Rebecca K Sripada1, Frederic C Blow2, Sheila A M Rauch3, Dara Ganoczy4, Rani Hoff5, Ilan Harpaz-Rotem5, Kipling M Bohnert2. 1. Veterans Affairs Center for Clinical Management Research and Veterans Affairs Ann Arbor Health Care System, Ann Arbor, MI, United States; University of Michigan, Department of Psychiatry, Ann Arbor, MI, United States. Electronic address: rekaufma@med.umich.edu. 2. Veterans Affairs Center for Clinical Management Research and Veterans Affairs Ann Arbor Health Care System, Ann Arbor, MI, United States; University of Michigan, Department of Psychiatry, Ann Arbor, MI, United States. 3. Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, United States; Atlanta VA Medical Center, Atlanta, GA, United States. 4. Veterans Affairs Center for Clinical Management Research and Veterans Affairs Ann Arbor Health Care System, Ann Arbor, MI, United States. 5. Veterans Affairs Northeast Program Evaluation Center, West Haven, CT, United States; Veterans Affairs National Center for PTSD, Veteran Affairs Connecticut Healthcare System, West Haven, CT, United States; Yale University, Department of Psychiatry, New Haven, CT, United States.
Abstract
OBJECTIVE: Although several treatments for PTSD have demonstrated efficacy, a substantial portion of patients do not experience clinically significant improvement. Predictors of treatment response are poorly understood. The current study was designed to investigate predictors of PTSD symptom change in a large national sample of treatment-seeking Veterans with PTSD. METHOD: We analyzed predictors of treatment response among Veterans engaged in residential PTSD treatment from 2012 to 2013 (N = 2715). Multilevel modeling was used to assess the association between individual-level factors and symptom improvement from treatment entry to post-discharge. Guided by the theory of Resources, Life Events and Changes in Psychological States, we hypothesized that individuals with greater psychological, social/contextual, material, and physical health resources would exhibit better treatment response. RESULTS: In adjusted analyses, accounting for facility, factors that predicted better treatment response included female gender, more psychological and social/contextual protective factors, and more years of education. Factors that predicted worse treatment response included Black race, comorbid personality disorder, greater pain severity, and current application for disability-related compensation. CONCLUSIONS: These findings highlight factors that place individuals at risk of poor treatment response. Treatment modifications may be needed in order to optimize response for subgroups who are less likely to benefit from residential PTSD treatment. Published by Elsevier Ltd.
OBJECTIVE: Although several treatments for PTSD have demonstrated efficacy, a substantial portion of patients do not experience clinically significant improvement. Predictors of treatment response are poorly understood. The current study was designed to investigate predictors of PTSD symptom change in a large national sample of treatment-seeking Veterans with PTSD. METHOD: We analyzed predictors of treatment response among Veterans engaged in residential PTSD treatment from 2012 to 2013 (N = 2715). Multilevel modeling was used to assess the association between individual-level factors and symptom improvement from treatment entry to post-discharge. Guided by the theory of Resources, Life Events and Changes in Psychological States, we hypothesized that individuals with greater psychological, social/contextual, material, and physical health resources would exhibit better treatment response. RESULTS: In adjusted analyses, accounting for facility, factors that predicted better treatment response included female gender, more psychological and social/contextual protective factors, and more years of education. Factors that predicted worse treatment response included Black race, comorbid personality disorder, greater pain severity, and current application for disability-related compensation. CONCLUSIONS: These findings highlight factors that place individuals at risk of poor treatment response. Treatment modifications may be needed in order to optimize response for subgroups who are less likely to benefit from residential PTSD treatment. Published by Elsevier Ltd.
Entities:
Keywords:
Department of Veterans Affairs; Posttraumatic stress disorder; Psychotherapy; Residential; VA
Authors: Jony Sheynin; Elizabeth R Duval; Anthony P King; Mike Angstadt; K Luan Phan; Naomi M Simon; Sheila A M Rauch; Israel Liberzon Journal: Depress Anxiety Date: 2020-07-15 Impact factor: 8.128