OEF/OIF/OND Veterans Seeking PTSD Treatment: Perceptions of Partner Involvement in Trauma-Focused Treatment

Malaktaris, Anne; Buzzella, Brian A.; Siegel, M; Myers, Ursula S.; Browne, Kendall C.; Norman, Sonya B.; Angkaw, Abigail C.

doi:10.1093/milmed/usy231

Cited by 8 publications

(6 citation statements)

References 34 publications

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“…One qualitative study by Snell and Tusaie (2008) found that the most frequently cited reason for seeking treatment was disruptions in relationships with significant others, including ultimatums issued by partners demanding that the veteran get help. Additionally, another study found that among veterans seeking treatment for PTSD, the majority reported current romantic relationship dissatisfaction (Malaktaris et al, 2019). Another study measuring mental health utilization using electronic medical record data found that relationship satisfaction was negatively related to mental health service use; however, PTSD symptom severity was only related to mental health service use at mean and high levels of relationship satisfaction (McGinn et al, 2017).…”

mentioning

confidence: 99%

Mental health treatment utilization and relationship functioning among male and female OEF/OIF veterans.

Harper¹,

Thompson‐Hollands²,

Keane³

et al. 2022

Psychological Services

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This study examined whether romantic relationship functioning was associated with mental health treatment utilization in male and female veterans. Veterans (N = 760) enrolled in a longitudinal registry completed self-report measures and a diagnostic interview for posttraumatic stress disorder (PTSD). Mental health treatment utilization data procured from Veterans Affairs administrative records were analyzed over 12 months. For men with PTSD, greater romantic relationship dysfunction was associated with more total mental health visits, medication management visits, and group psychotherapy visits. For women with PTSD, romantic relationship dysfunction was negatively associated with total mental health, individual psychotherapy, and group therapy visits. For women without PTSD, greater relationship dysfunction was associated with fewer total mental health visits and group therapy visits. For men, relationship difficulties appear to be positively related to mental health service use; however, for women, relationship difficulties appear to have no relation or a negative relation to mental health service use.

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mentioning

confidence: 99%

Mental health treatment utilization and relationship functioning among male and female OEF/OIF veterans.

Harper¹,

Thompson‐Hollands²,

Keane³

et al. 2022

Psychological Services

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“…27 Additionally, there is strong evidence from systematic reviews documenting the effectiveness of couples therapies for treating adult PTSD and improving interpersonal relationship problems secondary to PTSD symptoms. 11,12,28 Given the research linking PTSD and relational discord in veteran populations, this finding suggests potential underutilization of trauma-informed family therapy among VHA patients.…”

Section: Discussionmentioning

confidence: 99%

Retention in Individual Trauma-Focused Treatment Following Family-Based Treatment Among US Veterans

