Predictors of Mental Health and Medical Service Use in Veterans Presenting With Combat-Related Posttraumatic Stress Disorder.

Elhai, Jon D.; Reeves, Andrea N.; Frueh, B. Christopher

doi:10.1037/1541-1559.1.2.111

Cited by 31 publications

(46 citation statements)

References 56 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, Calhoun et al [2002] studied only combatexposed veterans, using the Mississippi Combat PTSD Scale to determine PTSD severity; Goto et al [2002] studied disaster victims regardless of PTSD, used the Impact of Event Scale-Revised (IES-R) to gauge PTSD severity, and relied on self-report of prospective MH service use. Other studies find no such relationship between PTSD severity and MH service use for combat veterans [Elhai et al, 2004] and witnesses to a shooting [Schwarz and Kowalski, 1992]. Thus, based on the current and past studies, we cannot conclude whether PTSD severity predicts prospective medical or MH service use.…”

Section: Discussioncontrasting

confidence: 65%

“…Specifically, studies demonstrate that a PTSD diagnosis predicts a greater likelihood (and intensity) of MH [Boscarino et al, 2002;New and Berliner, 2000;Zhang et al, 2004] and medical services [Fagan et al, 2003;Zhang et al, 2004]. Three investigations also reveal that PTSD severity increases the likelihood of MH care use [Calhoun et al, 2002;Goto et al, 2002;Weine et al, 2000], whereas two studies fail to support this finding [Elhai et al, 2004;Schwarz and Kowalski, 1992].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Symptom severity and lifetime and prospective health service use among military veterans evaluated for PTSD

et al. 2007

Self Cite

View full text Add to dashboard Cite

We used structural equation modeling with 174 treatment-seeking military trauma survivors evaluated for posttraumatic stress disorder (PTSD) at a VA Medical Center PTSD clinic to examine relationships among lifetime mental health service use, PTSD symptom severity and medical problems (from self-report), as well as prospective (1-year) mental health and medical care use visit counts extracted from medical records. We discovered an adequate statistical fit to a hypothesized model of previous and prospective health service use, and current PTSD severity and health-related problems. Previous inpatient mental health treatment was significantly related to PTSD severity and prospective outpatient mental health use. However, PTSD severity was unrelated to prospective use of mental health or medical services. Health problems were related to prospective medical service use. Clinical and administrative implications in predicting health care use among trauma survivors are discussed.

show abstract

Section: Discussioncontrasting

confidence: 65%

Section: Introductionmentioning

confidence: 99%

Symptom severity and lifetime and prospective health service use among military veterans evaluated for PTSD

et al. 2007

Self Cite

View full text Add to dashboard Cite

show abstract

“…Less is known regarding whether there are differences in demographic and psychosocial characteristics among veterans with PTSD who elect to seek treatment versus those who do not (e.g. 26 ). Additional research is needed to replicate and expand these findings in other clinical populations, including veterans from different geographical areas and those who are not currently treatment seeking.…”

Section: Discussionmentioning

confidence: 99%

Firearm Ownership Among Military Veterans With PTSD: A Profile of Demographic and Psychosocial Correlates

et al. 2016

View full text Add to dashboard Cite

Posttraumatic stress disorder (PTSD), a condition that disproportionately affects military veterans, is associated with heightened rates of aggression and suicide. Although experience with firearms is common among this population, virtually nothing is known regarding who is more likely to own a firearm and whether firearm ownership is differentially associated with psychological and behavioral risk factors among veterans with PTSD. Of 465 veterans (79% male) entering PTSD treatment, 28% owned a firearm (median number of firearms among owners = 3, range 1-40). Firearm owners reported higher income, were less likely to be unemployed, and were more likely to be male, Caucasian, married, and living in permanent housing. Ownership was associated with higher combat exposure and driving aggression, yet lower rates of childhood and military sexual trauma, suicidal ideation, and incarceration. Ownership was not associated with previous suicide attempt, arrest history, number of traumas experienced, PTSD symptoms, or depression. Together, among a sample of treatment-seeking military veterans with PTSD, those who owned a firearm appeared to demonstrate greater stability across a number of domains of functioning. Importantly though, routine firearm safety discussions (e.g., accessibility restrictions; violence risk assessments) and bolstering of anger management skills remain critical when working with this high-risk population.

show abstract

“…However, the research on the utilization of mental health treatment by veterans has revealed some important racial and ethnic differences. African American veterans receiving PTSD treatment attended fewer sessions (Rosenheck, Fontana, & Cotrol, 1995;Elhai, Reeves, & Frueh, 2004;Lester, Resick, Young-Xu, & Artz;.…”

Section: Psychotherapies For Ptsdmentioning

confidence: 99%

Effectiveness of Cognitive Processing Therapy and Prolonged Exposure in the Department of Veterans Affairs

et al. 2017

View full text Add to dashboard Cite

Multiple randomized clinical trials have shown that cognitive processing therapy (CPT) and prolonged exposure (PE) are evidence-based treatments for posttraumatic stress disorder (PTSD). However, additional research should verify the effectiveness of CPT and PE in conditions more reflective of clinical practice. The present study evaluated the effectiveness of CPT and PE at reducing veterans' self-reported PTSD symptoms as measured by total scores on the PTSD Checklist (PCL). This study involved a retrospective review of 2,030 charts. 750 veterans from 10 U.S. states who received CPT or PE in individual psychotherapy from the Veterans Health Administration were included in the study (N participants in CPT = 376; N participants in PE = 374). The study used multilevel modeling to evaluate the absolute and relative effectiveness of both treatments and to determine the relationship between patient-level factors and total PCL scores during treatment. Results showed that both CPT and PE were equally effective at reducing total PCL scores, but that the effectiveness of both therapies was reduced when compared to results obtained in randomized clinical trials. Patients who completed therapy reported significantly larger reductions on the PCL than patients who did not complete therapy. On average, patients who did not complete a full course of therapy reported little to no improvement on the PCL. Encouragingly, as a group these patients did not report an increase in the severity of their total PCL scores prior to dropping out from therapy. Patients who reported more severe total PCL scores at baseline experienced significantly larger reductions in PCL scores during therapy, but veterans at all levels of initial PTSD symptom severity benefited from treatment. Older veterans and Hispanic veterans had higher total PCL scores at baseline.However, veterans across all ages and three racial/ethnic groups (Caucasian, African American, Hispanic) experienced equivalent rates of symptom reduction. Therapist effects were small, but -ivstatistically significant. The study discusses the significance of these findings in light of prior research on trauma-focused therapy, future directions for research, and implications for practice.-v- Acknowledgements

show abstract

Predictors of Mental Health and Medical Service Use in Veterans Presenting With Combat-Related Posttraumatic Stress Disorder.

Cited by 31 publications

References 56 publications

Symptom severity and lifetime and prospective health service use among military veterans evaluated for PTSD

Symptom severity and lifetime and prospective health service use among military veterans evaluated for PTSD

Firearm Ownership Among Military Veterans With PTSD: A Profile of Demographic and Psychosocial Correlates

Effectiveness of Cognitive Processing Therapy and Prolonged Exposure in the Department of Veterans Affairs

Contact Info

Product

Resources

About