Running head: LOCUS OF CONTROL AND TREATMENT PREFERENCE

Locus of Control and Treatment Preference for PTSD

Rachel Millan, Ashley Monic, and Hsin-san Lin
Wesleyan College

LOCUS OF CONTROL AND TREATMENT PREFERENCE

Abstract
Post-Traumatic Stress Disorder (PTSD) is a mental illness that affects veterans and civilians
alike. Determining and understanding the correlation between perceived efficacy and treatment
preference mediated by locus of control and self efficacy is an important area in need of further
research. A sample of participants (N=75) received information about psychotherapy and
pharmacotherapy and then filled out a survey rating their self efficacy, locus of control,
perceived efficacy of the treatments, and their treatment preference. Those with low self efficacy
more highly preferred psychotherapy than pharmacotherapy. No significant relationship was
found with locus of control.

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Perceived Efficacy and Treatment Preference for Veterans with PTSD

Post-Traumatic Stress Disorder (PTSD) is a complex disorder that affects around 8% of
the U.S. general population at some point during their lives, with women being twice as likely as
men to develop the disorder (Antai-Otong, 2007). Female sexual assault survivors and male
combat veterans are the most frequently studied PTSD samples (Cooper, Carty, Creamer, 2005).
Symptoms of PTSD are marked by hyperarousal, nightmares, feelings of shame and guilt, and
the disorder is often comorbid with other illnesses including anxiety and depression. Although
there is not a unified consensus, psychotherapy is commonly recommended as the first line
treatment of PTSD, and despite the frequent use of drug therapy its efficacy is debated (Jeffreys,
Capehart & Friedman, 2012; Mott, Barrera, Hernandez, Graham & Teng, 2014; Reger et al.,
2013).
The most commonly utilized psychotherapies for PTSD are Cognitive Processing
Therapy (CPT) and Prolonged Exposure Therapy (PE) (Mott et al., 2014; Reger et al., 2013).
They are talk-based, trauma-focused, therapist led sessions conducted in a one-on-one setting or
as part of a group. CPT works to correct inconsistent cognitions that cause distress, such as a
woman fearing an attack in a relatively safe environment. CPT is grounded in empirical evidence
and is a primary route of PTSD therapy because it focuses on the management of a range of
emotions, which in turn contributes to the healing of comorbid disorders that PTSD sufferers
often experience (Chard, Schumm, Owens & Cottingham, 2010; Monson et al., 2006). The goal
of PE is to cease restrictive thoughts of trauma that interfere with daily life. This is completed
through sessions of repeated trauma exposure; the idea is that if the traumatic thoughts are

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confronted enough they will no longer have power over the individual (Kehle-Forbes, Polusny,
Erbes, Gerould, 2014; Reger et al., 2013). PE is one of the most frequently used PTSD therapies
because of its demonstrated effectiveness for a wide range of populations, including civilians and
combat veterans (Reger et al., 2013).
Pharmacotherapy is prescription medicine therapy. Generally, after an evaluation a
psychiatrist prescribes medication to the patient and they occasionally come in for a check-up to
monitor their status. Medications are taken daily and take a few weeks for the patient to feel any
effect. The exact mechanisms of these medications are unclear. Selective Serotonin Reuptake
Inhibitors (SSRIs) are considered the first line pharmacotherapy treatment for PTSD, among
them sertraline and praxotine are the only two US Food and Drug Administration (FDA)
approved medications for PTSD (Antai-Otong, 2007; Seedat, Stein, Carey, 2005). The core
symptoms that these medications work to affect are re-experiencing, avoidance, and hyperarousal
(Antai-Otong, 2007; Kobayashi, Patel, Lotito, 2015). SSRIs have demonstrated their
effectiveness on these core symptoms in recent randomized controlled studies that used large
samples of women with chronic PTSD (Seedat et al., 2005). Gender has been indicated to
mediate the effects of SSRIs in favor of women (Cooper et al., 2005; Seedat et al., 2005).
Some commonly cited reasons for choosing and/or maintaining pharmacotherapy is its
discreet nature, lower time commitment, and its ease of access and availability (Mott et al., 2014;
Reger et al., 2013). However, the most commonly known reason for choosing an alternative to
pharmacotherapy is the potential for side effects and risk of dependence (Mott et al., 2014; Reger
et al., 2014). Interestingly, even though pharmacotherapy for PTSD is widely disseminated,
medication-only treatment is not considered to be curative for the disorder; the original

