Defining post-traumatic stress disorder recovery in veterans: Benchmarking symptom change against functioning indicators.
benchmarking
post-traumatic stress disorder
recovery
treatment
veterans
Journal
Stress and health : journal of the International Society for the Investigation of Stress
ISSN: 1532-2998
Titre abrégé: Stress Health
Pays: England
ID NLM: 101089166
Informations de publication
Date de publication:
Aug 2021
Aug 2021
Historique:
revised:
07
11
2020
received:
04
08
2020
accepted:
11
12
2020
pubmed:
19
12
2020
medline:
14
8
2021
entrez:
18
12
2020
Statut:
ppublish
Résumé
Improved metrics of Post-traumatic stress disorder (PTSD) treatment response that extend beyond a focus on symptom reduction to incorporate meaningful, patient-centred indicators of functioning are needed in veteran populations. The aim of this study was to extend previous research by investigating whether indicators of functioning can successfully distinguish against symptom response categories derived from the Post-Traumatic Stress Disorder Checklist (PCL-5) pre- and post- PTSD treatment. Participants were 472 veterans receiving hospital-based treatment for PTSD. In addition to the PCL-5, measures included quality of life, social relationships, physical health and psychological distress. Four mutually exclusive, progressive response categories were used to define treatment response including: No Response, Response, Response and Below Threshold, and Remission. PTSD symptom reductions were associated with corresponding improvements in broader indicators of functioning. However, it was only when the magnitude of symptom reduction placed the individual in the 'Response and Below Threshold' category that improvement on functioning measures achieved levels indicative of a good end state. Traditional metrics of treatment 'response' in PTSD treatment do not necessarily indicate recovery on important functioning indicators. Only when an individual both responds to treatment and drops below threshold for probable disorder are they likely to report having meaningful levels of functioning.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
547-556Subventions
Organisme : Department of Veterans' Affairs, Australian Government
ID : N/A
Informations de copyright
© 2020 John Wiley & Sons Ltd.
Références
Andrews, G., & Slade, T. (2001). Interpreting scores on the Kessler psychological distress scale (K10). Australian & New Zealand Journal of Public Health, 25(6), 494-497.
Bentler, P. M. (2005). EQS structural equations program manual. Encino, CA: Multivariate software.
Blevins, C. A., Weathers, F. W., Davis, M. T., Witte, T. K., & Domino, J. L. (2015). The posttraumatic stress disorder checklist for DSM-5 (PCL-5): Development and initial psychometric evaluation. Journal of Traumatic Stress, 28(6), 489-498.
Bovin, M. J., Marx, B. P., Weathers, F. W., Gallagher, M. W., Rodriguez, P., Schnurr, P. P., & Keane, T. M. (2016). Psychometric properties of the PTSD checklist for diagnostic and statistical manual of mental disorders-fifth edition (PCL-5) in veterans. Psychological Assessment, 28(11), 1379.
Bryant, R. A., Gallagher, H. C., Gibbs, L., Pattison, P., MacDougall, C., Harms, L., … Ireton, G. (2016). Mental health and social networks after disaster. American Journal of Psychiatry, 174(3), 277-285.
Cederbaum, J. A., Wilcox, S. L., Sullivan, K., Lucas, C., & Schuyler, A. (2017). The influence of social support on dyadic functioning and mental health among military personnel during postdeployment reintegration. Public Health Reports, 132(1), 85-92.
Crosby, R. D., Kolotkin, R. L., & Williams, G. R. (2003). Defining clinically meaningful change in health-related quality of life. Journal of Clinical Epidemiology, 56(5), 395-407.
da Rocha, N. S., Power, M. J., Bushnell, D. M., & Fleck, M. P. (2012). The EUROHIS-QOL 8-item index: Comparative psychometric properties to its parent WHOQOL-BREF. Value in Health, 15(3), 449-457.
Darlington, R. B., & Hayes, A. F. (2016). Regression analysis and linear models: Concepts, applications, and implementation, New York, NY: Guilford Publications.
