The purpose of this study was to analyze the effectiveness of acceptance and commitment therapy (ACT) in a group setting for 8 weeks on the symptoms of posttraumatic stress disorder (PTSD) for women diagnosed with PTSD due to childhood trauma who have not served in the military. ACT was developed using contextualism with relational frame theory being the foundation for contextualism. Women diagnosed with PTSD due to childhood trauma were found to have higher rates of attempted suicide, higher rates of mental health disorders, as well as higher rates of medical disorders than those who were not diagnosed with PTSD. The PTSD symptoms were measured using the PTSD checklist-civilian (PCL-C). The PCL-C was completed during Session 1 and Session 8 of ACT group therapy. There was a total of 24 PCL-C score sheets utilized for this study and only the score sheets of women diagnosed with PTSD due to childhood trauma who did not have a thought disorder were included. The research design was considered a pre-experimental design and the statistical design used was ANOVA with repeated measures using subject x trials. Cohen's estimate of small effect size was used. Secondary data analysis was conducted using archival data from a community mental health agency. According to the statistical measure of the repeated ANOVA the null hypothesis was rejected as there was sufficient evidence to support that using ACT in a group setting for 8 weeks can decrease PTSD symptoms as measured by the PCL-C. This study contributes to social change by decreasing symptoms of PTSD, therefore decreasing suicidal thoughts, as well as behaviors, and lead to an increase in overall functioning and prosocial behaviors.

Abstract BACKGROUND: The PTSD Checklist-civilian (PCL-C) is one of the most commonly used self-report measures of PTSD symptoms, however, little is known about its validity when used in pregnancy. This study aims to evaluate the reliability and validity of the PCL-C as a screen for detecting PTSD symptoms among pregnant women. METHODS: A total of 3372 pregnant women who attended their first prenatal care visit in Lima, Peru participated in the study. We assessed the reliability of the PCL-C items using Cronbach's alpha. Criterion validity and performance characteristics of PCL-C were assessed against an independent, blinded Clinician-Administered PTSD Scale (CAPS) interview using measures of sensitivity, specificity and receiver operating characteristics (ROC) curves. We tested construct validity using exploratory and confirmatory factor analytic approaches. RESULTS: The reliability of the PCL-C was excellent (Cronbach's alpha =0.90). ROC analysis showed that a cut-off score of 26 offered optimal discriminatory power, with a sensitivity of 0.86 (95% CI: 0.78-0.92) and a specificity of 0.63 (95% CI: 0.62-0.65). The area under the ROC curve was 0.75 (95% CI: 0.71-0.78). A three-factor solution was extracted using exploratory factor analysis and was further complemented with three other models using confirmatory factor analysis (CFA). In a CFA, a three-factor model based on DSM-IV symptom structure had reasonable fit statistics with comparative fit index of 0.86 and root mean square error of approximation of 0.09. CONCLUSION: The Spanish-language version of the PCL-C may be used as a screening tool for pregnant women. The PCL-C has good reliability, criterion validity and factorial validity. The optimal cut-off score obtained by maximizing the sensitivity and specificity should be considered cautiously; women who screened positive may require further investigation to confirm PTSD diagnosis. / Revisión por pares