title: Trauma in Veterans With Substance Use Disorder: Similar Treatment Need Among Urban and Rural Residents.
abstract: The objective of this study is to determine whether rural residence is associated with trauma exposure or posttraumatic stress disorder symptoms among military veterans seeking treatment for substance use disorder (SUD) through the Department of Veterans Affairs (VA), Delivering mental health services to veterans in rural areas is a challenge, so identifying differences in the causes and outcomes of trauma exposure would assist in effectively targeting service delivery.
  
  
  
  Veterans (N = 196) entering SUD treatment at 3 Midwestern VA treatment centers were designated as either urban or rural, based on rural-urban commuting area (RUCA) codes. The veterans completed the Life Events Checklist, the Posttraumatic Stress Disorder Checklist, and the Addiction Severity Index's psychiatric status subscale. Hypothesized relationships between rural-urban residence and both trauma exposure and symptomology were tested using independent samples t tests, chi-square tests, and ordinary least squares regression.
  
  
  
  The range of traumatic experiences was similar between rural and urban veterans, and rural-urban residence was not significantly associated with the overall array of traumas experienced or the symptom measures' overall scores or subscores. Of 17 possible traumatic lifetime experiences, rural veterans differed from urban veterans on only 2, reporting significantly lower rates of transportation accidents and unwanted sexual experiences.
  
  
  
  In both the causes of trauma and the need for treatment, veterans residing in rural areas differ little from their urban counterparts.
authors: Communication Department, Western Illinois University-Quad Cities, Moline, Illinois.
authors: Lance Brendan
authors: LB
authors: Young
authors: Center for Innovation to Implementation, VA Palo Alto Health Care System, Menlo Park, California.|Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, California.
authors: Christine
authors: C
authors: Timko
authors: Department of Sociology, University of Nebraska-Lincoln, Lincoln, Nebraska.
authors: Kimberly A
authors: KA
authors: Tyler
authors: Substance Use Disorders Program, VA Nebraska-Western Iowa Health Care System, Omaha, Nebraska.|Department of Internal Medicine, University of Nebraska Medical Center, Omaha, Nebraska.
authors: Kathleen M
authors: KM
authors: Grant
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008605:Mental Health Services / Q000592:standards / Q000706:statistics & numerical data / Q000600:supply & distribution*; D008875:Middle Aged; D015146:Midwestern United States; D011594:Psychometrics / Q000295:instrumentation / Q000379:methods; D012424:Rural Population / Q000706:statistics & numerical data; D013313:Stress Disorders, Post-Traumatic / Q000523:psychology / Q000628:therapy; D019966:Substance-Related Disorders / Q000628:therapy*; D014481:United States; D014493:United States Department of Veterans Affairs / Q000458:organization & administration / Q000706:statistics & numerical data; D014728:Veterans / Q000523:psychology / Q000706:statistics & numerical data*; D014947:Wounds and Injuries / Q000523:psychology / Q000628:therapy*
keywords: health disparities; posttraumatic stress disorder; substance use disorder; trauma; veteran