title: Premature treatment termination by angry patients with combat-related post-traumatic stress disorder.
abstract: Angry patients with conjoined post-traumatic stress disorder often direct their anger at health care providers during the course of treatment. Such misplaced anger can interfere with treatment. Emerging treatments for trauma-related anger are effective. However, even in the course of psychotherapy for trauma-related anger, these patients direct anger at their therapists, compromising the treatment alliance and increasing the likelihood of premature termination. A case example is presented to illustrate the effect of anger on the treatment alliance. A therapeutic strategy is proposed to reduce the likelihood of premature treatment termination in these high-risk patients. This strategy may also be helpful in primary care contexts.
authors.affiliation: Pacific Islands Division, National Center for Post-Traumatic Stress Disorder, Department of Veterans Affairs, Honolulu, HI 96813, USA.
authors.forename: V E
authors.initials: VE
authors.lastname: Stevenson
authors.forename: C M
authors.initials: CM
authors.lastname: Chemtob
mesh_terms: D000328:Adult; D000786:Anger; D003130:Combat Disorders / Q000523:psychology* / Q000628:therapy*; D006801:Humans; D008297:Male; D008889:Military Personnel / Q000523:psychology*; D008890:Military Psychiatry / Q000379:methods; D010817:Physician-Patient Relations; D011613:Psychotherapy / Q000379:methods; D016312:Treatment Refusal / Q000523:psychology*; D014857:Warfare