Dodge,

Sullivan,

Grau

et al. 2023

JAMA Netw Open

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ImportanceDespite the availability of several empirically supported trauma-focused interventions, retention in posttraumatic stress disorder (PTSD) psychotherapy is poor. Preliminary efficacy data shows that brief, family-based interventions may improve treatment retention in a veteran’s individual PTSD treatment, although whether this occurs in routine clinical practice is not established.ObjectiveTo characterize receipt of family therapy among veterans diagnosed with PTSD and evaluate whether participation in family therapy is associated with an increased likelihood of completing individual trauma-focused treatment.Design, Setting, and ParticipantsThis retrospective cohort study used the Veterans Health Administration (VHA) Informatics and Computing Infrastructure to extract electronic health record data of participants. All participants were US veterans diagnosed with PTSD between October 1, 2015, and December 31, 2019, who attended at least 1 individual trauma-focused treatment session. Statistical analysis was performed from May to August 2023.ExposuresReceipt of any family psychotherapy and subtype of family-based psychotherapy.Main Outcomes and MeasuresMinimally adequate individual trauma-focused treatment completion (ie, 8 or more sessions of trauma-focused treatment in a 6-month period).ResultsAmong a total of 1 516 887 US veterans with VHA patient data included in the study, 58 653 (3.9%) received any family therapy; 334 645 (23.5%) were Black, 1 006 168 (70.5%) were White, and 86 176 (6.0%) were other race; 1 322 592 (87.2%) were male; 1 201 902 (79.9%) lived in urban areas; and the mean (SD) age at first individual psychotherapy appointment was 52.7 (15.9) years. Among the 58 653 veterans (3.9%) who received any family therapy, 36 913 (62.9%) received undefined family therapy only, 15 528 (26.5%) received trauma-informed cognitive-behavioral conjoint therapy (CBCT) only, 5210 (8.9%) received integrative behavioral couples therapy (IBCT) only, and 282 (0.5%) received behavioral family therapy (BFT) only. Compared with receiving no family therapy, the odds of completing individual PTSD treatment were 7% higher for veterans who also received CBCT (OR, 1.07 [95% CI, 1.01-1.13]) and 68% higher for veterans received undefined family therapy (OR, 1.68 [95% CI, 1.63-1.74]). However, compared with receiving no family therapy care, veterans had 26% lower odds of completing individual PTSD treatment if they were also receiving IBCT (OR, 0.74 [95% CI, 0.66-0.82]).Conclusions and RelevanceIn this cohort study of US veterans, family-based psychotherapies were found to differ substantially in their associations with individual PTSD psychotherapy retention. These findings highlight potential benefits of concurrently providing family-based therapy with individual PTSD treatment but also the need for careful clinical attention to the balance between family-based therapies and individual PTSD treatment.

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“…These findings are also consistent with qualitative work that suggests that male veterans often cite difficulties in their significant relationships as a reason for seeking mental health treatment (Snell & Tusaie, 2008). Problems in intimate relationships appear to be a particularly salient motivator for mental health treatment seeking among male veterans with PTSD (Harper et al, 2021; Malaktaris et al, 2019). Men tend to have smaller social networks than women, and disruptions in relationships more negatively impact social networks for men (McLaughlin et al, 2010).…”

Section: Discussionmentioning

confidence: 99%

“…In turn, poor intimate relationship functioning (i.e., difficulties with satisfaction, distress, support, and communication) can serve as a motivator for initiating mental health treatment. For example, difficulties in intimate relationships are often cited as a reason for mental health treatment seeking, especially among male veterans with PTSD (Malaktaris et al, 2019; Snell & Tusaie, 2008). However, little research has specifically examined the relationships between PTSD, intimate relationship functioning, and mental health treatment seeking.…”

mentioning

confidence: 99%

The role of PTSD symptom severity and relationship functioning in male and female veterans’ mental health service use.

Harper¹,

Vogt²,

Fox³

et al. 2023

Psychological Trauma: Theory, Research, Practice, and Policy

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Objective: Previous research has shown that difficulties in intimate relationships promote mental health treatment seeking for male veterans, but findings for female veterans have been mixed. The current study sought to further evaluate whether intimate relationship functioning is a motivator for mental health treatment seeking for male and female veterans and examine the impact of different types of trauma exposure on this association. Method: Using data from a longitudinal study, we examined whether intimate relationship functioning mediated the association between posttraumatic stress disorder (PTSD) symptom severity and mental health service use (0 = no mental health services, 1 = any mental health services) in male and female veterans (N = 1,200). We used multiple groups path analysis to examine whether intimate relationship functioning mediated the association between PTSD symptom severity and mental health service use for male and female veterans. Results: For male veterans, greater PTSD symptom severity was related to poorer intimate relationship functioning, which in turn explained increased likelihood of mental health service use (R2 = .18). This mediation effect was not significant for female veterans. Conclusions: Our findings suggest that targeting intimate relationship functioning in treatment for male veterans may be beneficial because difficulties in these relationships appear to be a motivating factor for treatment seeking.

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OEF/OIF/OND Veterans Seeking PTSD Treatment: Perceptions of Partner Involvement in Trauma-Focused Treatment

Cited by 8 publications

References 34 publications

Mental health treatment utilization and relationship functioning among male and female OEF/OIF veterans.

Mental health treatment utilization and relationship functioning among male and female OEF/OIF veterans.

Retention in Individual Trauma-Focused Treatment Following Family-Based Treatment Among US Veterans

The role of PTSD symptom severity and relationship functioning in male and female veterans’ mental health service use.

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