Jeremy Stout - Academia.edu (original) (raw)
Papers by Jeremy Stout
Bulletin of The Menninger Clinic, Jun 1, 2017
An estimated 18.5% of veterans returning from Operation Iraqi Freedom, Operation Enduring Freedom... more An estimated 18.5% of veterans returning from Operation Iraqi Freedom, Operation Enduring Freedom, and Operation New Dawn are suffering from posttraumatic stress or posttraumatic stress disorder (PTSD). The number of veterans and service duty personnel requesting VA health care services is increasing, and the VA's ability to handle requests is dwindling. Thus, both the content of interventions and the format by which these services are delivered need to be reconceptualized. The authors present a multicomponent intervention program known as Trauma Management Therapy (TMT), a comprehensive, empirically supported treatment that can be delivered in an intensive, 3-week outpatient format. TMT combines individual exposure therapy with group social and emotional rehabilitation skills training to address specific aspects of the combat-related PTSD syndrome.
A comprehensive sleep assessment of 45 firefighters was conducted over 9-days in an effort to det... more A comprehensive sleep assessment of 45 firefighters was conducted over 9-days in an effort to determine the impact of their 24 hour work and 48 hour off work schedule on their sleep duration, sleep quality, processing speed, sustained attention, vigilance, and mental health. Chronic patterns of poor sleep are associated with an increased likelihood of performing poorly on tasks that require processing speed and sustained attention/vigilance which could lead to firefighters' suboptimal work performance or an increased risk of injury. Firefighters completed sleep actigraphy, self-report measures, as well as neuropsychological sub-tests at their beginning of their shift and immediately at the end of their work shift. As measured by actigraphy, firefighters in this sample slept an average of 5 hours and 20.99 minutes at work, which was significantly less than was found in a large sample of U.S. working adults. Firefighters endorsed poor sleep efficiency and poor sleep quality as assessed by self-report and objective actigraphy. One limitation is that only 12 of the 45 firefighters endorsed responding to a nighttime call during the work night that occurred between the two neuropsychological assessments. Comparing changes in neuropsychological performance between firefighters who had disrupted sleep compared to firefighters who did not, significant performances decrements were evident only for the psychomotor vigilance test (PVT) reaction time. If confirmed with a larger sample, the results suggest that reaction time may be a sensitive indicator of decreasing cognitive performance because of sleep loss. Limitations, future study directions, and recommendations are discussed.
Military Psychology, Feb 9, 2017
The sleep characteristics of 37 military veterans and active-duty service members (17 with PTSD a... more The sleep characteristics of 37 military veterans and active-duty service members (17 with PTSD and 20 without PTSD) of recent wars were analyzed to determine if combat deployment, with its associated sleep restriction, may be an alternative explanation for the sleep complaints found among combat veterans with PTSD (as determined by PTSD Checklist Military Version scores). Over a 1-week period, sleep data were collected using sleep actigraphy and self-report. Across the entire sample, subjective and objective assessment methods of sleep were strongly correlated, although there were some notable within-group differences. Specifically, although sleep duration between groups did not differ based on actigraphy, veterans without PTSD reported sleeping 1 h and 11 min (p ϭ .002) longer than did veterans with PTSD. In an effort to determine why individuals without PTSD might be overreporting sleep, we found that symptoms of emotional arousal (anger, anxiety, and nightmares) were significantly correlated with self-reported sleep duration, suggesting a pattern of higher autonomic arousal found in veterans with PTSD. Thus, although sleeping for 6 h, the higher levels of emotional arousal reported by veterans with PTSD may mean that they do not perceive their sleep as restful. Further research is necessary to determine if the sleep architecture of veterans with PTSD is actually different from that of combat veterans without PTSD and if such differences are actually amenable to standard behavioral treatments for this disorder.
Journal of Anxiety Disorders, May 1, 2013
Veterans of Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) are presenting wit... more Veterans of Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) are presenting with high rates of co-occurring posttraumatic stress disorder (PTSD) and traumatic brain injury (TBI). The purpose of this study was to compare the clinical presentations of combat-veterans with PTSD and TBI (N = 40) to those with PTSD only (N = 56). Results suggest that the groups present two distinct clinical profiles, with the PTSD + TBI group endorsing significantly higher PTSD scores, higher overall anxiety, and more functional limitations. The higher PTSD scores found for the PTSD + TBI group appeared to be due to higher symptom intensity, but not higher frequency, across PTSD clusters and symptoms. Groups did not differ on additional psychopathology or self-report of PTSD symptoms or executive functioning. Further analysis indicated PTSD severity, and not TBI, was responsible for group differences, suggesting that treatments implicated for PTSD would likely be effective for this population.
