Risk for PTSD symptom worsening during new PTSD treatment episode in a nationally representative sample of treatment-seeking US veterans with subthreshold PTSD

被引:0
作者
Gross, Georgina M. [1 ,2 ,4 ]
Pietrzak, Robert H. [1 ,2 ,3 ]
Hoff, Rani A. [2 ,4 ]
Katz, Ira R. [5 ,6 ]
Harpaz-Rotem, Ilan [1 ,2 ,3 ,4 ]
机构
[1] VA Connecticut Healthcare Syst, 950 Campbell Ave, West Haven, CT 06516 USA
[2] Yale Univ Sch Med, Dept Psychiat, New Haven, CT USA
[3] US Dept Vet Affairs, Natl Ctr PTSD, West Haven, CT USA
[4] West Haven VA Med Ctr, Northeast Program Evaluat Ctr, VA Off Mental Hlth & Suicide Prevent, West Haven, CT USA
[5] Dept Vet Affairs, VA Off Mental Hlth & Suicide Prevent, Washington, DC USA
[6] Philadelphia VA Med Ctr, Philadelphia, PA USA
关键词
PTSD; Subthreshold PTSD; Veteran; Treatment utilization; POSTTRAUMATIC-STRESS-DISORDER; HEALTH-CARE; AFGHANISTAN; IRAQ; COMORBIDITY;
D O I
10.1016/j.jpsychires.2022.04.040
中图分类号
R749 [精神病学];
学科分类号
100205 ;
摘要
Previous research has examined risk factors associated with poorer treatment outcomes for military Veterans with PTSD. However, work has not examined risk for symptom worsening among Veterans with subthreshold PTSD. The aim of this study was to examine demographic, psychiatric, physical health, and pre-treatment PTSD symptom clusters associated with clinically significant worsening of PTSD among a nationally representative sample of United States (U.S.) Veterans with subthreshold PTSD. Participants were Veterans (weighted N = 3162; unweighted N = 236) with subthreshold PTSD entering a new episode of treatment at U.S. Veterans Affairs PTSD specialty clinics during fiscal years 2018 and 2019. Data was collected as part of the Veterans Outcome Assessment, a yearly baseline and 3-month follow-up telephone survey. Analyses used weighted calculations to support the use of VOA data to draw inferences about all eligible Veterans, and binary logistic regression was used to examine risk factors for symptom worsening. Over 1/3 (37.7%) of Veterans with subthreshold PTSD experienced clinically significant symptom worsening from baseline to follow-up. Adjusted analyses revealed several risk factors for symptom worsening, including demographic (e.g., male sex, White race), psychiatric (personality and anxiety disorders), health care utilization (e.g., more primary care encounters in the previous year), physical health disability, and specific baseline PTSD symptom clusters (negative affect and anxious arousal). Findings suggest that Veterans with subthreshold symptoms seeking treatment for PTSD are at risk for symptom worsening, and highlight the importance of assessment, prevention, and treatment in targeting veterans with PTSD symptoms below the diagnostic threshold.
引用
收藏
页码:304 / 310
页数:7
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