representation of goal-directed actions transforming stimulus-based responding. These two basic modes of interacting with the environment become visible in extreme situations where adaptive responses are goal-directed actions and trauma is expressed as stimulus based reaction. During resilience training, goal-directed actions are taken into past experiences of trauma, as indicated by the prominent forward arrow leading from the goal-directed pole to stimulus-based pole as experienced in trauma. The transformation is brought about by the qualities of goal-directed action: the person is an actor rather than reactor or object being acted upon by the environment, the action is independent of the environment, and the person changes how he/she experiences the environment or changes the environment itself. In this way, the person no longer is reactive to the environment, is no longer changed by the environment but is an agent, goal-directed in his/her actions, and affects changes related to the environment, as indicated by the reverse arrow.
© Copyright Policy
Related In: Results  -  Collection

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

behavsci-05-00264-f002: Schematic representation of goal-directed actions transforming stimulus-based responding. These two basic modes of interacting with the environment become visible in extreme situations where adaptive responses are goal-directed actions and trauma is expressed as stimulus based reaction. During resilience training, goal-directed actions are taken into past experiences of trauma, as indicated by the prominent forward arrow leading from the goal-directed pole to stimulus-based pole as experienced in trauma. The transformation is brought about by the qualities of goal-directed action: the person is an actor rather than reactor or object being acted upon by the environment, the action is independent of the environment, and the person changes how he/she experiences the environment or changes the environment itself. In this way, the person no longer is reactive to the environment, is no longer changed by the environment but is an agent, goal-directed in his/her actions, and affects changes related to the environment, as indicated by the reverse arrow.
Mentions: In the above exercise, participants complete the above stage simulation with examples from their own lives. For example, an explosion in a market in Baghdad is the stage or scenery and selling toys on the sidewalk from a childhood is the action in the Baghdad scenery. Participants are also provided with readings that illustrate challenges and responses in the intrapersonal context, the interpersonal context, and the context of the social environment. For example, Helen Keller is identified as someone responding to the intrapersonal physical context of impairments in hearing, vision, and speech. For her these had severe consequences until she learned the goal-directed skill of signing and communicating. Rosa Parks is someone who faced the external social environment of threats from racial discriminatory practices. Both individuals created opportunities for their development out of and despite the barriers in these different contexts. The transformation of stimulus-based responding to goal-directed action is summarized in Figure 2 below.

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