Research

ARE YOUR PROCESSES EVIDENCE BASED?

Evidence Based Practices (EBP) can take years of research for a new technique to become an EBP. Dr. Arnell started the evidence based practice research in 2022 searching for independent research outside of 22ZERO. Dr. Arnell contacted Arizona State University and ASU agreed to do the independent study for 22ZERO. The first study was published in 2024, while there are two additional research studies in the peer reviewed phase now.

One study is co-authored with Dr. Arnell. During 2025 and 2026, there are two additional research studies that are occurring at this time and one study, Dr. Arnell will co-author with ASU. While proving Evidence Based Practices is important to Dr. Arnell, the process can take time; which is why Dr. Arnell started the process to prove EBP in 2022. 22ZERO is grateful to Arizona State University for supporting the research journey.

22ZERO Studies 1-3 - 1,028 Clients

PTSD Threshold (PSSI5) 20-80 – PTSD Threshold (PCL5) 31-80

Anxiety threshold (GAD7) Mild Anxiety 5-9, Moderate Anxiety 10-14, and Severe Anxiety 15-21

Depression Threshold (PQH9) 5-27

22ZERO - Study Group 1

PTSD Symptom Scale Interview version 5

614 clients PTSD

Males:	259
Females:	355
Age Range:	11 – 103, 2 Children age 11 and 15
Pre Scores Average:	40.15
Post Score Average:	7.12
Average Number of Sessions:	1.27

22ZERO - Study Group 2

PTSD Checklist-version 5 (PCL5)

322 clients combined PTSD/Anxiety Study

Males:	188
Females:	134
Age Range:	6 – 75, 36 Children age 6-17
Pre Scores Average:	45.93
Post Score Average:	4.97
Average Number of Sessions:	1.24

General Anxiety Disorder version 7 (GAD7)

Pre Scores Average:	13.34
Post Score Average:	1.825
Average Number of Sessions:	1.24

22ZERO - Study Group 3

PTSD Checklist-version 5 (PCL5)

92 clients combined PTSD/Anxiety Study/Depression

Males:	188
Females:	134
Age Range:	6 – 75, 36 Children age 6-17
Pre Scores Average:	45.93
Post Score Average:	4.97
Average Number of Sessions:	1.24

General Anxiety Disorder version 7 (GAD7)

Pre Scores Average:	12.14
Post Score Average:	2.75
Average Number of Sessions:	1.27

Anxiety Threshold: Mild Anxiety 5-9, Moderate Anxiety 10-14, and Severe Anxiety 15-21

Pre Health Questionnaire version 9 (PQH9) – For Major Depressive Disorder (MDD)

Pre Scores Average:	12.14
Post Score Average:	2.75
Average Number of Sessions:	1.27

The PSSI-5 (Posttraumatic Stress Disorder Symptom Scale-Interview) is a structured interview for the assessment of symptoms of posttraumatic stress disorder (PTSD) according to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5). It is a clinician-administered measure that can be used to diagnose PTSD and evaluate treatment outcomes. Scores greater than 20 qualify for PTSD diagnosis.

The PCL-5 (Posttraumatic Stress Disorder Checklist for DSM-5) is a self-report measure for assessing symptoms of posttraumatic stress disorder (PTSD) according to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5).

It is a 20-item measure that assesses the presence and severity of symptoms associated with PTSD, including re-experiencing, avoidance, negative alterations in cognitions and mood, and alterations in arousal and reactivity.

Each item is rated on a 5-point scale (0 = Not at all to 4 = Extremely), with a total score range of 0-80. Scores greater than 31 qualify for PTSD diagnosis.

The PHQ-9 (Patient Health Questionnaire-9) is a self-report measure for assessing symptoms of major depressive disorder (MDD). It is a 9-item measure that assesses the presence and severity of symptoms associated with MDD, such as depressed mood, loss of interest, and difficulty concentrating. Each item is rated on a 4-point scale (0 = Not at all to 3 = Nearly every day), with a total score range of 0-27.

The GAD-7 (General Anxiety Disorder) Anxiety Severity Scoring

This is calculated by assigning scores of 0, 1, 2, and 3 to the response categories of “not at all,” “several days,” “more than half the days,” and “nearly every day,” respectively.

GAD-7 total score for the seven items ranges from 0 to 21. Scores 5, 10, and 15 represent cut points for mild, moderate, and severe anxiety, respectively.