Comparing Outcomes of Women-Only and Mixed-Gender Intensive Posttraumatic Stress Disorder Treatment for Female Veterans.

Abstract:

:Although most female veterans treated in specialized intensive Veterans Health Administration (VHA) posttraumatic stress disorder (PTSD) programs receive services in settings in which over 95% of participants are men, two programs include only women. Whether outcomes for women with PTSD are superior in women-only programs has not been evaluated. National program evaluation data on 1,357 women veterans from 57 sites were collected at program entry and 4 months after discharge. With adjustment for differences in baseline characteristics, outcomes of women in two women-only programs (n = 469) were compared with those from 55 mixed-gender programs (n = 888), using mixed models with random effect for site. The primary outcome was total PTSD symptom level, with supplementary information on PTSD assessment subscales, substance use, and other outcomes. At program entry, female veterans in women-only programs had lower scores on measures of total PTSD symptoms, p = .013, d = -0.24, and on several subscales. Adjusting for these differences, there were no significant differences between program types in terms of PTSD total score or scores on secondary measures. In women-only programs, veterans had longer lengths of stay and were rated by their clinicians to have a higher level of commitment to therapy at discharge. Thus, women-only programs did not show superior outcomes; however, compared to participants in mixed-gender programs, those in women-only programs had longer lengths of stay, higher levels of commitment to therapy, and were more likely to participate in posttreatment outcome assessments following discharge. :Spanish Abstracts by Asociación Chilena de Estrés Traumático (ACET) La comparación entre el tratamiento intensivo del trastorno de estrés postraumático para mujeres solamente o de género mixto para mujeres veteranas PROGRAMAS TEPT PARA MUJERES SOLAMENTE O MIXTOS (Pg 1) PROGRAMAS DE TEPT SEVERO SOLO PARA MUJERES (Pg 2) Aunque la mayoría de las mujeres veteranas tratadas en programas intensivos de la Administración de Salud de los Veteranos (VHA en su sigla en inglés) para el trastorno del estrés postraumático (TEPT), reciben servicios en contextos en los cuales 95% de los participantes son hombres, dos programas incluyen solo mujeres. No se ha evaluado si los resultados para las mujeres con TEPT son superiores en los programas solamente para mujeres. Los datos de una evaluación nacional del programa en 1,357 mujeres veteranas pertenecientes a 57 lugares fueron recolectados al inicio y luego de 4 meses del alta. Al ajustar las diferencias en las características de la línea base, los resultados de las mujeres en dos programas solo para mujeres (n = 469) fueron comparados con aquellos de los 55 programas con género mixtos (n = 888), usando modelos mixtos con efecto aleatorio por sitio. El resultado principal fue el nivel total de la sintomatología TEPT, con información suplementaria en las subescalas de evaluación del TEPT, uso de sustancias, y otros resultados. Al inicio del programa, las veteranas mujeres tenían puntajes más bajos en las medidas del total de los síntomas