Dunlop, B. W., Kaye, J. L., Youngner, C., & Rothbaum, B. (2014). Assessing treatment-resistant posttraumatic stress disorder: The Emory Treatment Resistance Interview for PTSD (E-TRIP). Behavioral Sciences (2076-328X), 4(4), 511-527. https://doi.org/10.3390/bs4040511
Ehlers, A., Clark, D. M., Hackmann, A., McManus, F., Fennell, M., Herbert, C., & Mayou, R. (2003). A randomized controlled trial of cognitive therapy, a self-help booklet, and repeated assessments as early interventions for posttraumatic stress disorder. Archives of General Psychiatry, 60(10), 1024-1032.
Evans, L., Cowlishaw, S., Forbes, D., Parslow, R., & Lewis, V. (2010). Longitudinal analyses of family functioning in veterans and their partners across treatment. Journal of Consulting and Clinical Psychology, 78(5), 611.
Foa, E. B., McLean, C. P., Zang, Y., Rosenfield, D., Yadin, E., Yarvis, J. S., … Dondanville, K. A. (2018). Effect of prolonged exposure therapy delivered over 2 weeks vs 8 weeks vs present-centered therapy on PTSD symptom severity in military personnel: A randomized clinical trial. JAMA, 319(4), 354-364.
Gladis, M. M., Gosch, E. A., Dishuk, N. M., & Crits-Christoph, P. (1999). Quality of life: Expanding the scope of clinical significance. Journal of Consulting and Clinical Psychology, 67(3), 320.
Hamner, M. B., Robert, S., & Frueh, B. C. (2014). Treatment-resistant posttraumatic stress disorder: strategies for intervention. CNS Spectrums, 9(10), 740-752. https://doi.org/10.1017/S1092852900022380
Hawthorne, G., Richardson, J., & Osborne, R. (1999). The assessment of quality of life (AQoL) instrument: A psychometric measure of health-related quality of life. Quality of Life Research, 8(3), 209-224.
Jacobson, N. S., & Truax, P. (1991). Clinical significance: A statistical approach to defining meaningful change in psychotherapy research. Journal of Consulting and Clinical Psychology, 59(1), 12.
Kessler, R. C., Andrews, G., Colpe, L. J., Hiripi, E., Mroczek, D. K., Normand, S.-L., … Zaslavsky, A. M. (2002). Short screening scales to monitor population prevalences and trends in non-specific psychological distress. Psychological Medicine, 32(6), 959-976.
Kobau, R., Sniezek, J., Zack, M. M., Lucas, R. E., & Burns, A. (2010). Well-being assessment: An evaluation of well-being scales for public health and population estimates of well-being among US adults. Applied Psychology: Health and Well-Being, 2(3), 272-297.
Kroenke, K., Spitzer, R. L., & Williams, J. B. (2002). The PHQ-15: Validity of a new measure for evaluating the severity of somatic symptoms. Psychosomatic Medicine, 64(2), 258-266.
Leonhart, R., De Vroege, L., Zhang, L., Liu, Y., Dong, Z., Schaefert, R., … van der Feltz-Cornelis, C. (2018). Comparison of the factor structure of the patient health questionnaire for somatic symptoms (PHQ-15) in Germany, the Netherlands, and China. A transcultural structural equation modelling (SEM) study. Frontiers in Psychiatry, 9, 240.
Linton, M.-J., Dieppe, P., & Medina-Lara, A. (2016). Review of 99 self-report measures for assessing well-being in adults: Exploring dimensions of well-being and developments over time. BMJ Open, 6(7), e010641.
Magruder, K. M., Frueh, B. C., Knapp, R. G., Johnson, M. R., Vaughan, J. A., Iii, Carson, T. C., … Hebert, R. (2004). PTSD symptoms, demographic characteristics, and functional status among veterans treated in VA primary care clinics. Journal of Traumatic Stress, 17(4), 293-301.
