Comparing the effectiveness of VA residential PTSD treatment for veterans who do and do not report a history of MST: A national investigation

Holliday, Ryan; Smith, Noelle B.; Holder, Nicholas; Gross, Georgina M.; Monteith, Lindsey L.; Maguen, Shira; Hoff, Rani A.; Harpaz‐Rotem, Ilan

doi:10.1016/j.jpsychires.2019.12.012

Cited by 20 publications

(41 citation statements)

References 40 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our first hypothesis was supported, as we found veterans with MST-IT were more likely to be female than male, even in our nearly balanced sample of 186 men and 147 women. In line with our findings, several previous studies have found that veterans with MST-IT were more likely to be female (Carroll et al, 2018; Holliday et al, 2020; Voelkel et al, 2015); however, only a few studies have also found veterans with MST-IT to be older (Carroll et al, 2018; Holliday et al, 2020) and to have served pre-9/11 (Carroll et al, 2018). Like Kimerling et al (2007), we found that men, regardless of MST-IT status, were more likely to be of a minority status.…”

Section: Discussionsupporting

confidence: 92%

“…The results of hierarchical regression models showed that neither MST-IT status, gender, nor the interaction between MST-IT and gender predicted post-treatment self-or clinician-rated overall PTSD severity after accounting for pre-treatment severity. These findings are consistent with previous literature (Holliday et al, 2020;Tiet et al, 2015;Voelkel et al, 2015), suggesting residential CPT is similarly effective in reducing PTSD symptoms in individuals with and without MST-IT, regardless of gender. Our study is also one of the first to compare reductions in NPCs across groups by MST-IT status and gender in NP20717 cohorts with mixed trauma type.…”

Section: Np20716supporting

confidence: 93%

“…Although some studies have found that individuals with MST are less likely to be currently married (Kimerling et al, 2007; Voelkel et al, 2015), this was only true for men with MST-IT in our sample. Given the mixed findings throughout the literature comparing demographic variables for individuals with and without MST (Carroll et al, 2018; Holliday et al, 2020; Khan et al, 2020; Kimerling et al, 2007; Voelkel et al, 2015), it remains difficult to conclude any distinct differences in demographic presentation beyond gender for individuals with and without MST-IT.…”

Section: Discussionmentioning

confidence: 99%

“…To do this, we examined differences among various demographic variables (i.e., age, employment, marital status, minority status, and gender), military service variables (i.e., combat exposure, military branch, service connection status, and service era) and comorbid diagnoses when we compared groups on MST-IT status (i.e., MST-IT vs. no MST-IT, the category representing individuals with all other index trauma type), gender (i.e., men vs. women), and gender within MST-IT status (i.e., interaction of MST-IT by gender). We expected to find more women in the MST-IT group (Carroll et al, 2018;Holliday et al, 2020;Khan et al, 2020;Voelkel et al, 2015), but did not make hypotheses about other variables given the inconsistencies in the literature.…”

Section: Np20706mentioning

confidence: 99%

“…Although there is variability across samples, those with MST-IT are more likely to be women, racial minorities, veterans of the Army, unmarried, unemployed, and less educated (Carroll et al, 2018;Voelkel et al, 2015). Also, those with MST-IT tend to have more severe PTSD when presenting for treatment than those with PTSD from other traumas (Holliday et al, 2020;Voelkel et al, 2015), though this has not always been found (Khan et al, 2020;Tiet et al, 2015).…”

Section: Introductionmentioning

confidence: 98%

See 4 more Smart Citations

Comparing Veterans with Posttraumatic Stress Disorder Related to Military Sexual Trauma or Other Trauma Types: Baseline Characteristics and Residential Cognitive Processing Therapy Outcomes

