Characteristics of U.S. Veterans Who Begin and Complete Prolonged Exposure and Cognitive Processing Therapy for PTSD
Characteristics of U.S. Veterans Who Begin and Complete Prolonged Exposure and Cognitive Processing Therapy for PTSD
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DOI：
10.1002/jts.21927
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发表时间：
2014-06-01
影响因子：
3.3
通讯作者：
Teng, Ellen J.
中科院分区：
文献类型：
--
作者：
Mott, Juliette M.;Mondragon, Sasha;Teng, Ellen J.
这项回顾性图表回顾研究考察了在寻求治疗的美国退伍军人中开始和完成创伤后应激障碍(PTSD)的循证心理治疗(EBP)的患者水平的相关性。我们确定了一家大型退伍军人事务部创伤后应激障碍和焦虑诊所的所有患者(N=796)，他们至少与8名接受过EBP培训的提供者中的1名进行了个人心理治疗预约。在这组患者中，91名患者(11.4%)接受了EBP(认知加工疗法或长期暴露)，59名患者(7.9%)完成了EBP。所有EBP患者(n=91)的医疗记录和接受另一种形式的个人心理治疗的提供者匹配的患者样本(n=66)由4名独立评分者审查。Logistic回归分析显示，伊拉克和阿富汗退伍军人开始EBP的概率低于其他服役时期的退伍军人，OR=0.48，95%CI=[0.24，0.94]，有创伤后应激障碍的退伍军人比没有服役联系的退伍军人更有可能开始EBP，OR=2.33，95%CI=[1.09，5.03]。在开始EBP的患者中，伊拉克和阿富汗退伍军人的OR=0.09(95%CI=[0.03，0.30])和精神科住院史OR=0.13(95%CI=[0.03，0.54])与EBP完成的可能性降低有关。
This retrospective chart-review study examined patient-level correlates of initiation and completion of evidence-based psychotherapy (EBP) for posttraumatic stress disorder (PTSD) among treatment-seeking U. S. veterans. We identified all patients (N = 796) in a large Veterans Affairs PTSD and anxiety clinic who attended at least 1 individual psychotherapy appointment with 1 of 8 providers trained in EBP. Within this group, 91 patients (11.4%) began EBP (either Cognitive Processing Therapy or Prolonged Exposure) and 59 patients (7.9%) completed EBP. The medical records of all EBP patients (n = 91) and a provider-matched sample of patients who received another form of individual psychotherapy (n = 66) were reviewed by 4 independent raters. Logistic regression analyses revealed that Iraq and Afghanistan veterans were less likely to begin EBP than veterans from other service eras, OR = 0.48, 95% CI = [0.24, 0.94], and veterans who were service connected for PTSD were more likely than veterans without service connection to begin EBP, OR = 2.33, 95% CI = [1.09, 5.03]. Among those who began EBP, Iraq and Afghanistan veteran status, OR = 0.09, 95% CI = [0.03, 0.30], and a history of psychiatric inpatient hospitalization, OR = 0.13, 95% CI = [0.03, 0.54], were associated with decreased likelihood of EBP completion.