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Characteristics of U.S. Veterans Who Begin and Complete Prolonged Exposure and Cognitive Processing Therapy for PTSD

Authors

  • Juliette M. Mott,

    Corresponding author
    1. Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas, USA
    2. Menninger Department of Psychiatry and Behavioral Sciences at Baylor College of Medicine, Houston, Texas, USA
    3. South Central Mental Illness Research, Education, and Clinical Center, Houston, Texas, USA
    • Correspondence concerning this article should be addressed to Juliette Mott, National Center for PTSD, VA Medical Center (116D), 215 North Main Street, White River Junction, VT 05009. E-mail: Juliette.Mott@va.gov

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  • Sasha Mondragon,

    1. Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas, USA
    2. Menninger Department of Psychiatry and Behavioral Sciences at Baylor College of Medicine, Houston, Texas, USA
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  • Natalie E. Hundt,

    1. Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas, USA
    2. Menninger Department of Psychiatry and Behavioral Sciences at Baylor College of Medicine, Houston, Texas, USA
    3. South Central Mental Illness Research, Education, and Clinical Center, Houston, Texas, USA
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  • Melissa Beason-Smith,

    1. Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas, USA
    2. Menninger Department of Psychiatry and Behavioral Sciences at Baylor College of Medicine, Houston, Texas, USA
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  • Rebecca H. Grady,

    1. Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas, USA
    2. Menninger Department of Psychiatry and Behavioral Sciences at Baylor College of Medicine, Houston, Texas, USA
    3. South Central Mental Illness Research, Education, and Clinical Center, Houston, Texas, USA
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  • Ellen J. Teng

    1. Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas, USA
    2. Menninger Department of Psychiatry and Behavioral Sciences at Baylor College of Medicine, Houston, Texas, USA
    3. South Central Mental Illness Research, Education, and Clinical Center, Houston, Texas, USA
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  • Juliette Mott is currently affiliated with the National Center for PTSD in White River Junction, Vermont USA.

  • This research was supported in part by the Office of Academic Affiliations VA Advanced Fellowship Program in Mental Illness Research and Treatment, by the Houston VA HSR&D Center of Excellence (Houston Center for Innovations in Quality, Effectiveness and Safety (CIN 13-413), and by a VA Clinical Sciences Research and Development (CSR&D) Career Development Award (#CADE-MHN/F09) awarded to Ellen J. Teng at the Michael E. DeBakey Veterans Affairs Medical Center. The views expressed reflect those of the authors and not necessarily the Department of Veterans Affairs/Baylor College of Medicine.

Abstract

This retrospective chart-review study examined patient-level correlates of initiation and completion of evidence-based psychotherapy (EBP) for posttraumatic stress disorder (PTSD) among treatment-seeking U.S. veterans. We identified all patients (N = 796) in a large Veterans Affairs PTSD and anxiety clinic who attended at least 1 individual psychotherapy appointment with 1 of 8 providers trained in EBP. Within this group, 91 patients (11.4%) began EBP (either Cognitive Processing Therapy or Prolonged Exposure) and 59 patients (7.9%) completed EBP. The medical records of all EBP patients (n = 91) and a provider-matched sample of patients who received another form of individual psychotherapy (n = 66) were reviewed by 4 independent raters. Logistic regression analyses revealed that Iraq and Afghanistan veterans were less likely to begin EBP than veterans from other service eras, OR = 0.48, 95% CI = [0.24, 0.94], and veterans who were service connected for PTSD were more likely than veterans without service connection to begin EBP, OR = 2.33, 95% CI = [1.09, 5.03]. Among those who began EBP, Iraq and Afghanistan veteran status, OR = 0.09, 95% CI = [0.03, 0.30], and a history of psychiatric inpatient hospitalization, OR = 0.13, 95% CI = [0.03, 0.54], were associated with decreased likelihood of EBP completion.

Traditional and Simplified Chinese Abstracts by AsianSTSS

標題:啟動和完成治療PTSD延續暴露和認知處理療法的退役軍人的特性

撮要:本回溯性圖表檢閱研究檢視求醫的美國退役兵中治療創傷後壓力症(PTSD)的實証為本療法(EBP)的啟動和完成的病人相關因素。我們在一個大型退伍軍人事務PTSD和焦慮診所中發現樣本的所有病人(N = 796),曾受EBP訓練的八位治療師中一位提供至少一節個人治療予這些病人。91名病者(11.4%)開展EBP(認知處理療法或延續暴露療法)和59名病人(7.9%)完成EBP。所有EBP病人(n = 91)的醫療紀錄和治療師配對病人樣本(接受其他個人治療類別)(n = 66)均接受四名獨立評估人員檢閱。邏輯回歸分析指出伊拉克和阿富汗地區的退役兵比其他戰區更少開展EBP(奇偶比〔OR〕 = 0.48, 95% 置信區間﹝CI﹞ = ﹝0.24, 0.94﹞),而服役與PTSD相關者比沒有相關服役者更容易啟動EBP (OR = 2.33, 95% CI = ﹝1.09, 0.94﹞)。已啟動EBP者, 伊拉克和阿富汗退役軍人(OR = 0.09, 95% CI = ﹝0.03, 0.30﹞)和有精神病院住院病史(OR = 0.13, 95% CI = ﹝0.03, 0.54﹞)與較低EBP完成率有相連。

标题:启动和完成治疗PTSD延续暴露和认知处理疗法的退役军人的特性

撮要:本回溯性图表检阅研究检视求医的美国退役兵中治疗创伤后压力症(PTSD)的实证为本疗法(EBP)的启动和完成的病人相关因素。我们在一个大型退伍军人事务PTSD和焦虑诊所中发现样本的所有病人(N = 796),曾受EBP训练的八位治疗师中一位提供至少一节个人治疗予这些病人。91名病者(11.4%)开展EBP(认知处理疗法或延续暴露疗法)和59名病人(7.9%)完成EBP。所有EBP病人(n = 91)的医疗纪录和治疗师配对病人样本(接受其他个人治疗类别)(n = 66)均接受四名独立评估人员检阅。逻辑回归分析指出伊拉克和阿富汗地区的退役兵比其他战区更少开展EBP(奇偶比〔OR〕 = 0.48, 95% 置信区间﹝CI﹞ = ﹝0.24, 0.94﹞),而服役与PTSD相关者比没有相关服役者更容易启动EBP (OR = 2.33, 95% CI = ﹝1.09, 0.94﹞)。已启动EBP者, 伊拉克和阿富汗退役军人(OR = 0.09, 95% CI = ﹝0.03, 0.30))和有精神病院住院病史(OR = 0.13, 95% CI = ﹝0.03, 0.54))与较低EBP完成率有相连。

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