Christ

Blain

Pukay‐Martin

et al. 2021

J Interpers Violence

View full text Add to dashboard Cite

The Veterans Health Administration (VHA) has called for improved assessment and intervention for survivors of military sexual trauma (MST) to mitigate deleterious sequalae, including posttraumatic stress disorder (PTSD). Research on the impact of MST-related PTSD (MST-IT) on men is limited, and few studies have examined the differential effects of treatment across genders and MST-IT. Additionally, studies have utilized varying definitions of MST (e.g., sexual assault only vs. including sexual harassment), contributing to disparate outcomes across studies. Utilizing data from 343 veterans seeking residential cognitive processing therapy (CPT) for PTSD in VHA, this study examined the impact of MST-IT and gender on differences in demographic characteristics; pre-treatment severity of PTSD (overall and clusters), depression, and negative posttraumatic cognitions (NPCs); and post-treatment severity of these variables after accounting for pre-treatment severity. Results from 2x2 factorial ANOVAs found no differences in pre-treatment depression or overall PTSD by MST-IT, gender, or their interaction; however, MST-IT survivors presented with greater pre-treatment avoidance, global NPCs, and self-blame. Results from hierarchical linear regression models found only pre-treatment symptom severity significantly predicted post-treatment severity for overall PTSD and all NPCs. These findings suggest veteran survivors of MST-IT appear to benefit similarly from CPT delivered in a VHA residential PTSD program compared to veterans with other index traumas, regardless of gender. Although there were minimal post-treatment differences in PTSD and NPCs by MST-IT status and gender, residual symptoms related to negative cognitions and mood appear to differ across gender and MST-IT status. Specifically, in individuals without MST-IT, post-treatment PTSD symptoms of negative alterations in cognition and mood were higher in men than women. Moreover, women with MST-IT reported more symptoms of depression than both men with MST-IT and women without MST-IT. These findings suggest depressive symptoms decrease through residential PTSD treatment differentially by MST-IT status and gender and warrant further examination.

show abstract

Section: Discussionsupporting

confidence: 92%

Section: Np20716supporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Section: Np20706mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 98%

See 3 more Smart Citations

Comparing Veterans with Posttraumatic Stress Disorder Related to Military Sexual Trauma or Other Trauma Types: Baseline Characteristics and Residential Cognitive Processing Therapy Outcomes

Christ

Blain

Pukay‐Martin

et al. 2021

J Interpers Violence

View full text Add to dashboard Cite

show abstract

State of the Knowledge of VA Military Sexual Trauma Research

et al. 2022

View full text Add to dashboard Cite

Despite substantial efforts to counter sexual assault and harassment in the military, both remain persistent in the Armed Services. In February 2021, President Biden directed the U.S. Department of Defense to establish a 90-day Independent Review Commission on Sexual Assault in the Military (IRC) to assess the department’s efforts and make actionable recommendations. As servicemembers discharge from the military, effects of military sexual trauma (MST) are often seen in the Veterans Health Administration (VA). In response to an IRC inquiry about VA MST research, we organized an overview on prevalence, adverse consequences, and evidence-based treatments targeting the sequelae of MST. Women are significantly more likely to experience MST than their male counterparts. Other groups with low societal and institutional power (e.g., lower rank) are also at increased risk. Although not all MST survivors experience long-term adverse consequences, for many, they can be significant, chronic, and enduring and span mental and physical health outcomes, as well as cumulative impairments in functioning. Adverse consequences of MST come with commonalities shared with sexual trauma in other settings (e.g., interpersonal betrayal, victim-blaming) as well as unique aspects of the military context, where experiences of interpersonal betrayal may be compounded by perceptions of institutional betrayal (e.g., fear of reprisal or ostracism, having to work/live alongside a perpetrator). MST’s most common mental health impact is posttraumatic stress disorder, which rarely occurs in isolation, and may coincide with major depression, anxiety, eating disorders, substance use disorders, and increased suicidality. Physical health impacts include greater chronic disease burden (e.g., hypertension), and impaired reproductive health and sexual functioning. Advances in treatment include evidence-based psychotherapies and novel approaches relying on mind-body interventions and peer support. Nonetheless, much work is needed to enhance detection, access, care, and support or even the best interventions will not be effective.

show abstract

Conceptualizing traumatic stress and the structure of posttraumatic psychopathology through the lenses of RDoC and HiTOP

Hawn

Wolf

Neale

2022

Clinical Psychology Review

View full text Add to dashboard Cite

Comparing the effectiveness of VA residential PTSD treatment for veterans who do and do not report a history of MST: A national investigation

Cited by 20 publications

References 40 publications

Comparing Veterans with Posttraumatic Stress Disorder Related to Military Sexual Trauma or Other Trauma Types: Baseline Characteristics and Residential Cognitive Processing Therapy Outcomes

Comparing Veterans with Posttraumatic Stress Disorder Related to Military Sexual Trauma or Other Trauma Types: Baseline Characteristics and Residential Cognitive Processing Therapy Outcomes

State of the Knowledge of VA Military Sexual Trauma Research

Conceptualizing traumatic stress and the structure of posttraumatic psychopathology through the lenses of RDoC and HiTOP

Contact Info

Product

Resources

About