Comparing the effectiveness of VA residential PTSD treatment for veterans who do and do not report a history of MST: A national investigation. (March 2020)

• Record Type: Journal Article
• Authors: Holliday, Ryan; Smith, Noelle B.; Holder, Nicholas; Gross, Georgina M.; Monteith, Lindsey L.; Maguen, Shira; Hoff, Rani A.; Harpaz-Rotem, Ilan
• Is Part Of: Journal of psychiatric research. Volume 122(2020)
• Page Start: 42
• Page End: 47
• Publication Date: 2020-03
• Subjects: Military sexual trauma -- Posttraumatic stress disorder -- Treatment -- Veteran; Psychiatry -- Periodicals; Mental Disorders -- Periodicals; Maladies mentales -- Périodiques; Psychiatry; Electronic journals; Periodicals; 616.89005
• DOI: 10.1016/j.jpsychires.2019.12.012
• Languages: English
• ISSNs: 0022-3956

Abstract

Abstract: The Department of Veterans Affairs (VA) has implemented initiatives to promote veterans' recovery from the health sequelae of military sexual trauma (MST), including posttraumatic stress disorder (PTSD). MST can impact emotion regulation, interpersonal functioning, and perceptions of trust and safety, as well as increase risk for psychiatric comorbidity, which may impede PTSD treatment.. VA PTSD Residential Rehabilitation Treatment Programs (RRTPs) may facilitate the therapeutic process by offering increased structure, support, and adjunctive services. Limited research has examined the effect of MST on PTSD RRTP outcomes. Utilizing data from 7918 men and women veterans participating in a VA PTSD RRTP, the impact of the experience of MST on rates of program completion and changes in PTSD symptoms during and after treatment were examined. Rates of program completion were similar between those who did and did not report experiencing MST. Multilevel modeling was utilized to examine the impact of MST on PTSD symptoms after accounting for gender, age, race/ethnicity, and program completion. MST survivors endorsed more severe PTSD symptoms at admission; however, PTSD symptom severity scores were similar to those who did not report experiencing MST by discharge. Additionally, MST survivors had larger initial reductions in PTSD symptoms, followed by a greater recurrence of PTSD symptoms over time, compared to those who did not report experiencing MST. MST survivors appear able to participate in and benefit from PTSD RRTPs. Nonetheless, the increased recurrence of PTSD symptoms following discharge from residential treatment indicates the need for strategies to maintain post-treatment gains among MST survivors. Highlights: MST survivors had larger initial reductions in PTSD symptoms. Both groups experienced a recurrence in PTSD symptoms over time. MST survivors had a greater rate of PTSD symptom recurrence. Understanding of strategies to maintain post-treatment gains is needed.