Journal of Health Psychology, Mar 4, 2020
Daytime performance can be affected by hours slept, time awake, disrupted sleep, and sleep inerti... more Daytime performance can be affected by hours slept, time awake, disrupted sleep, and sleep inertia or impairment in alertness level (Elliot and Kuehl, 2007). Within one sample of firefighters, screening positively for a sleep disorder was
The sleep characteristics of 37 military combat veterans (17 with PTSD and 20 without PTSD) of re... more The sleep characteristics of 37 military combat veterans (17 with PTSD and 20 without PTSD) of recent wars were analyzed to determine if combat deployment, with its resultant wartime sleep restriction, may be an alternative explanation for the sleep duration complaints found among combat veterans with PTSD (as determined by PCL-M scores). Participants completed sleep actigraphy and a self-report measure of sleep duration over a 1-week period. Although strongly correlated, a comparison of subjective (e.g., self-report) and objective (e.g., actigraphy) sleep duration revealed a significant difference in sleep duration based on method of assessment. With respect to group differences, actigraphy data did not reveal a significant difference in sleep duration based on the presence of PTSD, whereas there was a significant difference based on self-report. Veterans without PTSD self-reported a significantly longer sleep duration than what was recorded by actigraphy; a difference of one hour and 11 minutes (p = 0.000); the difference was one hour and nine minutes. In an effort to determine why veterans without PTSD perceived that they slept longer than they actually did, factors related to sleep quality were examined. The results indicated that measures of hyper arousal (anger, anxiety, nightmares) were significantly correlated with sleep duration, suggesting a pattern of autonomic arousal that is known to interfere with restful sleep. Further research is necessary to determine if the sleep of veteran with PTSD is actually different from that of combat veterans without PTSD, and if such differences are actually amenable to treatment for PTSD.
Bulletin of the Menninger Clinic, 2017
An estimated 18.5% of veterans returning from Operation Iraqi Freedom, Operation Enduring Freedom... more An estimated 18.5% of veterans returning from Operation Iraqi Freedom, Operation Enduring Freedom, and Operation New Dawn are suffering from posttraumatic stress or posttraumatic stress disorder (PTSD). The number of veterans and service duty personnel requesting VA health care services is increasing, and the VA's ability to handle requests is dwindling. Thus, both the content of interventions and the format by which these services are delivered need to be reconceptualized. The authors present a multicomponent intervention program known as Trauma Management Therapy (TMT), a comprehensive, empirically supported treatment that can be delivered in an intensive, 3-week outpatient format. TMT combines individual exposure therapy with group social and emotional rehabilitation skills training to address specific aspects of the combat-related PTSD syndrome. The authors present the format of this novel intensive outpatient program, describe the components, and address implementation fact...
Journal of Health Psychology, 2020
Firefighters are at risk for chronic sleep disruption due to their rotating 24-hour on and 48-hou... more Firefighters are at risk for chronic sleep disruption due to their rotating 24-hour on and 48-hour off work schedule and hazardous work conditions. Forty-five firefighters were assessed to determine the impact of their shift schedule on sleep duration, sleep quality, processing speed, sustained attention, vigilance, and mental health. Assessments were conducted at the start and end of shift. Firefighters endorsed sleeping 5 hours 21 minutes at work, and the results suggest that even minimal sleep disruption affected cognitive functioning (e.g. processing speed, visual-motor coordination, and reaction time), increasing the likelihood of poor work performance or injury.
Journal of Anxiety Disorders, 2013
Veterans of Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) are presenting wit... more Veterans of Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) are presenting with high rates of co-occurring posttraumatic stress disorder (PTSD) and traumatic brain injury (TBI). The purpose of this study was to compare the clinical presentations of combat-veterans with PTSD and TBI (N = 40) to those with PTSD only (N = 56). Results suggest that the groups present two distinct clinical profiles, with the PTSD + TBI group endorsing significantly higher PTSD scores, higher overall anxiety, and more functional limitations. The higher PTSD scores found for the PTSD + TBI group appeared to be due to higher symptom intensity, but not higher frequency, across PTSD clusters and symptoms. Groups did not differ on additional psychopathology or self-report of PTSD symptoms or executive functioning. Further analysis indicated PTSD severity, and not TBI, was responsible for group differences, suggesting that treatments implicated for PTSD would likely be effective for this population.
