Objective: Measurement-based care is designed to track symptom levels during treatment and leverage clinically significant change benchmarks to improve quality and outcomes. Though the Veterans Health Administration promotes monitoring progress within posttraumatic stress disorder (PTSD) clinical teams, actionability of data is diminished by a lack of population-based benchmarks for clinically significant change. We reported the state of repeated measurement within PTSD clinical teams, generated benchmarks, and examined outcomes based on these benchmarks. Method: PTSD Checklist for the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition data were culled from the Corporate Data Warehouse from the pre-COVID-19 year for Veterans who received at least eight sessions in 14 weeks (episode of care [EOC] cohort) and those who received sporadic care (modal cohort). We used the Jacobson and Truax (1991) approach to generate clinically significant change benchmarks at clinic, regional, and national levels and calculated the frequency of cases that deteriorated, were unchanged, improved, or probably recovered, using our generated benchmarks and benchmarks from a recent study, for both cohorts. Results: Both the number of repeated measurements and the cases who had multisession care in the Corporate Data Warehouse were very low. Clinically significant change benchmarks were similar across locality levels. The modal cohort had worse outcomes than the EOC cohort. Conclusions: National benchmarks for clinically significant change could improve the actionability of assessment data for measurement-based care. Benchmarks created using data from Veterans who received multisession care had better outcomes than those receiving sporadic care. Measurement-based care in PTSD clinical teams is hampered by low rates of repeated assessments of outcome.
We examined performance on the Multisource Interference Task (MSIT) as a moderator of the relationship between traumatic experience and posttraumatic stress symptom (PTSS) severity. A college sample ( N = 108) completed the MSIT, the Wisconsin Card Sorting Task (WCST), and self-report questionnaires. Both MSIT and WCST performance were examined in moderation models to demonstrate the specificity of MSIT performance as a moderator. Absolute processing speed during the MSIT significantly moderated the relationship between number of traumatic experiences and PTSS severity. Moderation was not demonstrated for WCST performance, relative processing speed during the MSIT, or absolute or relative MSIT error rates. Implications for research and practical applications are discussed.
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