Jack Tsai1,2,3, Vanessa Schick2, Belinda Hernandez2, Robert H Pietrzak3,4. 1. U.S. Department of Veterans Affairs, National Center on Homelessness Among Veterans, Tampa, Florida, USA. 2. School of Public Health, University of Texas Health Science Center at Houston, Houston, Texas, USA. 3. Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA. 4. U.S. Department of Veterans Affairs, National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven, Connecticut, USA.
Abstract
METHODS: Data from a nationally representative sample of 4,069 U.S. veterans in 2019-2020 were used to examine the prevalence of full and subthreshold PTSD in veterans with a history of homelessness; identify characteristics associated with PTSD; examine the proportion of veterans who reported homelessness as an index trauma event and screened positive for PTSD. RESULTS: Among veterans with a history of homelessness, lifetime prevalence of full and subthreshold PTSD was 33.0% and 32.0%; and past-month prevalence of full and subthreshold PTSD was 5.6% and 12.7%. These prevalence estimates were more than five times higher than nonhomeless veterans. Among veterans with a history of homelessness, 14.1% reported that homelessness was their "worst" traumatic event which was associated with a fivefold greater odds of current PTSD and nearly threefold greater odds of subthreshold PTSD even after adjustment for other trauma exposures. CONCLUSIONS: Veterans who have been homeless have extensive trauma histories and both events that occur during homelessness and the experience of homelessness itself may be traumatic and lead to PTSD, substantiating efforts to provide trauma-informed care for this population.
METHODS: Data from a nationally representative sample of 4,069 U.S. veterans in 2019-2020 were used to examine the prevalence of full and subthreshold PTSD in veterans with a history of homelessness; identify characteristics associated with PTSD; examine the proportion of veterans who reported homelessness as an index trauma event and screened positive for PTSD. RESULTS: Among veterans with a history of homelessness, lifetime prevalence of full and subthreshold PTSD was 33.0% and 32.0%; and past-month prevalence of full and subthreshold PTSD was 5.6% and 12.7%. These prevalence estimates were more than five times higher than nonhomeless veterans. Among veterans with a history of homelessness, 14.1% reported that homelessness was their "worst" traumatic event which was associated with a fivefold greater odds of current PTSD and nearly threefold greater odds of subthreshold PTSD even after adjustment for other trauma exposures. CONCLUSIONS: Veterans who have been homeless have extensive trauma histories and both events that occur during homelessness and the experience of homelessness itself may be traumatic and lead to PTSD, substantiating efforts to provide trauma-informed care for this population.