Department of Veterans Affairs New England Mental Illness Research.
Psychol Trauma. 2020 Mar;12(3):272-280. doi: 10.1037/tra0000495. Epub 2019 Jul 8.
Posttraumatic stress disorder (PTSD) among female veterans is a problem of growing importance. Comparison of treatment outcomes and measures of program participation between female and male veterans receiving treatment in specialized intensive Veterans Health Administration (VHA) programs may identify potential gaps in service.
National program evaluation data were collected at program entry and 4 months after discharge. The study sample consists of N = 3,370 veterans who were successfully followed up. With adjustment for differences in baseline characteristics outcomes of women and men were compared on changes in PTSD symptoms, substance use, and other outcomes using Cohen's d to evaluate effect sizes. Further analyses examined gender differences in program participation and their effect on differences in outcomes by gender.
Compared to males, females showed greater improvement (i.e., greater reduction) in total PTSD symptom scores (p < .001, Cohen's d = -.29) and in several subscales including Numbness (p < .001, d = -.34), Arousal (p = .01, d = -.22), Reexperiencing Past Traumas (p < .01, d = -.23), and Irritability (p = .01, d = -.18), with small to medium effect size differences. These gender-based differences were partially explained by differences in program participation such as greater length of stay among women.
In spite of the predominantly male environment of these VHA PTSD programs, women experienced greater improvement than men in PTSD symptoms and subscales. The differences were partially explained by positive indicators of program participation. Further studies are needed to better understand these differences. (PsycINFO Database Record (c) 2020 APA, all rights reserved).
创伤后应激障碍(PTSD)在女性退伍军人中是一个日益重要的问题。比较接受专门强化退伍军人健康管理局(VHA)项目治疗的女性和男性退伍军人的治疗结果和项目参与措施,可能会发现服务中的潜在差距。
在项目开始时和出院后 4 个月收集了全国性计划评估数据。研究样本包括 N = 3370 名成功随访的退伍军人。通过调整基线特征的差异,使用 Cohen's d 评估效应大小,比较女性和男性 PTSD 症状、物质使用和其他结果的变化。进一步的分析检查了项目参与中的性别差异及其对按性别划分的结果差异的影响。
与男性相比,女性 PTSD 症状总评分的改善(即,更大的减少)更大(p <.001,Cohen's d = -.29),包括麻木(p <.001,d = -.34)、唤醒(p =.01,d = -.22)、重新体验过去的创伤(p <.01,d = -.23)和易怒(p =.01,d = -.18)在内的几个亚量表也有更大的改善,差异具有中等至小的效应量。这些基于性别的差异部分可以通过项目参与的差异来解释,例如女性的住院时间更长。
尽管这些 VHA PTSD 项目以男性为主,但女性在 PTSD 症状和亚量表方面的改善程度大于男性。这些差异部分可以通过积极的项目参与指标来解释。需要进一步研究以更好地理解这些差异。