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symptoms can return with the cessation of medication (Cooper et al., 2005). The combination of
pharmacotherapy and psychotherapy can give patients a better chance at maintaining
improvement than using a single intervention, though the literature is inconsistent (Cooper et al.,
2005; Jeffreys et al., 2012; Mott et al., 2014)
Perception of control is a core aspect of treatment choice for some people with PTSD.
The perception of control can influence how a particular person views, reacts to, and copes with
a traumatic event. An individuals perception of control can be characterized by their locus of
control (LOC), whether it is internal or external. LOC identifies a persons belief about how in
control they are of their own life. A person with an internal LOC believes that they possess the
power to change their circumstances. Conversely, someone with an external LOC feels that
outside forces determine their fate and they have relatively little power to change that. Multiple
studies have shown a correlation between external LOC and psychological distress associated
with trauma, and that this relationship may be moderated by type of trauma and frequency of
exposure (Brown, 2002; Cheng, Cheung, Chio, Chan, 2013).
Reger et al. (2013) cited previous research that associated a soldiers belief of the cause
of their PTSD symptoms with their preferred treatment. Soldiers who believed combat exposure
(external events) caused their PTSD symptoms were more likely to select a treatment that
utilized external mechanisms (exposure-based therapy) rather than pharmacotherapy that
centered on biological (internal) aspects (Reger et al., 2013).
There is evidence to suggest that psychotherapy would be more beneficial to someone
with an internal LOC because it requires the patient to be active in therapy, rather than a passive
recipient of medication. Goodson and colleagues (2013) study of 84 Operation Iraqi Freedom

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(OIF) and Operation Enduring Freedom (OEF) participants found that veterans who were
prescribed medication reported less symptom reduction than those who were not prescribed
medication. The proposed reasoning suggested that the symptom reduction that did occur might
have been attributed to the medicine itself, not the veterans belief in their increased ability to
manage their symptoms.
A similar finding occurred in a Swiss study of 49 civilian outpatients participating in
cognitive-behavioral therapy (Delsignore, Carraro, Mathier, Znoj & Schnyder, 2008). Some
participants failed to maintain therapeutic gains when the trial ended. Those patients scored high
on a scale of external LOC (Delsignore et al., 2008). The patients who delegated the success of
therapy to their therapist may have attributed the gains they made to the therapist, not their own
ability, thereby negatively impacting their self-efficacy and accounting for the loss of therapeutic
gains (Delsignore et al., 2008). Contrarily, patients who took responsibility for their therapy
outcome by becoming actively engaged maintained clinical improvement (Delsignore et al.,
2008).
Locus of control and self-efficacy are closely intertwined, and they both have a direct
impact on perceived etiology of a disorder, treatment preference, and maintenance of gains in
post therapy life. Whereas LOC is the perception of control that someone has over their life, selfefficacy is ones belief that they are capable of succeeding. Someone with high/strong selfefficacy believes that they can overcome a distressing event and they take the challenge head on.
A person with low/weak self-efficacy believes that they cannot succeed over the distressing event
and typically avoid any attempt at doing so. In both veteran and civilian populations self-efficacy
has been found to be negatively correlated with PTSD severity and prevalence (Blackburn &

