Lesbian, Gay, Bisexual, Transgender, and Queer (LGBTQ+) Health Program, Veterans Health Administration.
Department of Veterans Affairs Medical Center, VA Informatics and Computing Infrastructure, VA Salt Lake City Health Care System.
J Consult Clin Psychol. 2021 Oct;89(10):856-868. doi: 10.1037/ccp0000691.
Questionnaire studies show people with minoritized sexual orientations (MSOs) face increased risk for conditions including posttraumatic stress disorder (PTSD). This study replicated Harrington et al.'s (2019) electronic health record probabilistic algorithm to evaluate lifetime PTSD prevalence in Veterans Health Administration (VHA)-using veterans. In 115,853 MSO veterans and a 1:3 matched (on sex assigned at birth, and age at and year of first VHA visit) sample of non-MSO veterans. Each veteran was given a probability of "likely PTSD" (0.0-1.0) and thresholds (e.g., 0.7) applied to minimize false positive classifications. Veterans with MSO were 2.35 times, CI [2.33, 2.38], more likely to have "likely PTSD" than veterans with non-MSO. The prevalence of "likely PTSD" using the rule-based International Classification of Diseases (ICD) approach was 40.8% among the MSO group compared to 22.0% among the non-MSO group after excluding those with bipolar or schizophrenia diagnoses and those with limited VHA engagement. Without those exclusions, prevalence was slightly higher in both groups (46.1% vs. 24.3%, respectively; prevalence ratio: 1.90). Despite increased prevalence of exposure to military sexual trauma (MST; MSO = 20.7%; non-MSO = 8.3%) and double "likely PTSD" among MSO veterans, they were less likely to have a service-connected PTSD disability than their matched non-MSO (MSO = 78.1%; non-MSO = 87.6%) comparators. VHA-using veterans with MSO were twice as likely to have "likely PTSD" and exposure to MST than veterans with non-MSO. Veterans with MSO were less likely to be service connected for PTSD than non-MSO counterparts. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
问卷研究表明，性少数群体（MSOs）面临包括创伤后应激障碍（PTSD）在内的多种疾病的风险增加。本研究复制了 Harrington 等人（2019 年）的电子健康记录概率算法，以评估退伍军人事务部（VA）使用退伍军人中的终身 PTSD 患病率。在 115853 名 MSO 退伍军人和一个 1:3 匹配（按出生时的性别、首次 VA 就诊时的年龄和年份）的非 MSO 退伍军人样本中。每位退伍军人都被给予“可能患有 PTSD”的概率（0.0-1.0）和阈值（例如，0.7），以最小化假阳性分类。与非 MSO 退伍军人相比，MSO 退伍军人更有可能“可能患有 PTSD”，可能性是其 2.35 倍，CI [2.33, 2.38]。使用基于规则的国际疾病分类（ICD）方法，MSO 组中“可能患有 PTSD”的患病率为 40.8%，而非 MSO 组中为 22.0%，排除双相情感障碍或精神分裂症诊断以及 VHA 参与度有限的退伍军人后。如果不排除这些因素，两组的患病率都会略高（分别为 46.1%和 24.3%，患病率比：1.90）。尽管 MSO 退伍军人接触军事性创伤（MSO = 20.7%；非 MSO = 8.3%）和双“可能患有 PTSD”的风险增加，但他们获得与服务相关的 PTSD 残疾的可能性却低于其匹配的非 MSO（MSO = 78.1%；非 MSO = 87.6%）对照组。与非 MSO 退伍军人相比，使用 VHA 的 MSO 退伍军人“可能患有 PTSD”和接触 MST 的可能性是其两倍。与非 MSO 退伍军人相比，MSO 退伍军人 PTSD 与服务相关的可能性较小。
