VA Bedford Healthcare System, MIRECC Program, 200 Springs Road, Bedford, MA, 01730, USA.
Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA.
Psychiatr Q. 2021 Sep;92(3):981-994. doi: 10.1007/s11126-020-09864-w. Epub 2021 Jan 6.
Severe Post-Traumatic Stress Disorder (PTSD) has been identified as a significant impediment to employment. However, little is known about correlates of employment recovery after a period of not working among veterans with severe PTSD treated in specialized intensive treatment programs. This study examines rates and correlates of transitioning from not being employed at admission to working four months after discharge using national Veterans Health Administration (VHA) program evaluation data on veterans engaged in specialized intensive PTSD treatment (N = 27,339). Results suggest that only 5.68% of the sample made the transition to employment while 10.6% lost employment, 8.9% worked both at admission and following discharge, and 74.9%, did not work either at admission or following discharge. Multinomial regression analysis found that compared to other groups, veterans who became employed were younger, less likely to receive service-connected disability payments, and experienced a significantly greater reduction in PTSD symptoms. Findings from this study highlight that this distinct population has very poor employment outcomes and deserves more attention, and that reducing PTSD symptoms can lead to improved employment outcomes. Efforts to integrate evidence-based vocational rehabilitation practice into residential PTSD treatment targeting PTSD symptoms is encouraged.
严重创伤后应激障碍（PTSD）已被确定为就业的重大障碍。然而，对于在专门的强化治疗计划中接受治疗的患有严重 PTSD 的退伍军人在一段时间不工作后，就业恢复的相关因素知之甚少。本研究使用参与专门强化 PTSD 治疗的退伍军人的全国退伍军人健康管理局（VHA）计划评估数据，检查了从入院时未就业到出院后四个月就业的过渡率和相关因素（N=27339）。结果表明，只有 5.68%的样本过渡到就业，而 10.6%的样本失去了就业，8.9%的样本在入院和出院后都有工作，74.9%的样本在入院和出院后都没有工作。多项回归分析发现，与其他组相比，就业的退伍军人更年轻，获得服务连接残疾抚恤金的可能性更低，并且 PTSD 症状显著减轻。这项研究的结果强调了这一特定人群的就业结果非常差，值得更多关注，并且减轻 PTSD 症状可以带来更好的就业结果。鼓励将循证职业康复实践纳入针对 PTSD 症状的住宅 PTSD 治疗中。
