title: Characteristics of U.S. veterans who begin and complete prolonged exposure and cognitive processing therapy for PTSD.
abstract: 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.
authors.affiliation: Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas, USA; Menninger Department of Psychiatry and Behavioral Sciences at Baylor College of Medicine, Houston, Texas, USA; South Central Mental Illness Research, Education, and Clinical Center, Houston, Texas, USA.
authors.forename: Juliette M
authors.initials: JM
authors.lastname: Mott
authors.forename: Sasha
authors.initials: S
authors.lastname: Mondragon
authors.forename: Natalie E
authors.initials: NE
authors.lastname: Hundt
authors.forename: Melissa
authors.initials: M
authors.lastname: Beason-Smith
authors.forename: Rebecca H
authors.initials: RH
authors.lastname: Grady
authors.forename: Ellen J
authors.initials: EJ
authors.lastname: Teng
mesh_terms: D000328:Adult; D055826:Afghan Campaign 2001-; D000367:Age Factors; D000368:Aged; D015928:Cognitive Behavioral Therapy; D004522:Educational Status; D019317:Evidence-Based Medicine; D005260:Female; D006760:Hospitalization; D006778:Hospitals, Psychiatric; D006801:Humans; D007171:Implosive Therapy; D054542:Iraq War, 2003-2011; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D012189:Retrospective Studies; D013313:Stress Disorders, Post-Traumatic / Q000523:psychology / Q000628:therapy*; D014481:United States; D014728:Veterans / Q000523:psychology*