del TEPT, p = .013, d = -0.24, y en varias subescalas. Al ajustar estas diferencias, no hubo diferencias significativas entre los tipos de programas en términos del puntaje total del TEPT o los puntajes en las medidas secundarias. En los programas solo para mujeres, las veteranas permanecieron por más tiempo y fueron evaluadas por sus terapeutas como teniendo un más alto nivel de compromiso con la terapia al momento del alta. Así, los programas con solo mujeres no mostraron resultados superiores; sin embargo, comparados a los participantes en los programas con género mixtos, aquellos programas con mujeres solamente tuvieron mayor permanencia, más altos niveles de compromiso con la terapia, y fueron más propensas a participar en las evaluaciones de los resultados posterior al tratamiento luego del alta. :Traditional and Simplified Chinese Abstracts by the Asian Society for Traumatic Stress Studies (AsianSTSS) 簡體及繁體中文撮要由亞洲創傷心理研究學會翻譯 Comparison between Women-Only and Mixed-Gender Intensive Posttraumatic Stress Disorder (PTSD) Treatment for Female Veterans Traditional Chinese 標題: 比較退役女軍人接受專屬女性或男女混合的創傷後壓力症(PTSD)密集式治療計劃的效果 撮要: 大多數於美國退伍軍人健康管理局(VHA)接受創傷後壓力症(PTSD)專科密集式治療計劃的退役女軍人, 都於有超過95%男性參與者的環境下進行療程。不過, 當局有兩項計劃專屬女性參與。過往未有研究檢視在專屬女性參與的計劃接受治療的PTSD女患者, 是否會取得較好療效。我們於57個地點收集全國性計劃評核數據, 樣本為1,357名退役女軍人。我們分別於患者加入計劃時及完成療程4個月後收集數據。因應基線特徵差異作調整;採用混合模型、隨機地點, 比較參與兩個專屬女性的治療計劃的樣本療效(n = 469), 及參與55個男女混合治療計劃的樣本療效(n = 888)。研究主要檢視的結果為整體PTSD症狀水平, 其他檢視的補充資料為PTSD評估子量表、藥物使用和其他療效。在樣本初加入計劃時, 於專屬女性計劃的樣本的整體PTSD症狀分數(p = .013, d = -0.24)及數個子量表分數都較低。我們對此差異作調整後, 發現不同的計劃類型其所得的整體PTSD症狀分數或子測量的分數並無顯著差異。專屬女性計劃的樣本留院治療的時間較長, 並在出院時獲治療師評價為較投入治療。因此, 參與專屬女性的治療計劃並無反映會取得更好療效。然而, 與參與男女混合治療計劃的樣本相比, 專屬女性計劃裡的樣本留院治療的時間較長、較投入治療, 並較大機會在完成療程後接受療效評估。 Simplified Chinese 标题: 比较退役女军人接受专属女性或男女混合的创伤后压力症(PTSD)密集式治疗计划的效果 撮要: 大多数于美国退伍军人健康管理局(VHA)接受创伤后压力症(PTSD)专科密集式治疗计划的退役女军人, 都于有超过95%男性参与者的环境下进行疗程。不过, 当局有两项计划专属女性参与。过往未有研究检视在专属女性参与的计划接受治疗的PTSD女患者, 是否会取得较好疗效。我们于57个地点收集全国性计划评核数据, 样本为1,357名退役女军人。我们分别于患者加入计划时及完成疗程4个月后收集数据。因应基线特征差异作调整;采用混合模型、随机地点, 比较参与两个专属女性的治疗计划的样本疗效(n = 469), 及参与55个男女混合治疗计划的样本疗效(n = 888)。研究主要检视的结果为整体PTSD症状水平, 其他检视的补充数据为PTSD评估子量表、药物使用和其他疗效。在样本初加入计划时, 于专属女性计划的样本的整体PTSD症状分数(p = .013, d = -0.24)及数个子量表分数都较低。我们对此差异作调整后, 发现不同的计划类型其所得的整体PTSD症状分数或子测量的分数并无显著差异。专属女性计划的样本留院治疗的时间较长, 并在出院时获治疗师评价为较投入治疗。因此, 参与专属女性的治疗计划并无反映会取得更好疗效。然而, 与参与男女混合治疗计划的样本相比, 专属女性计划里的样本留院治疗的时间较长、较投入治疗, 并较大机会在完成疗程后接受疗效评估。.

journal_name

J Trauma Stress

authors

Stefanovics EA,Rosenheck RA

doi

10.1002/jts.22417

subject

Has Abstract

pub_date

2019-08-01 00:00:00

pages

606-615

issue

4

eissn

0894-9867

issn

1573-6598

journal_volume

32

pub_type

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    更新日期:2020-06-01 00:00:00

  • Dissociation and pain perception: an experimental investigation.

    abstract::Dissociative symptoms and abnormalities in pain perception have been associated with a range of disorders. The authors tested whether experimentally induced increases in state dissociation would cause an analgesic response. Participants (N = 120) were randomized to a dissociation induction condition via audiophotic st...

    journal_title:Journal of traumatic stress

    pub_type: 杂志文章,随机对照试验

    doi:10.1002/jts.20226

    authors: Horowitz JD,Telch MJ

    更新日期:2007-08-01 00:00:00