Symptom severity and lifetime and prospective health service use among military veterans evaluated for PTSD

Abstract

We used structural equation modeling with 174 treatment-seeking military trauma survivors evaluated for posttraumatic stress disorder (PTSD) at a VA Medical Center PTSD clinic to examine relationships among lifetime mental health service use, PTSD symptom severity and medical problems (from self-report), as well as prospective (1-year) mental health and medical care use visit counts extracted from medical records. We discovered an adequate statistical fit to a hypothesized model of previous and prospective health service use, and current PTSD severity and health-related problems. Previous inpatient mental health treatment was significantly related to PTSD severity and prospective outpatient mental health use. However, PTSD severity was unrelated to prospective use of mental health or medical services. Health problems were related to prospective medical service use. Clinical and administrative implications in predicting health care use among trauma survivors are discussed.

Rates of Subthreshold PTSD Among U.S. Military Veterans and Service Members: A Literature Review

“…Some definitions of partial PTSD include meeting at least one symptom in each symptom cluster, Criteria B-D (Stein et al, 1997). Other definitions of subclinical PTSD include having numerous symptoms, but failure to meet full criteria (e.g., Elhai et al, 2007). Finally, some definitions of subsyndromal PTSD include meeting Criteria A, B, E, F, and Criterion C or D (Inslicht et al, 2013) and scoring > 30 on the Clinician-Administered PTSD Scale (CAPS; Blake et al, 1995).…”

Multicomponent behavioral treatment for chronic combat-related posttraumatic stress disorder: A randomized controlled trial

“…Furthermore, 11% of all veterans treated in VA primary care clinics meet criteria for PTSD (Magruder et al, 2005). The disorder is generally associated with significant clinical distress, social and occupational impairment, reduced quality of life, and medical and psychiatric comorbidity (Dohrenwend et al, 2006; Elhai, Kashdan, Snyder, North, Heaney, & Frueh, 2007; Frueh, Turner, Beidel, & Cahill, 2001; Schnurr, Spiro, & Paris, 2000). Anger management problems in particular are a significant source of distress and impairment (Chemtob, Hamada, Roitbla, & Muraoka, 1994; Frueh et al, 2001; Taft et al, 2007), affecting individual veterans as well as their spouses and families (Teten et al, 2010).…”

PTSD telehealth treatments for veterans: Comparing outcomes from in-person, clinic-to-clinic, and home-based telehealth therapies.

“…Every year, roughly eight million U.S. adults in the general population meet diagnostic criteria for posttraumatic stress disorder (PTSD; Reisman, 2016), exhibiting symptoms of (a) involuntary and intrusive memories, nightmares, and/or flashbacks, (b) internal and/or external patterns of avoidance, (c) negative alterations in cognition and mood, and (d) arousal and reactivity. When examining this within rural military communities, approximately one-half of Armed Forces recruits have been drawn from isolated areas (Boscarino et al, 2020; U.S. Office of the Under Secretary of Defense Personnel & Readiness, 2008), with heightened prevalence rates of PTSD compared to those residing in urban or suburban regions (Elhai et al, 2007). Several evidence-based psychotherapies (EBPs) have been shown to effectively treat Veterans with PTSD across a variety of Criterion A traumatic militaryrelated events, including exposure actual or threatened death, serious injury, or sexual violence.…”

“…When examining this within rural military communities, approximately one-half of Armed Forces recruits have been drawn from isolated areas (Boscarino et al, 2020; U.S. Office of the Under Secretary of Defense Personnel & Readiness, 2008), with heightened prevalence rates of PTSD compared to those residing in urban or suburban regions (Elhai et al, 2007). Several evidence-based psychotherapies (EBPs) have been shown to effectively treat Veterans with PTSD across a variety of Criterion A traumatic military-related events, including exposure actual or threatened death, serious injury, or sexual violence.…”