Treatment barriers for low‐income, urban African Americans with undiagnosed posttraumatic stress disorder

Davis, Rogena; Ressler, Kerry J.; Schwartz, Ann C.; Stephens, Kisha James; Bradley, Rebekah

doi:10.1002/jts.20313

Cited by 139 publications

(118 citation statements)

References 15 publications

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“…These are particularly important individual difference variables to consider given that access to treatment 38 and factors such as stigma 39 can vary substantially across these groups. Research on the acceptability of treatment for depression has suggested that African American and Hispanic participants report lower acceptability of medication relative to White participants.…”

Section: Discussionmentioning

confidence: 99%

Patient Preference for Psychological vs Pharmacologic Treatment of Psychiatric Disorders

McHugh¹,

Whitton²,

Peckham³

et al. 2013

J. Clin. Psychiatry

619

390

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Objective Models of evidence-based practice emphasize the consideration of treatment efficacy/effectiveness, clinical expertise, and patient preference in treatment selection and implementation. However, patient preference for psychiatric treatment has been understudied. The aim of this meta-analytic review was to provide an estimate of the proportion of patients preferring psychological treatment relative to medication for psychiatric disorders. Data Sources A literature search was conducted using PubMed, PsycINFO, and the Cochrane Collaboration Library through August, 2011 for studies written in English that assessed patient preferences for the treatment of psychiatric disorders. Study Selection Studies assessing the preferred type of treatment including at least one psychological treatment and one pharmacological treatment were included. Of the 641 articles initially identified, 34 met criteria for inclusion. Data Extraction Authors extracted relevant data including the proportion of participants reporting preference for psychological and pharmacological treatment. Results Across studies, the proportion preferring psychological treatment was 0.75 (95% CI: 0.69 to 0.80), which was significantly higher than equivalent preference (i.e., higher than 0.50, p < .001). Sensitivity analyses suggested that younger patients (p < .05) and women (p < .01) were significantly more like to choose psychological treatment. A preference for psychological treatment was consistently evident in both treatment-seeking and unselected samples (ps < .05), but was somewhat stronger for the unselected samples. Conclusions Aggregation of patient preferences across diverse settings yielded a significant three-fold preference for psychological treatment relative to medication. Given the similar efficacy of these treatments for depression and anxiety, improving access to evidence-based psychological treatment is needed to connect more patients to their preferred treatment.

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Section: Discussionmentioning

confidence: 99%

Patient Preference for Psychological vs Pharmacologic Treatment of Psychiatric Disorders

McHugh¹,

Whitton²,

Peckham³

et al. 2013

J. Clin. Psychiatry

619

390

View full text Add to dashboard Cite

show abstract

“…19 Despite the apparent need for trauma treatment among African American women, PTSD remains under-diagnosed and undertreated within the African American community. 20,21 Due to the high prevalence of trauma among substance using African American women, treatment providers in substance treatment settings are likely to encounter additional co-occurring health and mental health problems among their patients. Among inner-city African American women, Paranjape et al found greater depressive symptoms among women who reported both high levels of intimate partner violence and alcohol problems.…”

Section: Introductionmentioning

confidence: 99%

Posttraumatic Stress Disorder, Health Problems, and Depression Among African American Women in Residential Substance Use Treatment

Meshberg‐Cohen

Presseau

Thacker

et al. 2016

Journal of Women's Health

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Background: Rates of posttraumatic stress disorder (PTSD) are high among women seeking treatment for substance use disorders (SUDs). Minority women, in particular, experience high rates of trauma and may be less likely to disclose trauma history. This article identifies items from pre-existing screening measures that can be used across settings to sensitively but noninvasively identify women with likely PTSD. Method: For a sample of 104 African American women in residential SUD treatment who provided informed consent as a part of a larger randomized clinical trial, the prevalence of trauma and PTSD, as well as the relationships between trauma, health, depression, and distress, was examined. Measures included Posttraumatic Stress Diagnostic Scale (PDS), Center for Epidemiologic Studies-Depression Scale (CES-D), Pennebaker Inventory of Limbic Languidness (PILL), and Brief Symptom Inventory (BSI). Additional analyses were undertaken to determine if a subset of noninvasive items could serve to identify the presence of a probable PTSD diagnosis. Results: Most women (94.2%) reported at least one lifetime trauma, with over half (51.0%) meeting DSM-IV criteria for PTSD. Women with greater trauma symptom severity reported more health problems and higher levels of depression and distress. Five BSI items and one CES-D item were significantly associated with a probable PTSD diagnosis with a sensitivity of 88.7%, a specificity of 66.7%, a positive predictive value of 73.4%, a negative predictive value of 85.0%, and an accuracy of 77.9%. Conclusion: Findings affirm that African American women with SUDs present for residential treatment with comorbid psychiatric and emotional conditions that warrant assessment and treatment. Results highlight potential benefits of brief screening with routine measures and coordinated access to ancillary psychiatric and medical services, in conjunction with substance treatment, such as in residential or primary care.

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“…Instead, helpers should use the opportunity to engage in psychoeducational interventions. Lack of knowledge and the stigma of mental health treatment have been recognized as significant barriers to help-seeking among African Americans (Alim et al, 2008;Davis et al, 2008;Pole et al, 2008). Psychoeducation is a standard procedure in CBT for psychological disorders related to traumatic events (Feske, 2008;Jones et al, 2008;Zappert & Westrup, 2008).…”

Section: Identifying and Interpreting The Emotions Of Katrina Survivorsmentioning

confidence: 99%

“…Reviews of the literature on PTSD in African Americans also reveal a need for more culturally informed treatment approaches (Alim, Charney, & Mellman, 2008;Pole, Gone, & Kulkarni, 2008). Cultural factors were among the barriers to treatment for PTSD identified by Davis et al (2008) among low-income African Americans. Thus, as some clinicians and researchers point out (Jones, Immel, Moore, & Hadder, 2008;Madrid & Grant, 2008), cultural competence is an additional feature of effective engagement in mental health care for survivors of this natural disaster and other traumatic events.…”

mentioning

confidence: 97%

Trauma Among Survivors of Hurricane Katrina: Considerations and Recommendations for Mental Health Care

Whaley

2009

Journal of Loss and Trauma

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Treatment barriers for low‐income, urban African Americans with undiagnosed posttraumatic stress disorder

Cited by 139 publications

References 15 publications

Patient Preference for Psychological vs Pharmacologic Treatment of Psychiatric Disorders

Patient Preference for Psychological vs Pharmacologic Treatment of Psychiatric Disorders

Posttraumatic Stress Disorder, Health Problems, and Depression Among African American Women in Residential Substance Use Treatment

Trauma Among Survivors of Hurricane Katrina: Considerations and Recommendations for Mental Health Care

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