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Owens, 2015; Galor & Hentschel, 2012; Hirschel & Schulenberg, 2009). High self-efficacy
serves as a protective barrier to PTSDs distressing symptoms and has been linked to
successfully managing PTSD outcomes (Blackburn & Owens, 2015; Galor & Hentschel, 2012).
An understanding of therapy mechanisms can contribute to the perceived efficacy of a
treatment which influences the treatment preference for those with PTSD. We hypothesize that
those with an internal LOC will be more likely to choose psychotherapy than pharmacotherapy
based on their belief of the therapys mechanism of efficacy and their own self-efficacy. If a
reliable relationship can be predicted between someones LOC and their best matched therapy it
would result in a reduction of wasted resources and delayed time in getting them the care that
they need.
Method
Participants
Participants of this study included 75 College students, faculty and staff. Participants
included 1 Male, 73 Females, and 1 individual who preferred not to answer about their gender;
ranging in age from 18 to 46. Of the participants, 32 were White, 7 were Hispanic or Latino, 10
were Black or African American, 17 were Asian or Pacific Islander, and 9 identified as a race or
ethnicity not listed. Four participants reported that they had been diagnosed with PTSD, and
fourteen participants had undergone some form of psychotherapy or pharmacotherapy prior to
the study.
Participants were recruited both by email and social media. A call for participants was
emailed to the students and staff of a small liberal arts women's college in the Southeastern
United States. Additionally those conducting the study posted the same call on Facebook. All
participants in this study were volunteers. Participants were offered the choice of extra credit in
participating classes, or the chance to win a $15.00 Starbucks gift card.
Materials
Each participant was presented with a short vignette that asked them to imagine they had
been diagnosed with PTSD and were seeking help. They were given balanced information about

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both psychotherapy and pharmacotherapy including what the therapy is, how it works, and its
time commitment. The participants then completed a survey comprised of questions that asked
about their perceived treatment efficacy and treatment preference; the answer options were
formatted on a 5 point likert scale (1= strongly disagree, 5= strongly agree). The questions used
were adopted from Reger et al.s Treatment Reactions Scale (2013; Cronbachs alpha of .95) that
was constructed for similar purposes. In order to preserve validity we only slightly modified the
scale. In most cases we omitted a military reference and if necessary added the civilian
equivalent. An example of a modified question is I would tell my buddies coming home from
deployment about this treatment was changed to I would tell my buddies about this treatment
(Reger et al., 2013). The participants completed the Modified Treatment Scale for both
psychotherapy and pharmacotherapy. The participants then filled out a 10-item Locus of Control
scale to determine their perception of control (Paulhus, 1983). Lastly, the participants filled out
the 10-item Generalized Self-efficacy scale which was used to assess their belief that their
actions are responsible for successful outcomes (Schwarzer & Jerusalem, 1995).
Design and Procedure
This study used a modified correlational research design, which investigated the
relationship between locus of control, self-efficacy, and preference in psychological treatment.
LOC and SE score were treated as subject variables after being subjected to a median split during
our analysis.
The entire study was conducted online. After completing their informed consent,
participants were asked to follow a link to the actual survey. Participants were asked a series of
demographic questions, which included if they had ever been a member of the military or if they

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had undergone either of the two therapies we were investigating. The next page of the survey
contained a Locus of Control Scale (Paulhus, 1983) with instructions to complete it, that stated
that there were no right or wrong answers. After completing the measure of locus of control,
participants were then asked to complete the Generalized Self-efficacy scale, measuring their
level of self efficacy, once again stating that there are no right or wrong answers (Schwarzer &
Jerusalem, 1995).
The next section of the survey instructed the participant to read a small vignette and
imagine that they were three months out of a traumatic event, and seeking help. Below the
vignette were the descriptions of two forms of therapy, psychotherapy and pharmacotherapy.
Participants then proceeded to answer a treatment reaction scale that had been modified from
Reger et al.s Treatment Reactions Scale. Participants answered this scale twice, once for
psychotherapy and again for pharmacotherapy. After completing the questionnaires participants
were then directed to a page that contained the debriefing.
Results
Descriptive Results
Out of 87 surveys, 75 were used for data analysis and 12 were deleted because
participants did not complete the whole survey. Means and standard deviations for age, locus of
control, self-efficacy, psychotherapy treatment reaction, and pharmacotherapy treatment reaction
are presented in Table 1. The mean age of participants was 21 and most of the participants were
around this age. Also, the mean score of locus of control among participants was 46.89 out of 70,
higher than the median 35, indicating an internal locus of control among participants. Moreover,

