Presenting Concerns of Veterans Entering Treatment for Posttraumatic Stress Disorder

Authors

  • Craig Rosen,

    Corresponding author
    1. National Center for PTSD, Dissemination & Training Division, VA Palo Alto Health Care System, Menlo Park, California, USA
    2. Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, California, USA
    • Correspondence concerning this article should be addressed to Craig S. Rosen, National Center for PTSD (334-PTSD), VA Palo Alto Health Care System, 795 Willow Road, Menlo Park, CA 94025. E-mail: Craig.Rosen@va.gov

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  • Emerald Adler,

    1. National Center for PTSD, Dissemination & Training Division, VA Palo Alto Health Care System, Menlo Park, California, USA
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  • Quyen Tiet

    1. National Center for PTSD, Dissemination & Training Division, VA Palo Alto Health Care System, Menlo Park, California, USA
    2. Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, California, USA
    3. California School of Professional Psychology, Alliant International University, San Francisco, California, USA
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  • This research was supported in part by grant TEL-03-135 from the Department of Veterans Affairs Health Services Research and Development program and grant W81XWH-08-2-0096 from the Congressionally Directed Medical Research Program. The opinions expressed are those of the authors and do not necessarily reflect the views of the U.S. Department of Veterans Affairs or the U.S. Department of Defense. The authors thank Mark A. Greenbaum for help with accessing administrative data.

Abstract

Patient-centered care involves engaging patients as partners in establishing treatment priorities. No prior studies have examined what specific problems veterans hope to address when they enter posttraumatic stress disorder (PTSD) treatment. Veterans starting outpatient (n = 216) and residential (n = 812) PTSD treatment in 2 multisite care management trials specified (open-ended) the 2 or 3 problems that they most wanted to improve through treatment. Over 80% mentioned PTSD-symptom-related concerns including PTSD or trauma (19.2% to 19.9% of patients), anger (31.0% to 36.7%), sleep problems (14.3% to 27.3%), nightmares (12.3% to 19.4%), and estrangement/isolation (7.9% to 20.8%). Other common problems involved depression (23.1% to 36.5%), anxiety not specific to PTSD (23.9% to 27.8%), relationships (20.4% to 24.5%), and improving coping or functioning (19.2% to 20.4%). Veterans’ treatment goals varied significantly by outpatient versus residential setting, gender, and period of military service. Our findings confirm the importance of educating patients about how available efficacious treatments relate to clients’ personal goals. Our results also suggest that clinicians should be prepared to offer interventions or provide referrals for common problems such as anger, nightmares, sleep, depression, or relationship difficulties if these problems do not remit with trauma-focused psychotherapy or if patients are unwilling to undergo trauma-focused treatment.

Traditional and Simplified Chinese Abstracts by AsianSTSS

標題:退役軍人接受創傷後壓力症治療的主要關注

撮要:病人為本治理包括確立治療的優先次序時,要以病人為伙伴。未有現存研究檢視接受PTSD治療的退役軍人所關注的具體問題。退役軍人是在兩個治療方案測試中接受門診(n=216)和住宿(n=812)的兩個創傷後壓力症(PTSD)多地點治療,他們在開放式提問下表達2至3個治療最希望能改善的毛病。超過80%提及PTSD症狀相關情況,包括:PTSD或創傷(19%至20%病人),憤怒(31%至37%),睡眠問題(14%至27%),噩夢(12%至19%),及隔閡/疏離(8%至20%)。其他常見問題包括:抑鬱(23%至36%),焦慮(不限於PTSD)(24%至28%),關係(20%至25%),和改善應對或功能(19%至20%)。退役軍人的治療目的與門診或住宿治療模式,性別和服役年期中各有顯著分別。研究確定教育病人現存有效而適切個人需要治療的重要性,亦提出:如聚焦創傷心理治療未令問題解決又或病人不願接受聚焦創傷的心理治療,治療師必須轉介或提供介入治療去處理常見問題如憤怒、惡夢、睡眠、抑鬱和關係問題。

标题:退役军人接受创伤后压力症治疗的主要关注

撮要:病人为本治理包括确立治疗的优先次序时,要以病人为伙伴。未有现存研究检视接受PTSD治疗的退役军人所关注的具体问题。退役军人是在两个治疗方案测试中接受门诊(n=216)和住宿(n=812)的两个创伤后压力症(PTSD)多地点治疗,他们在开放式提问下表达2至3个治疗最希望能改善的毛病。超过80%提及PTSD症状相关情况,包括:PTSD或创伤(19%至20%病人),愤怒(31%至37%),睡眠问题(14%至27%),噩梦(12%至19%),及隔阂/疏离(8%至20%)。其他常见问题包括:忧郁(23%至36%),焦虑(不限于PTSD)(24%至28%),关系(20%至25%),和改善应对或功能(19%至20%)。退役军人的治疗目的与门诊或住宿治疗模式,性别和服役年期中各有显著分别。研究确定教育病人现存有效而适切个人需要治疗的重要性,亦提出:如聚焦创伤心理治疗未令问题解决又或病人不愿接受聚焦创伤的心理治疗,治疗师必须转介或提供介入治疗去处理常见问题如愤怒、恶梦、睡眠、忧郁和关系问题。

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