Military Psychology, 2017
The sleep characteristics of 37 military veterans and active-duty service members (17 with PTSD a... more The sleep characteristics of 37 military veterans and active-duty service members (17 with PTSD and 20 without PTSD) of recent wars were analyzed to determine if combat deployment, with its associated sleep restriction, may be an alternative explanation for the sleep complaints found among combat veterans with PTSD (as determined by PTSD Checklist Military Version scores). Over a 1-week period, sleep data were collected using sleep actigraphy and self-report. Across the entire sample, subjective and objective assessment methods of sleep were strongly correlated, although there were some notable within-group differences. Specifically, although sleep duration between groups did not differ based on actigraphy, veterans without PTSD reported sleeping 1 h and 11 min (p ϭ .002) longer than did veterans with PTSD. In an effort to determine why individuals without PTSD might be overreporting sleep, we found that symptoms of emotional arousal (anger, anxiety, and nightmares) were significantly correlated with self-reported sleep duration, suggesting a pattern of higher autonomic arousal found in veterans with PTSD. Thus, although sleeping for 6 h, the higher levels of emotional arousal reported by veterans with PTSD may mean that they do not perceive their sleep as restful. Further research is necessary to determine if the sleep architecture of veterans with PTSD is actually different from that of combat veterans without PTSD and if such differences are actually amenable to standard behavioral treatments for this disorder.
Journal of Anxiety Disorders, 2013
Veterans of Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) are presenting wit... more Veterans of Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) are presenting with high rates of co-occurring posttraumatic stress disorder (PTSD) and traumatic brain injury (TBI). The purpose of this study was to compare the clinical presentations of combat-veterans with PTSD and TBI (N = 40) to those with PTSD only (N = 56). Results suggest that the groups present two distinct clinical profiles, with the PTSD + TBI group endorsing significantly higher PTSD scores, higher overall anxiety, and more functional limitations. The higher PTSD scores found for the PTSD + TBI group appeared to be due to higher symptom intensity, but not higher frequency, across PTSD clusters and symptoms. Groups did not differ on additional psychopathology or self-report of PTSD symptoms or executive functioning. Further analysis indicated PTSD severity, and not TBI, was responsible for group differences, suggesting that treatments implicated for PTSD would likely be effective for this population.
Bulletin of The Menninger Clinic, Jun 1, 2017
An estimated 18.5% of veterans returning from Operation Iraqi Freedom, Operation Enduring Freedom... more An estimated 18.5% of veterans returning from Operation Iraqi Freedom, Operation Enduring Freedom, and Operation New Dawn are suffering from posttraumatic stress or posttraumatic stress disorder (PTSD). The number of veterans and service duty personnel requesting VA health care services is increasing, and the VA's ability to handle requests is dwindling. Thus, both the content of interventions and the format by which these services are delivered need to be reconceptualized. The authors present a multicomponent intervention program known as Trauma Management Therapy (TMT), a comprehensive, empirically supported treatment that can be delivered in an intensive, 3-week outpatient format. TMT combines individual exposure therapy with group social and emotional rehabilitation skills training to address specific aspects of the combat-related PTSD syndrome.
A comprehensive sleep assessment of 45 firefighters was conducted over 9-days in an effort to det... more A comprehensive sleep assessment of 45 firefighters was conducted over 9-days in an effort to determine the impact of their 24 hour work and 48 hour off work schedule on their sleep duration, sleep quality, processing speed, sustained attention, vigilance, and mental health. Chronic patterns of poor sleep are associated with an increased likelihood of performing poorly on tasks that require processing speed and sustained attention/vigilance which could lead to firefighters' suboptimal work performance or an increased risk of injury. Firefighters completed sleep actigraphy, self-report measures, as well as neuropsychological sub-tests at their beginning of their shift and immediately at the end of their work shift. As measured by actigraphy, firefighters in this sample slept an average of 5 hours and 20.99 minutes at work, which was significantly less than was found in a large sample of U.S. working adults. Firefighters endorsed poor sleep efficiency and poor sleep quality as assessed by self-report and objective actigraphy. One limitation is that only 12 of the 45 firefighters endorsed responding to a nighttime call during the work night that occurred between the two neuropsychological assessments. Comparing changes in neuropsychological performance between firefighters who had disrupted sleep compared to firefighters who did not, significant performances decrements were evident only for the psychomotor vigilance test (PVT) reaction time. If confirmed with a larger sample, the results suggest that reaction time may be a sensitive indicator of decreasing cognitive performance because of sleep loss. Limitations, future study directions, and recommendations are discussed.