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the mean of pharmacotherapy is higher than the mean of psychotherapy, indicated higher
preference for pharmacotherapy among participants. Figure 1 shows the frequency of
participants who have diagnosed PTSD before, participants who have undergone psychotherapy
treatment and pharmacotherapy treatment before, as well as participants who have been a
member of military. Most of participants have never diagnosed with PTSD, undergone either
psychotherapy or pharmacotherapy, and most of them have never been in military.
Main Results
To address the research question: whether or not people with an internal locus of control
will be more likely to choose psychotherapy than pharmacotherapy based on their belief of the
therapys mechanism of efficacy and their own self-efficacy, a pair of t-tests were conducted to
look at those subject variations on the two outcome measures. Before starting T-tests analysis,
median split was conducted on the two scales of locus of control and self-efficacy, and they were
considered as subject variables in current study. As the results showed, an independent-samples
t-test indicated that external locus of control was not significantly related to psychotherapy
treatment reaction (M= 68.97, SD= 21.90), t(73)= -1.20, p= .24, as well as pharmacotherapy (M=
89.74 , SD= 23.93 ), t(73)= .98 ,p= .33. There was also no significant relationship between
internal locus of control and psychotherapy treatment reaction(M=74.7, SD=19.39), or
pharmacotherapy (M=84.49, SD=22.68). Thus, there is no difference for locus of control between
two groups on scales. Furthermore, self-efficacy was not significantly correlated to the
preference of either pharmacotherapy treatment (M= 86.36 , SD= 25.77 ), t(73)= -.36 , p= .72.
However, lower score on self-efficacy was marginally significantly related to the preference of
psychotherapy treatment (M= 77.13 , SD= 16.89), t(72)= -1.95 , p= .055, which means

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participants who do not believe his or her ability of succeeding in specific thing or
accomplishing something will prefer to choose psychotherapy treatment. Notice that Levenes
test indicated unequal variance (F= 5.021, p= .028), so degrees of freedom were adjusted from
73 to 72.
Discussion
The aim of this study was to investigate how a person's locus of control and self efficacy
affected their treatment preference and perceived efficacy of treatment. We surveyed a sample of
participants about their own self efficacy and locus of control, as well as their reaction to both
psychotherapy and pharmacotherapy. The surveys were completed after the participants read a
short vignette asking them to imagine they had PTSD and were looking to seek therapy. We
expected that those with an internal locus of control and high self efficacy would prefer
psychotherapy rather than pharmacotherapy. Based on previous research we felt that those with
such characteristics would be drawn to the kind of therapy that they have some control over,
rather than being the passive recipient of medication.
However, we did not find such a relationship, thus our results did not support our
hypothesis. There was no relationship detected between locus of control and psychotherapy.
Contrary to our hypothesis, there was a marginally significant relationship between low self
efficacy and a preference for psychotherapy. This finding may suggest that those who do not
believe that they can achieve successful outcomes rely on the guidance and support of a therapist
in psychotherapy. It has been found that those who tend to place power in others may attribute
their therapeutic gains to the skills of the therapist, and that this attribution negatively affects the
patient's self efficacy (Delsignore et al., 2008).

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There were several limiting factors that our study faced. Our study had a smaller sample
size than is preferred. A larger sample size could have highlighted relationships that were too
small to be significant in our analyses. Having a larger more diverse sample would also increase
the external validity of our study and allow for its findings to be more generalizable. Our results
are inconsistent with much of the current research, an outcome that may be attributable to our
homogenous sample, and that our participants were simply asked to imagine themselves as
suffering from PTSD, and not actually afflicted by the disorder, after all, imagining having a
disorder is different from having it in the reality. Furthermore, since our study is only
representative of female participants from a small liberal arts women's college in the
Southeastern United States, the results are not generalizable to the general public. Interestingly,
given our large percentage of female participants (97.3%) it is surprising that that there was not a
stronger preference for psychotherapy. Previous research has shown that females, particularly
undergraduates, which our sample pool comes from, prefer exposure based therapies (Reger et
al., 2013). Perhaps, a persons treatment preference is affected by factors other than locus of
control and self-efficacy. Stigma attached to psychotherapy, for example, could be a potential
factor that affects a persons treatment choice. The labels attached to mental illness result in
publics stereotype of people with mental illness. (Corrigan, 2004) Since mental health services
are associated with mental illness, people thus avoid professional psychological help, and choose
a pharmacological approach instead. Lastly, a persons perception of locus of control could be
affected by his or her religious belief, which might be an extraneous variable that has impact on
our subjects.

