Veterans Affairs Center for Clinical Management Research.
Veteran Affairs Northeast Program Evaluation Center.
Psychol Serv. 2020 Feb;17(1):84-92. doi: 10.1037/ser0000284. Epub 2018 Oct 4.
Although most veterans in the Department of Veterans Affairs (VA) health system are treated for posttraumatic stress disorder (PTSD) in the outpatient setting, the VA has approximately 40 residential PTSD treatment facilities across the country for those requiring more intensive care. The symptom profiles of these veterans are poorly understood. Thus, the current study was designed to characterize classes of PTSD symptoms in a national sample of veterans undergoing residential treatment. We analyzed latent classes of PTSD symptoms among 2,452 veterans entering VA PTSD residential treatment in fiscal year 2013. The model with the best fit was a 4-class model comprising a low symptom class, moderate symptom class with high reexperiencing symptoms, a moderate symptom class with high emotional numbing, and a high symptom class. Compared to classes identified in outpatient samples, these classes were similar in type but greater in severity. Classes differed by age, race/ethnicity, trauma type, co-occurring medical conditions, co-occurring psychiatric conditions, and social functioning. Compared to the moderate class with high emotional numbing, those in the moderate class with high reexperiencing symptoms were more likely to be non-White, have greater pain severity, greater sleep problems, and were less likely to be depressed. Our findings suggest that veterans in residential treatment who have more severe PTSD symptoms also experience other medical and psychosocial stressors. A better understanding of symptom profiles may help to create more individualized treatment planning and thus potentially improve care for these veterans. (PsycINFO Database Record (c) 2020 APA, all rights reserved).
尽管美国退伍军人事务部(VA)医疗系统中的大多数退伍军人都在门诊环境中接受创伤后应激障碍(PTSD)治疗,但 VA 在全国约有 40 个 PTSD 治疗住院设施,为那些需要更密集护理的退伍军人提供服务。这些退伍军人的症状特征了解甚少。因此,目前的研究旨在描述接受 VA PTSD 住院治疗的退伍军人的 PTSD 症状类别。我们对 2013 财年进入 VA PTSD 住院治疗的 2452 名退伍军人进行了 PTSD 症状的潜在类别分析。拟合度最佳的模型是 4 类模型,包括一个低症状类、一个高再体验症状的中度症状类、一个高情感麻木的中度症状类和一个高症状类。与门诊样本中确定的类别相比,这些类别在类型上相似,但严重程度更高。不同类别的退伍军人在年龄、种族/民族、创伤类型、共病医疗状况、共病精神状况和社会功能方面存在差异。与高情感麻木的中度症状类相比,那些高再体验症状的中度症状类更可能是非白人,疼痛更严重,睡眠问题更多,抑郁的可能性更小。我们的研究结果表明,在住院治疗中 PTSD 症状更严重的退伍军人也会经历其他医疗和心理社会压力源。更好地了解症状特征可能有助于制定更个性化的治疗计划,从而有可能改善这些退伍军人的护理。