Military Psychology, Feb 9, 2017
The sleep characteristics of 37 military veterans and active-duty service members (17 with PTSD a... more The sleep characteristics of 37 military veterans and active-duty service members (17 with PTSD and 20 without PTSD) of recent wars were analyzed to determine if combat deployment, with its associated sleep restriction, may be an alternative explanation for the sleep complaints found among combat veterans with PTSD (as determined by PTSD Checklist Military Version scores). Over a 1-week period, sleep data were collected using sleep actigraphy and self-report. Across the entire sample, subjective and objective assessment methods of sleep were strongly correlated, although there were some notable within-group differences. Specifically, although sleep duration between groups did not differ based on actigraphy, veterans without PTSD reported sleeping 1 h and 11 min (p ϭ .002) longer than did veterans with PTSD. In an effort to determine why individuals without PTSD might be overreporting sleep, we found that symptoms of emotional arousal (anger, anxiety, and nightmares) were significantly correlated with self-reported sleep duration, suggesting a pattern of higher autonomic arousal found in veterans with PTSD. Thus, although sleeping for 6 h, the higher levels of emotional arousal reported by veterans with PTSD may mean that they do not perceive their sleep as restful. Further research is necessary to determine if the sleep architecture of veterans with PTSD is actually different from that of combat veterans without PTSD and if such differences are actually amenable to standard behavioral treatments for this disorder.
Journal of Anxiety Disorders, May 1, 2013
Veterans of Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) are presenting wit... more Veterans of Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) are presenting with high rates of co-occurring posttraumatic stress disorder (PTSD) and traumatic brain injury (TBI). The purpose of this study was to compare the clinical presentations of combat-veterans with PTSD and TBI (N = 40) to those with PTSD only (N = 56). Results suggest that the groups present two distinct clinical profiles, with the PTSD + TBI group endorsing significantly higher PTSD scores, higher overall anxiety, and more functional limitations. The higher PTSD scores found for the PTSD + TBI group appeared to be due to higher symptom intensity, but not higher frequency, across PTSD clusters and symptoms. Groups did not differ on additional psychopathology or self-report of PTSD symptoms or executive functioning. Further analysis indicated PTSD severity, and not TBI, was responsible for group differences, suggesting that treatments implicated for PTSD would likely be effective for this population.
Journal of Health Psychology, Mar 4, 2020
Daytime performance can be affected by hours slept, time awake, disrupted sleep, and sleep inerti... more Daytime performance can be affected by hours slept, time awake, disrupted sleep, and sleep inertia or impairment in alertness level (Elliot and Kuehl, 2007). Within one sample of firefighters, screening positively for a sleep disorder was
The sleep characteristics of 37 military combat veterans (17 with PTSD and 20 without PTSD) of re... more The sleep characteristics of 37 military combat veterans (17 with PTSD and 20 without PTSD) of recent wars were analyzed to determine if combat deployment, with its resultant wartime sleep restriction, may be an alternative explanation for the sleep duration complaints found among combat veterans with PTSD (as determined by PCL-M scores). Participants completed sleep actigraphy and a self-report measure of sleep duration over a 1-week period. Although strongly correlated, a comparison of subjective (e.g., self-report) and objective (e.g., actigraphy) sleep duration revealed a significant difference in sleep duration based on method of assessment. With respect to group differences, actigraphy data did not reveal a significant difference in sleep duration based on the presence of PTSD, whereas there was a significant difference based on self-report. Veterans without PTSD self-reported a significantly longer sleep duration than what was recorded by actigraphy; a difference of one hour and 11 minutes (p = 0.000); the difference was one hour and nine minutes. In an effort to determine why veterans without PTSD perceived that they slept longer than they actually did, factors related to sleep quality were examined. The results indicated that measures of hyper arousal (anger, anxiety, nightmares) were significantly correlated with sleep duration, suggesting a pattern of autonomic arousal that is known to interfere with restful sleep. Further research is necessary to determine if the sleep of veteran with PTSD is actually different from that of combat veterans without PTSD, and if such differences are actually amenable to treatment for PTSD.
