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审查基于证据的创伤后应激障碍治疗在军事性创伤后保留方面的民族种族差异。

Examining Ethnoracial Differences in Retention in Evidence-Based Treatments for Posttraumatic Stress Disorder Secondary to Military Sexual Trauma.

机构信息

VA Center for Clinical Management Research, Ann Arbor, MI, USA

Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA.

出版信息

Violence Vict. 2024 Oct 14;39(5):618-633. doi: 10.1891/VV-2023-0069.

Abstract

Improving and expanding mental health treatment for Veterans who have experienced military sexual trauma (MST) is currently a top priority in Veterans Healthcare Administration. Many of these Veterans develop posttraumatic stress disorder (PTSD), and there is increasing recognition that diversity is a core treatment consideration for Veterans who have experienced trauma. As such, more information is needed concerning the relationship between trauma-focused treatment attrition and ethnoracial identity in Veterans who have experienced MST. This article presents two studies exploring dropout from a Midwestern Department of Veterans Affairs (VA) PTSD clinic in samples of Veterans who experienced MST. These studies aim to reduce this knowledge gap by contrasting Black and White Veterans' retention in trauma-focused care. In Study 1 ( = 141), we examined ethnoracial differences in dropout in a cohort of treatment-seeking Veterans who experienced MST and engaged in cognitive processing therapy (CPT) in a VA specialty PTSD clinic. In Study 2 ( = 109), we explored the same questions related to treatment attrition in a separate cohort of treatment-seeking Veterans who experienced MST and engaged in prolonged exposure (PE) in a VA specialty PTSD clinic. Results from both studies did not indicate ethnoracial differences in attrition rate (for both total sessions and an 8-week minimally adequate care [MAC] window) across evidence-based PTSD treatment. However, it remains important to consider the impact of racial and cultural factors on retention. Future research should aim to recruit a larger racially and ethnically diverse sample to explore possible varying retention outcomes of CPT and PE for MST-related PTSD.

摘要

提高和扩大经历过军事性创伤(MST)的退伍军人的心理健康治疗目前是退伍军人医疗保健管理局的首要任务。许多退伍军人患有创伤后应激障碍(PTSD),人们越来越认识到,多样性是经历过创伤的退伍军人核心治疗考虑因素之一。因此,需要更多关于经历过 MST 的退伍军人中创伤焦点治疗脱落与族裔身份之间关系的信息。本文介绍了两项研究,这些研究探索了中西部退伍军人事务部(VA)创伤后应激障碍诊所中经历过 MST 的退伍军人样本中的脱落情况。这些研究旨在通过对比经历过 MST 的黑人和白人退伍军人在创伤焦点治疗中的保留率来缩小这一知识差距。在研究 1(n=141)中,我们检查了经历过 MST 并在 VA 专业 PTSD 诊所接受认知加工疗法(CPT)的治疗寻求退伍军人队列中脱落的族裔差异。在研究 2(n=109)中,我们在经历过 MST 并在 VA 专业 PTSD 诊所接受延长暴露(PE)的另一组治疗寻求退伍军人中探索了与治疗脱落相关的相同问题。两项研究的结果均表明,在基于证据的 PTSD 治疗中,脱落率(总疗程和 8 周最低充分治疗[MAC]窗口)没有族裔差异。然而,考虑种族和文化因素对保留率的影响仍然很重要。未来的研究应该招募更多的种族和族裔多样化的样本,以探索 MST 相关 PTSD 的 CPT 和 PE 可能存在不同的保留结果。

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