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The findings of our study suggest that there may be relationships between the extent to
which an individual believes they can succeed and their preference in psychological treatment
for PTSD. Future studies could explore the multitude of reasons as to why individuals differ in
their belief of personal control, and how that can impact their preference of treatment. For
instance, a study could look at how an individual's religiosity could affect their treatment
preference, since those that score high on a measure of religiosity would believe in powerful
others (external LOC). Having firm beliefs in powerful others could affect their LOC and SE,
thus also affecting how they respond to a therapist and their course after therapy. Another area of
future study would be how individuals perceive side effects of the different types of therapies,
such as the risk of dependence, and how that affects preference. Additionally, most of the
literature that was examined dealt with PTSD that was caused by combat situations or sexual
assault, future studies could examine if there is a difference in treatment preference based on
difference in trauma from which the PTSD stems.
By knowing more about how individuals react to therapy, mental health professionals can
use this information to better suit the needs of their patients. For instance if our findings hold true
and individuals with low self efficacy prefer psychotherapy, then it would be beneficial to the
patient's long term success to work on building their sense of self efficacy during treatment so
that they can continue to make gains after discontinuing therapy. The goal of treatment should
be that individuals have the tools to cope with daily their life successfully. Being conscious
about how the patient might react to therapy from the start could be crucial to the quality of the
treatment that they receive and their outcome, and could streamline the process of getting an
individual the help they need.

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References
Antai-Otong, D. (2007). Pharmacologic Management of Posttraumatic Stress Disorder.
Perspectives In Psychiatric Care, 43(1), 55-59
Blackburn, L., & Owens, G. P. (2015). The effect of self efficacy and meaning in life on
posttraumatic stress disorder and depression severity among veterans.Journal Of Clinical
Psychology, 71(3), 219-228.
Brown, J. S. (2002). Incident-Related Stressors, Locus of Control, Coping, and Psychological
Distress Among Firefighters in Northern Ireland. Journal Of Traumatic Stress, 15(2),
161.

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15

Chard, K. M. (2010). A comparison of OEF and OIF veterans and Vietnam veterans receiving
cognitive processing therapy. Journal Of Traumatic Stress, 23(1), 25-32.
Cheng, C., Cheung, S., Chio, J. H., & Chan, M. S. (2013). Cultural meaning of perceived
control: A meta-analysis of locus of control and psychological symptoms across 18
cultural regions. Psychological Bulletin, 139(1), 152-188.
Cooper, J., Carty, J., & Creamer, M. (2005). Pharmacotherapy for posttraumatic stress disorder:
empirical review and clinical recommendations. Australian & New Zealand Journal Of
Psychiatry, 39(8), 674-682.
Corrigan, P. (2004). How Stigma Interferes with Mental Health Care. American Psychologists,
59(7), 614-625.
Delsignore, A., Carraro, G., Mathier, F., Znoj, H., & Schnyder, U. (2008). Perceived
responsibility for change as an outcome predictor in cognitive-behavioural group therapy.
British Journal of Clinical Psychology, 47(3), 281-293.
Galor, S., & Hentschel, U. (2012). Problem-solving tendencies, coping styles, and self-efficacy
among Israeli veterans diagnosed with PTSD and depression. Journal Of Loss &
Trauma, 17(6), 522-535.
Goodson, J. T., Lefkowitz, C. M., Helstrom, A. W., & Gawrysiak, M. J. (2013). Outcomes of
Prolonged Exposure therapy for veterans with posttraumatic stress disorder. Journal of
Traumatic Stress, 26(4), 419-425.