Bulletin of the Menninger Clinic, 2017
An estimated 18.5% of veterans returning from Operation Iraqi Freedom, Operation Enduring Freedom... more An estimated 18.5% of veterans returning from Operation Iraqi Freedom, Operation Enduring Freedom, and Operation New Dawn are suffering from posttraumatic stress or posttraumatic stress disorder (PTSD). The number of veterans and service duty personnel requesting VA health care services is increasing, and the VA's ability to handle requests is dwindling. Thus, both the content of interventions and the format by which these services are delivered need to be reconceptualized. The authors present a multicomponent intervention program known as Trauma Management Therapy (TMT), a comprehensive, empirically supported treatment that can be delivered in an intensive, 3-week outpatient format. TMT combines individual exposure therapy with group social and emotional rehabilitation skills training to address specific aspects of the combat-related PTSD syndrome. The authors present the format of this novel intensive outpatient program, describe the components, and address implementation fact...
Journal of Health Psychology, 2020
Firefighters are at risk for chronic sleep disruption due to their rotating 24-hour on and 48-hou... more Firefighters are at risk for chronic sleep disruption due to their rotating 24-hour on and 48-hour off work schedule and hazardous work conditions. Forty-five firefighters were assessed to determine the impact of their shift schedule on sleep duration, sleep quality, processing speed, sustained attention, vigilance, and mental health. Assessments were conducted at the start and end of shift. Firefighters endorsed sleeping 5 hours 21 minutes at work, and the results suggest that even minimal sleep disruption affected cognitive functioning (e.g. processing speed, visual-motor coordination, and reaction time), increasing the likelihood of poor work performance or injury.
Journal of Anxiety Disorders, 2013
Veterans of Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) are presenting wit... more Veterans of Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) are presenting with high rates of co-occurring posttraumatic stress disorder (PTSD) and traumatic brain injury (TBI). The purpose of this study was to compare the clinical presentations of combat-veterans with PTSD and TBI (N = 40) to those with PTSD only (N = 56). Results suggest that the groups present two distinct clinical profiles, with the PTSD + TBI group endorsing significantly higher PTSD scores, higher overall anxiety, and more functional limitations. The higher PTSD scores found for the PTSD + TBI group appeared to be due to higher symptom intensity, but not higher frequency, across PTSD clusters and symptoms. Groups did not differ on additional psychopathology or self-report of PTSD symptoms or executive functioning. Further analysis indicated PTSD severity, and not TBI, was responsible for group differences, suggesting that treatments implicated for PTSD would likely be effective for this population.
Military Psychology, 2017
The sleep characteristics of 37 military veterans and active-duty service members (17 with PTSD a... more The sleep characteristics of 37 military veterans and active-duty service members (17 with PTSD and 20 without PTSD) of recent wars were analyzed to determine if combat deployment, with its associated sleep restriction, may be an alternative explanation for the sleep complaints found among combat veterans with PTSD (as determined by PTSD Checklist Military Version scores). Over a 1-week period, sleep data were collected using sleep actigraphy and self-report. Across the entire sample, subjective and objective assessment methods of sleep were strongly correlated, although there were some notable within-group differences. Specifically, although sleep duration between groups did not differ based on actigraphy, veterans without PTSD reported sleeping 1 h and 11 min (p ϭ .002) longer than did veterans with PTSD. In an effort to determine why individuals without PTSD might be overreporting sleep, we found that symptoms of emotional arousal (anger, anxiety, and nightmares) were significantly correlated with self-reported sleep duration, suggesting a pattern of higher autonomic arousal found in veterans with PTSD. Thus, although sleeping for 6 h, the higher levels of emotional arousal reported by veterans with PTSD may mean that they do not perceive their sleep as restful. Further research is necessary to determine if the sleep architecture of veterans with PTSD is actually different from that of combat veterans without PTSD and if such differences are actually amenable to standard behavioral treatments for this disorder.
Journal of Anxiety Disorders, 2013
Veterans of Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) are presenting wit... more Veterans of Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) are presenting with high rates of co-occurring posttraumatic stress disorder (PTSD) and traumatic brain injury (TBI). The purpose of this study was to compare the clinical presentations of combat-veterans with PTSD and TBI (N = 40) to those with PTSD only (N = 56). Results suggest that the groups present two distinct clinical profiles, with the PTSD + TBI group endorsing significantly higher PTSD scores, higher overall anxiety, and more functional limitations. The higher PTSD scores found for the PTSD + TBI group appeared to be due to higher symptom intensity, but not higher frequency, across PTSD clusters and symptoms. Groups did not differ on additional psychopathology or self-report of PTSD symptoms or executive functioning. Further analysis indicated PTSD severity, and not TBI, was responsible for group differences, suggesting that treatments implicated for PTSD would likely be effective for this population.