PTSD Treatment of African American Adults in Primary Care: The Gap Between Current Practice and Evidence-Based Treatment Guidelines

Graves, Ruth Elaine; Freedy, John R.; Aigbogun, Notalelomwan; Lawson, William B.; Mellman, Thomas A.; Alim, Tanya N.

doi:10.1016/s0027-9684(15)30384-9

Cited by 24 publications

(18 citation statements)

References 34 publications

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“…However, mental health concerns in men and African Americans often go undetected in medical care settings, [18] and African Americans with PTSD are reported to be under-diagnosed due, in part, to a lack of access to mental healthcare. [19,20] This study describes a large realworld sample of individuals in acute psychiatric settings, and demonstrates patterns of diagnosis similar to previous research in medical settings. The continuing differences in diagnosis patterns in a psychiatric setting suggest further research may be needed to identify potential bias in behavioral health settings.…”

Section: Discussionsupporting

confidence: 66%

Presence and influence of trauma in inpatient psychiatric care

Nowlin¹,

Brown²,

Ingram³

et al. 2019

IJH

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Background: Previous research indicates traumatic exposure and posttraumatic stress disorder (PTSD) occur at a higher rate in people with severe mental illness (SMI) than in the general population, and co-occurring PTSD symptoms can worsen outcomes for patients with SMI.Objective: This study assessed the presence and influence of PTSD symptoms in individuals with SMI in an inpatient psychiatric setting, and rates of PTSD diagnoses in this population.Methods: Retrospective analysis of demographic information and behavioral health outcomes, using a representative sample of adult and geriatric inpatient psychiatric patients (N = 4,126).Results: This study found elevated PTSD symptoms in over 65% of patients, and significant positive correlations between PTSD symptomatology and behavioral and emotional dysfunction. This study also explored differences in patients with PTSD symptoms who did and did not receive a PTSD diagnosis, finding associations for admission severity, race, and gender.Conclusions: Traumatization and PTSD symptoms were prevalent in psychiatric inpatient settings, and had an impact on behavioral health outcomes. Recommendations include the use of PTSD screening in behavioral healthcare admission processes, and the furtherance of trauma-informed care for inpatient psychiatric patients with SMI, due to the volume of traumatization and PTSD symptoms in the population.

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Section: Discussionsupporting

confidence: 66%

Presence and influence of trauma in inpatient psychiatric care

Nowlin¹,

Brown²,

Ingram³

et al. 2019

IJH

View full text Add to dashboard Cite

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“…For example, in a cross-sectional study of more than 200 patients receiving services at an urban hospital, less than 14% with PSTD had ever received trauma-focused treatment, citing barriers such as transportation, finances, lack of family approval, and lack of information about how to access services (Davis et al, 2008). In a more recent study in primary care, of the 91 participants diagnosed with current PTSD, 69.2% had never received treatment from a mental health provider (Graves et al, 2011). Overall, in comparison to non-Latino Whites, African Americans with PTSD have less consistent contact with medical professionals (Seng et al, 2005) and are less likely to receive treatment for PTSD (Roberts et al, 2011).…”

Section: ) Discussionmentioning

confidence: 99%

Posttraumatic stress disorder in African Americans: A two year follow-up study

Benítez

Sibrava

Kohn-Wood

et al. 2014

Psychiatry Research

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The present study was a prospective, naturalistic, longitudinal investigation of the two year course of posttraumatic stress disorder (PTSD) in a sample of African Americans with anxiety disorders. The study objectives were to examine the two year course of PTSD and to evaluate differences between African Americans with PTSD and anxiety disorders and African Americans with anxiety disorders but no PTSD with regard to comorbidity, psychosocial impairment, physical and emotional functioning, and treatment participation. The participants were 67 African Americans with PTSD and 98 African Americans without PTSD (mean age 41.5 years, 67.3% female). Individuals with PTSD were more likely to have higher comorbidity, lower functioning, and they were less likely to seek treatment than those with other anxiety disorders but no PTSD. The rate of recovery from PTSD over two years was .10 and recovery from comorbid Major Depressive Disorder was .55. PTSD appears to be persistent over time in this populattion. The rates of recovery were lower than what has been reported in previous longitudinal studies with predominantly non-Latino Whites. It is imperative to examine barriers to treatment and factors related to treatment engagement for this population.

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“…Seeking mental health care at appropriate referral points is a first step for individuals to access evidence-based specialty care for complex disorders such as PTSD. Although there are many barriers that may prevent receipt of evidence-based care for individuals after they initially access the general health care system [43], helping individuals initially access care is an important issue in improving receipt of evidence-based treatment, and a barrier that larger local, state and federal policies are best poised to address.…”

Section: Discussionmentioning

confidence: 99%

Predictors of treatment utilization and unmet treatment need among individuals with posttraumatic stress disorder from a national sample

Nobles

Valentine

Gerber

et al. 2016

General Hospital Psychiatry

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Objective Posttraumatic stress disorder (PTSD) is a chronic psychiatric condition associated with significant disability that often remains untreated. Sociodemographic and family-level factors may serve as predictors of unmet treatment need, identifying groups that would most benefit from policies aimed at increasing access to the mental healthcare system. Method Data from the nationally-representative Collaborative Psychiatric Epidemiologic Surveys was used to identify predictors of mental health treatment utilization, both with a mental health specialist and with a general health practitioner, and self-reported unmet treatment need among individuals who endorsed past-year PTSD. We defined unmet treatment need as self-reporting a mental health problem and not accessing mental health care in the general or specialty mental health care system. Results Among 600 participants, predictors of unmet treatment need included being non-Latino black (OR 2.11, 95% CI 1.25–3.54), having a high school education versus some college (OR 2.45, 95% CI 1.34–4.48), and being employed or unemployed verses not being in the workforce (OR 1.74, 95% CI 1.00–3.02 and OR 4.95, 95% CI 1.60–15.34, respectively). Recursive partitioning identified younger age and being married as predictors of low treatment utilization. Conclusions Future research should elucidate barriers to accessing treatment among those with PTSD in these underserved groups.

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PTSD Treatment of African American Adults in Primary Care: The Gap Between Current Practice and Evidence-Based Treatment Guidelines

Cited by 24 publications

References 34 publications

Presence and influence of trauma in inpatient psychiatric care

Presence and influence of trauma in inpatient psychiatric care

Posttraumatic stress disorder in African Americans: A two year follow-up study

Predictors of treatment utilization and unmet treatment need among individuals with posttraumatic stress disorder from a national sample

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