Metcalf, O., Stone, C., Hinton, M., O'Donnell, M., Hopwood, M., McFarlane, A., … Freijah, I. (2019). Treatment augmentation for posttraumatic stress disorder: A systematic review. Clinical Psychology: Science and Practice, 27(1), e12310.
O'Donnell, M. L., Varker, T., Holmes, A. C., Ellen, S., Wade, D., Creamer, M., … Forbes, D. (2013). Disability after injury: the cumulative burden of physical and mental health. Journal of Clinical Psychiatry.74(2), 137-147.
Phelps, A., Steel, Z., Metcalf, O., Alkemade, N., Kerr, K., O'Donnell, M., … Armstrong, R. (2018). Key patterns and predictors of response to treatment for military veterans with post-traumatic stress disorder: A growth mixture modelling approach. Psychological Medicine, 48(1), 95-103.
Ravn, S. L., Vaegter, H. B., Cardel, T., & Andersen, T. E. (2018). The role of posttraumatic stress symptoms on chronic pain outcomes in chronic pain patients referred to rehabilitation. Journal of Pain Research, 11, 527.
Rosen, C., Adler, E., & Tiet, Q. (2013). Presenting concerns of veterans entering treatment for posttraumatic stress disorder. Journal of Traumatic Stress, 26(5), 640-643.
Schnurr, P. P., Hayes, A. F., Lunney, C. A., McFall, M., & Uddo, M. (2006). Longitudinal analysis of the relationship between symptoms and quality of life in veterans treated for posttraumatic stress disorder. Journal of Consulting and Clinical Psychology, 74(4), 707.
Schnurr, P. P., & Lunney, C. A. (2016). Symptom benchmarks of improved quality of life in PTSD. Depression and Anxiety, 33(3), 247-255.
Steenkamp, M. M., Litz, B. T., Hoge, C. W., & Marmar, C. R. (2015). Psychotherapy for military-related PTSD: A review of randomized clinical trials. JAMA, 314(5), 489-500.
Tran, T. V., Canfield, J., & Chan, K. T. (2017). Differential association between unemployment status and mental health among veterans and civilians. Social Work in Mental Health, 15(4), 419-434.
US National Centre for PTSD. (2017). Using the PTSD checklist for DSM-5 (PCL-5). Retrieved from http://www.ptsd.va.gov/professional/assessment/adult-sr/ptsd-checklist.asp
van Ravesteijn, H., Wittkampf, K., Lucassen, P., van de Lisdonk, E., van den Hoogen, H., van Weert, H., … Speckens, A. (2009). Detecting somatoform disorders in primary care with the PHQ-15. The Annals of Family Medicine, 7(3), 232-238.
Varker, T., Kartal, D., Watson, L., Freijah, I., O'Donnell, M., Forbes, D., … Hinton, M. (2020). Defining response and non-response to PTSD treatments: A systematic review. Clinical Psychologist: Science & Practice, e12355. https://doi.org/10.1111/cpsp.12355
Weathers, F. W., Blake, D. D., Schnurr, P. P., Kaloupek, D. G., Marx, B. P., & Keane, T. M. (2015). The clinician-administered PTSD scale for DSM-5 (CAPS-5) - Past Week [Measurement instrument]. Retrieved from https://www.ptsd.va.gov/professional/assessment/documents/CAPS_5_Past_Week.pdf
Weathers, F. W., Litz, B. T., Keane, T. M., Palmieri, P. A., Marx, B. P., & Schnurr, P. P. (2013). The PTSD checklist for DSM-5 (PCL-5). Retrieved from www.ptsd.va.gov.
Wortmann, J. H., Jordan, A. H., Weathers, F. W., Resick, P. A., Dondanville, K. A., Hall-Clark, B., … Hembree, E. A. (2016). Psychometric analysis of the PTSD Checklist-5 (PCL-5) among treatment-seeking military service members. Psychological Assessment, 28(11), 1392.