title: Unique PTSD clusters predict intention to seek mental health care and subsequent utilization in US veterans with PTSD symptoms.
abstract: Many veterans return from deployment with posttraumatic stress disorder (PTSD), but most attend only a limited number of mental health care visits. Although global PTSD relates to seeking mental health care, it is unclear whether specific features of PTSD inform the low rates of mental health care utilization. This study examined PTSD cluster severities of avoidance, reexperiencing, dysphoria, and hyperarousal as predictors of intention to seek mental health care and prospective treatment utilization. US veterans with at least subthreshold PTSD (N = 189) completed a PTSD symptom measure and indicated whether they intended to seek mental health care. Prospective Department of Veterans Affairs mental health care utilization was extracted from the medical record. At the bivariate level, each cluster was positively associated with a positive intention to seek mental health care and prospective treatment utilization. In multivariate models, however, dysphoria severity (OR = 1.16, 95% CI [1.06, 1.26]) was uniquely and positively correlated with intention to seek mental health care, whereas higher avoidance severity (IRR = 0.86, 95% CI [0.76, 0.98]) predicted lower treatment utilization, and higher reexperiencing severity (IRR = 1.07, 95% CI [1.01, 1.14]) predicted greater treatment utilization. It is critical to tailor interventions to target specific features of PTSD and to meet patients where they are.
authors.affiliation: Mental Health Service, VA Puget Sound-Seattle Division, Seattle, Washington, USA.
authors.forename: Rebecca K
authors.initials: RK
authors.lastname: Blais
authors.forename: Katherine D
authors.initials: KD
authors.lastname: Hoerster
authors.forename: Carol
authors.initials: C
authors.lastname: Malte
authors.forename: Stephen
authors.initials: S
authors.lastname: Hunt
authors.forename: Matthew
authors.initials: M
authors.lastname: Jakupcak
mesh_terms: D000328:Adult; D055826:Afghan Campaign 2001-; D000368:Aged; D000704:Analysis of Variance; D016000:Cluster Analysis; D015897:Comorbidity; D005544:Forecasting; D006801:Humans; D033182:Intention; D054542:Iraq War, 2003-2011; D016015:Logistic Models; D008605:Mental Health Services / Q000706:statistics & numerical data*; D008875:Middle Aged; D019964:Mood Disorders / Q000453:epidemiology / Q000523:psychology* / Q000628:therapy; D010342:Patient Acceptance of Health Care / Q000523:psychology* / Q000706:statistics & numerical data; D011446:Prospective Studies; D012720:Severity of Illness Index; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology / Q000523:psychology* / Q000628:therapy; D014481:United States / Q000453:epidemiology; D014728:Veterans / Q000523:psychology*