Anger and predictors of drop-out from PTSD treatment of veterans and first responders

Abstract

Background: Drop-out is an important barrier in treating post-traumatic stress disorder (PTSD) with consequences that negatively impact clients, clinicians and mental health services as a whole. Anger is a common experience in people with PTSD and is more prevalent in military veterans. To date, no research has examined if anger may predict drop-out in military veterans or first responders. Aims: The present study aimed to determine the variables that predict drop-out among individuals receiving residential treatment for PTSD. Method: Ninety-five military veterans and first responders completed pre-treatment measures of PTSD symptom severity, depression, anxiety, anger, and demographic variables. Logistic regression analyses were used to determine if these variables predicted drop-out from treatment or patterns of attendance. Results: Female gender was predictive of drop-out. However, when analysed by occupation female gender was predictive of drop-out among first responders and younger age was predictive of drop-out in military participants. Anger, depression, anxiety and PTSD symptom severity were not predictive of drop-out in any of the analyses. No variables were found to predict attendance patterns (consistent or inconsistent) or early versus late drop-out from the programme. Conclusion: These results suggest that although anger is a relevant issue for treating PTSD, other factors may be more pertinent to drop-out, particularly in this sample. In contrast with other findings, female gender was predictive of drop-out in this study. This may indicate that in this sample, there are unique characteristics and possible interacting variables that warrant exploration in future research.

Association between different dimensions of anger and symptoms of post-traumatic stress disorder in at-risk cardiovascular patients during the COVID-19 pandemic

“…On the other hand, a benefit of anger interventions was found in subjects with anger problems. You can therefore also benefit from such interventions before starting trauma-specific therapy ( 60 ) because anger has been shown to be a relevant factor in PTSD therapy ( 61 ).…”

Sex-Based Contributors to and Consequences of Post-traumatic Stress Disorder

“…A study of 95 veterans and first responders found that females were more likely to drop out of a residential treatment for PTSD ( r = 0.270; overall dropout rate 59%). The number of females in this sample was small ( n = 13) [ 54 ]. Finally, an analysis of prescribing patterns for 877,785 US veterans receiving treatment for PTSD in 2019 (13.5% women) found that women were slightly more likely than men to receive antidepressants recommended for PTSD (adjusted OR = 1.07), but were also more likely to receive medications recommended against use for PTSD, including benzodiazepines (adjusted OR = 1.62), anticonvulsants (a OR = 1.41), and antidepressants recommended against use for PTSD (adjusted OR = 1.26), in analyses adjusted for comorbidities and other confounders [ 55 •].…”