Department of Veterans Affairs (VA) New England Mental Illness Research and Education Clinical Center (MIRECC), West Haven, Connecticut, USA.
Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA.
J Trauma Stress. 2019 Aug;32(4):606-615. doi: 10.1002/jts.22417. Epub 2019 Jul 30.
Although most female veterans treated in specialized intensive Veterans Health Administration (VHA) posttraumatic stress disorder (PTSD) programs receive services in settings in which over 95% of participants are men, two programs include only women. Whether outcomes for women with PTSD are superior in women-only programs has not been evaluated. National program evaluation data on 1,357 women veterans from 57 sites were collected at program entry and 4 months after discharge. With adjustment for differences in baseline characteristics, outcomes of women in two women-only programs (n = 469) were compared with those from 55 mixed-gender programs (n = 888), using mixed models with random effect for site. The primary outcome was total PTSD symptom level, with supplementary information on PTSD assessment subscales, substance use, and other outcomes. At program entry, female veterans in women-only programs had lower scores on measures of total PTSD symptoms, p = .013, d = -0.24, and on several subscales. Adjusting for these differences, there were no significant differences between program types in terms of PTSD total score or scores on secondary measures. In women-only programs, veterans had longer lengths of stay and were rated by their clinicians to have a higher level of commitment to therapy at discharge. Thus, women-only programs did not show superior outcomes; however, compared to participants in mixed-gender programs, those in women-only programs had longer lengths of stay, higher levels of commitment to therapy, and were more likely to participate in posttreatment outcome assessments following discharge.
尽管大多数在退伍军人事务部（VHA）专门的创伤后应激障碍（PTSD）项目中接受治疗的女性退伍军人都是在男性参与者超过 95%的环境中接受服务，但有两个项目仅包括女性。女性 PTSD 患者在仅限女性的项目中的治疗效果是否更好，尚未得到评估。在项目开始时和出院后 4 个月，从 57 个地点收集了 1357 名女性退伍军人的国家项目评估数据。通过调整基线特征的差异，使用具有站点随机效应的混合模型，将两个仅限女性项目（n = 469）的女性患者的结果与 55 个男女混合项目（n = 888）的结果进行了比较。主要结果是 PTSD 症状总水平，同时提供了 PTSD 评估子量表、物质使用和其他结果的补充信息。在项目开始时，仅限女性项目中的女性退伍军人在 PTSD 总症状测量方面的得分较低，p =.013，d = -0.24，并且在几个子量表上也是如此。在考虑到这些差异后，在 PTSD 总分或次要测量得分方面，两种项目类型之间没有显著差异。在仅限女性的项目中，退伍军人的住院时间更长，其临床医生在出院时评定他们对治疗的承诺程度更高。因此，仅限女性的项目并没有显示出更好的结果；但是，与混合性别项目的参与者相比，仅限女性的项目中的参与者住院时间更长，对治疗的承诺程度更高，并且更有可能在出院后参加治疗后的结果评估。
