Kline Alexander C, McCabe Cameron T, Campbell Justin S, Walter Kristen H
Naval Health Research Center.
Leidos, Inc.
Psychol Trauma. 2024 Dec;16(Suppl 3):S502-S510. doi: 10.1037/tra0001621. Epub 2024 Jan 18.
Even after the most effective posttraumatic stress disorder (PTSD) treatments, symptoms often persist. Understanding residual symptoms is particularly relevant in military populations, who may be less responsive to PTSD interventions.
The sample consisted of 282 male service members who engaged in a residential PTSD treatment program at a military treatment facility that provided evidence-based PTSD psychotherapies and adjunctive interventions. PTSD and depression symptoms were assessed before and after treatment and weekly during treatment via the PTSD Checklist-Military Version and Patient Health Questionnaire-8. Logistic regression with Hochberg's step-up procedure compared the likelihood of individual residual symptoms between service members who did ( = 92, 32.6%) and did not ( = 190, 67.4%) experience clinically significant PTSD change (≥ 10-point PTSD Checklist-Military Version reduction).
Not achieving clinically significant PTSD change was associated with greater odds of nearly all residual symptoms ( = 2.03-6.18), excluding two Patient Health Questionnaire-8 items (appetite and psychomotor changes). Among service members experiencing clinically significant PTSD change, concentration difficulties (73.3%), physical reactions to reminders (71.1%), and intrusions (70.8%) were PTSD symptoms most likely to persist. Poor sleep (56.2%), low energy (50.0%), and concentration difficulties (48.3%) were the most common for depression.
To our knowledge, this study is the first to examine residual PTSD and depression symptoms following residential PTSD treatment for active duty service members. Given the low rates of clinically significant PTSD change and the high frequency of residual symptoms, strategies may be needed to improve residential PTSD treatment outcomes in the military. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
即使经过最有效的创伤后应激障碍（PTSD）治疗，症状往往仍会持续。了解残留症状在军人群体中尤为重要，因为他们可能对PTSD干预措施的反应较小。
样本包括282名男性现役军人，他们在一家军事治疗机构参加了住院PTSD治疗项目，该项目提供基于证据的PTSD心理治疗和辅助干预措施。通过PTSD检查表-军事版和患者健康问卷-8在治疗前后以及治疗期间每周评估PTSD和抑郁症状。采用霍奇伯格逐步法进行逻辑回归，比较了经历（n = 92，32.6%）和未经历（n = 190，67.4%）临床显著PTSD变化（PTSD检查表-军事版减少≥10分）的军人个体残留症状的可能性。
未实现临床显著PTSD变化与几乎所有残留症状的更高可能性相关（比值比 = 2.03 - 6.18），不包括患者健康问卷-8中的两项（食欲和精神运动变化）。在经历临床显著PTSD变化的军人中，注意力不集中（73.3%）、对提示的身体反应（71.1%）和闯入性思维（70.8%）是最有可能持续存在的PTSD症状。睡眠不佳（56.2%）、精力不足（50.0%）和注意力不集中（48.3%）是最常见的抑郁症状。
据我们所知，本研究是首个针对现役军人住院PTSD治疗后残留PTSD和抑郁症状进行研究的。鉴于临床显著PTSD变化的发生率较低以及残留症状的高频率，可能需要采取策略来改善军队中住院PTSD治疗的效果。（PsycInfo数据库记录（c）2024美国心理学会版权所有）