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16

Jeffreys, M., Capehart, B., & Friedman, M. J. (2012). Pharmacotherapy for posttraumatic stress
disorder: Review with clinical applications. Journal of Rehabilitation Research &
Development, 49(6), 703-715.
Hirschel, M. J., & Schulenberg, S. E. (2009). Hurricane Katrinas impact on the Mississippi Gulf
Coast: General self-efficacys relationship to PTSD prevalence and severity.
Psychological Services, 6(4), 293-303.
Kehle-Forbes, S. M., Polusny, M. A., Erbes, C. R., & Gerould, H. (2014). Acceptability of
prolonged exposure therapy among U.S. Iraq war veterans with PTSD
symptomology. Journal of Traumatic Stress, 27(4), 483-487.
Kobayashi, T. M., Patel, M., & Lotito, M. (2015). Pharmacotherapy for posttraumatic stress
disorder at a Veterans Affairs facility. American Journal of Health-System
Pharmacy, 72(1), 11-15.
Monson, C. M., Schnurr, P. P., Resick, P. A., Friedman, M. J., Young-Xu, Y., & Stevens, S. P.
(2006). Cognitive processing therapy for veterans with military-related posttraumatic
stress disorder. Journal of Consulting and Clinical Psychology, 74(5), 898-907.
Mott, J.M., Barrera, T., Hernandez, C., Graham, D., & Teng, E. (2014). Rates and predictors of
referral for individual psychotherapy, group psychotherapy, and medications among Iraq
and Afghanistan veterans with PTSD. Journal of Behavioral Health Services &
Research, 41(2), 99-109.
Paulhus, D. (1983). Sphere-specific measures of perceived control. Journal Of Personality And
Social Psychology, 44(6), 1253-1265.

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Reger, G. M., Durham, T. L., Tarantino, K. A., Luxton, D. D., Holloway, K. M., & Lee, J. A.
(2013). Deployed soldiers reactions to exposure and medication treatments for
PTSD. Psychological Trauma: Theory, Research, Practice, and Policy, 5(4), 309-316.
Schwarzer, R and M Jerusalem (1995) Generalized Self-Efficacy Scale. In: Weinman, J, S
Wright, and M Johnson (eds.)Measures in health psychology: A user's portfolio, Causal
and control beliefs. pp. 35-37, Windsor England: NFER-NELSON.
Seedat, S., Stein, D. J., & Carey, P. D. (2005). Post-Traumatic Stress Disorder in Women:
Epidemiological and Treatment Issues. CNS Drugs, 19(5), 411-427.
Appendix A
Modified Treatment Reactions Scale (original: Reger, 2013)
1. I would be interested in receiving this treatment if I was having this type of problem.
2. I would deny receiving this treatment if someone asked me about it.
3. Receiving this treatment would change the way I feel about myself for the worst.
4. If this type of treatment was in my record, I would have fewer career opportunities.
5. Important people in my life would think less of me if they were to find out that I was
receiving this treatment.
6. I would have less confidence in myself if I were receiving this treatment.
7. If I had received this treatment, I would share my experience with someone dealing with
similar
8. I would NOT feel badly about myself if I needed this treatment.
9. I would trust a mental health professional offering this treatment.
10. I would see myself as weak for receiving this treatment.
11. If I were experiencing this type of problem at this point in my life, I would be confident that I
could find relief in this treatment.
12. I would NOT think less of myself for receiving this treatment.

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13. If a good friend asked my advice about a [omitted post-combat] psychological problem, I
would recommend that they seek this treatment.
14. Receiving this treatment would harm my career.
15. This treatment would be easy to talk about with someone needing help.
16. Others would see me as weak for receiving this treatment.
17. I would want to get this treatment if I were worried or upset for a long period of time.
18. Someone who requires this treatment is not fit for the workplace [omitted duty in the
military].
19. My boss [omitted unit leadership] would treat me differently if they knew I was receiving
this
20. I would tell my buddies [omitted coming home from deployment] about this treatment.
21. If a family member of mine needed similar help I would suggest this treatment.
22. If I were receiving this treatment, I would keep it a secret.
23. I think this treatment should be advertised [omitted the military should advertise this
treatment], or should we do I think this treatment should be advertised at work/school?
24. I would NOT feel ashamed if others found out that I was in this treatment.
25. This type of treatment makes sense to most people (or students) [omitted soldiers].
26. Getting this type of therapy would be a last resort.
27. Accepting help in this form would be to admit that I am broken.
28. If I were receiving this treatment, it would be OK with me if my boss [omitted NCO] knew
about
29. It would be too embarrassing to seek this treatment.
30. I would rather seek a different form of treatment than this treatment.
31. I would be uncomfortable seeking this type of professional help.

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Mean and Standard Deviation of Participants Age and Scores

Note. LOC and Self-Efficacy scores were subjected to a median split during our analysis

Table 1

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Figure 1

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