Negative Problem Orientation Is Associated With Mental Health Outcomes for Veterans Enrolled in Problem-Solving Training

Abstract

Dysfunctional beliefs about problem-solving ability, also called negative problem orientation (NPO), may contribute to the development and maintenance of mental health disorders. Problem-solving therapy is an evidence-based treatment that aims to reduce NPO, and thus improve mental health. This report examined whether baseline to posttreatment change in NPO was associated with changes in anxiety and depression symptom severity and suicidal ideation in patients receiving Veterans Affairs (VA) problem-solving training (PST): skills-based psychosocial interventions for veterans based on the key components of problem-solving therapy. PST was delivered in one of three VA national PST programs: PST—Home-Based Primary Care, PST—Primary Care, or group-based PST in inpatient and outpatient mental health clinics. Self-report measures assessed NPO, anxiety, and depressive symptom severity (including a suicidal ideation rating) at baseline and posttreatment. After adjusting for age and PST program, greater reductions in NPO from baseline to posttreatment significantly predicted greater reductions in depressive and anxiety symptom severity and suicidal ideation. Findings suggest that PST is associated with reduced NPO, which is associated with greater improvement of mental health symptom severity. Future studies should assess NPO at treatment midpoint to determine whether NPO change is an early indicator and possible mediator of PST treatment progress.