Posttraumatic stress disorder symptoms and coping with the lockdown among help-seeking veterans before and during the COVID-19 pandemic

Abstract

Aim To compare the severity of posttraumatic stress disorder (PTSD) symptoms and of particular PTSD clusters among help-seeking veterans before and during the COVID-19 lockdown. The second aim was to identify the main coping strategies used.Methods Male war veterans (N = 176) receiving outpatient treatment at the Referral Center for PTSD were assessed at baseline (12-18 months before the pandemic declaration in March 2020) and during the COVID-19 pandemic lockdown (March-June 2020). The Life Events Checklist for DSM-5, PTSD Checklist for DSM-5, and The Brief COPE were used.Results Direct exposure to the virus in our sample was low, and the majority of participants followed the preventive measures. The severity of the overall PTSD symptoms and of clusters of symptoms significantly decreased compared with the first assessment. At the second assessment, all participants still fulfilled the PTSD diagnosis criteria. During the lockdown, the participants used emotion-focused and problem-focused coping rather than dysfunctional coping. ConclusionThe severity of PTSD symptoms decreased during the lockdown. Further research is needed to study the trajectories of long-term psychopathology.

PTSD Symptoms and Coping with COVID-19 Pandemic among Treatment-Seeking Veterans: Prospective Cohort Study

“…In a nationally representative sample of US military veterans, the prevalence of major depressive disorder and PTSD positive screens remained stable while the prevalence of generalized anxiety disorder positive screens increased [ 10 ] and the rate of suicidal ideation decreased nearly 10 months into the pandemic [ 9 ]. Regarding the mental health among treatment-seeking veterans with pre-existing mental health difficulties, the UK study revealed no significant changes in symptoms of PTSD during the pandemic [ 11 ] and a study conducted in Croatia revealed a decrease in PTSD symptoms during the onset of the pandemic as compared to the measurement a year before [ 12 ]. PTSD symptoms and particularly avoidance symptoms may have reduced because of the restrictive measures that prevented greater extent of exposure to reminders of trauma in everyday life.…”

“…PTSD symptoms and particularly avoidance symptoms may have reduced because of the restrictive measures that prevented greater extent of exposure to reminders of trauma in everyday life. Adherence to treatment, regularity of appointments, and stability of treatment as all participants continued to be treated as usual (TAU) may also be viewed as a functional coping strategy that prevented considerable risk of worsening PTSD symptoms [ 12 ]. The results emphasize the importance of treatment engagement of veterans who meet criteria for mental disorder, since approximately 60% of them do not seek help because of concerns about stigma, with many expecting to face prejudice and discrimination [ 30 ].…”

“…In treatment-seeking veterans, those who reported more COVID-related stressors and lower levels of social support may have been particularly vulnerable to an increasing severity of a range of mental health difficulties [ 11 , 33 ]. The results of this study indicating no correlation of PTSD symptom level with COVID-related PTE and non-PTE can be explained by a lower potential of COVID-related stressful experiences worsening PTSD symptoms because they differ from the central negative traumatic events (war-related criterion A) [ 12 , 29 ]. As the veteran cohort in this study was aged 54 (SD = 5.97), the results could be explained in light of the recent findings indicating that older adults may be more resilient and less affected by the mental health effects of the pandemic than younger age groups [ 3 ].…”

“…Compliance with the measures may be viewed as an adaptive coping strategy of acceptance. A possible explanation for compliance with the measures may be returning to “combat mode” and military subordination [ 12 ].…”

“…A recent longitudinal study, conducted during the period between two lockdowns among treatment-seeking veterans with pre-existing mental health difficulties in the UK, did not find any significant changes in symptoms of PTSD, common mental health disorders, anger, or alcohol use between the lockdowns [ 11 ]. A study that compared prepandemic and peripandemic levels of PTSD symptoms among Croatian treatment-seeking veterans with pre-existing PTSD demonstrated a reduction in PTSD symptom levels during the onset of the COVID-19 pandemic [ 12 ]. As the COVID-19 pandemic is often referred to as a “marathon, not a sprint,” and is spread around the world, there remains a need for further longitudinal studies to examine long-term changes in mental health of veterans with pre-existing difficulties in different settings.…”