The Association Between Service Connection and Treatment Outcome in Veterans Undergoing Residential PTSD Treatment
The Department of Veterans Affairs has invested significant time and resources into the treatment of posttraumatic stress disorder (PTSD). Despite concerted efforts, a significant portion of patients do not respond optimally to trauma-focused treatment. One of the factors that has been hypothesized...
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| Veröffentlicht in: | Psychiatric quarterly 2022-03, Vol.93 (1), p.285-296 |
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| container_title | Psychiatric quarterly |
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| creator | Rodriguez, Jessica L. Hale, Andrew C. Marston, Holloway N. Sage-Germain, Chelsea E. Wright, Theodore P. Driesenga, Scott A. Martin, Shannon M. Sripada, Rebecca K. |
| description | The Department of Veterans Affairs has invested significant time and resources into the treatment of posttraumatic stress disorder (PTSD). Despite concerted efforts, a significant portion of patients do not respond optimally to trauma-focused treatment. One of the factors that has been hypothesized to be associated with treatment response is participation in the Veterans Benefits Administration service-connected disability process. This factor may be particularly relevant in the residential treatment setting, where most participants are engaged in the compensation seeking process. We conducted a retrospective chart review of 105 veterans who completed Cognitive Processing Therapy (CPT) in a residential rehabilitation program. ANCOVAs that adjusted for baseline PTSD severity compared symptom change between those who were and were non-compensation seeking at the time of treatment. Compensation seeking status was associated with significantly less symptom improvement over the course of CPT after adjusting for baseline PTSD severity (
F
(1, 102) = 4.29,
p
|
| doi_str_mv | 10.1007/s11126-021-09940-9 |
| format | Article |
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F
(1, 102) = 4.29,
p
< .001, η
2
= .03). Sensitivity analyses did not detect a similar effect during a prior coping skills phase of treatment. During CPT, clinically significant change was met by 66.7% of non-compensation seeking veterans (
M
= –15,
SD
= 14.56) and by 40.1% of the compensation seeking group (
M
= –7.1,
SD
= 12.24). Compensation-seeking may be associated with reduced response to trauma-focused treatment in certain settings. Future research is needed to better understand the mechanisms underlying this effect.</description><identifier>ISSN: 0033-2720</identifier><identifier>EISSN: 1573-6709</identifier><identifier>DOI: 10.1007/s11126-021-09940-9</identifier><identifier>PMID: 34532825</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Change agents ; Chart reviews ; Clinical significance ; Cognition ; Cognitive ability ; Compensation ; Coping strategies ; Disability ; Health services utilization ; Help seeking behavior ; Humans ; Information processing ; Medicine ; Medicine & Public Health ; Military hospitals ; Original Paper ; Post traumatic stress disorder ; Psychiatry ; Public Health ; Rehabilitation ; Residential care ; Residential Treatment ; Retrospective Studies ; Sensitivity analysis ; Sociology ; Stress Disorders, Post-Traumatic - psychology ; Trauma ; Treatment Outcome ; Veterans ; Veterans - psychology</subject><ispartof>Psychiatric quarterly, 2022-03, Vol.93 (1), p.285-296</ispartof><rights>This is a U.S. government work and not under copyright protection in the U.S.; foreign copyright protection may apply 2021</rights><rights>2021. This is a U.S. government work and not under copyright protection in the U.S.; foreign copyright protection may apply.</rights><rights>This is a U.S. government work and not under copyright protection in the U.S.; foreign copyright protection may apply 2021.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c408t-20074272042d65f55068f181d5de2a470e2003a4f35cb4e1bcf40706b5da49763</citedby><cites>FETCH-LOGICAL-c408t-20074272042d65f55068f181d5de2a470e2003a4f35cb4e1bcf40706b5da49763</cites><orcidid>0000-0002-1778-9816</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s11126-021-09940-9$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s11126-021-09940-9$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,12846,27924,27925,30999,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34532825$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Rodriguez, Jessica L.</creatorcontrib><creatorcontrib>Hale, Andrew C.</creatorcontrib><creatorcontrib>Marston, Holloway N.</creatorcontrib><creatorcontrib>Sage-Germain, Chelsea E.</creatorcontrib><creatorcontrib>Wright, Theodore P.</creatorcontrib><creatorcontrib>Driesenga, Scott A.</creatorcontrib><creatorcontrib>Martin, Shannon M.</creatorcontrib><creatorcontrib>Sripada, Rebecca K.</creatorcontrib><title>The Association Between Service Connection and Treatment Outcome in Veterans Undergoing Residential PTSD Treatment</title><title>Psychiatric quarterly</title><addtitle>Psychiatr Q</addtitle><addtitle>Psychiatr Q</addtitle><description>The Department of Veterans Affairs has invested significant time and resources into the treatment of posttraumatic stress disorder (PTSD). Despite concerted efforts, a significant portion of patients do not respond optimally to trauma-focused treatment. One of the factors that has been hypothesized to be associated with treatment response is participation in the Veterans Benefits Administration service-connected disability process. This factor may be particularly relevant in the residential treatment setting, where most participants are engaged in the compensation seeking process. We conducted a retrospective chart review of 105 veterans who completed Cognitive Processing Therapy (CPT) in a residential rehabilitation program. ANCOVAs that adjusted for baseline PTSD severity compared symptom change between those who were and were non-compensation seeking at the time of treatment. Compensation seeking status was associated with significantly less symptom improvement over the course of CPT after adjusting for baseline PTSD severity (
F
(1, 102) = 4.29,
p
< .001, η
2
= .03). Sensitivity analyses did not detect a similar effect during a prior coping skills phase of treatment. During CPT, clinically significant change was met by 66.7% of non-compensation seeking veterans (
M
= –15,
SD
= 14.56) and by 40.1% of the compensation seeking group (
M
= –7.1,
SD
= 12.24). Compensation-seeking may be associated with reduced response to trauma-focused treatment in certain settings. Future research is needed to better understand the mechanisms underlying this effect.</description><subject>Change agents</subject><subject>Chart reviews</subject><subject>Clinical significance</subject><subject>Cognition</subject><subject>Cognitive ability</subject><subject>Compensation</subject><subject>Coping strategies</subject><subject>Disability</subject><subject>Health services utilization</subject><subject>Help seeking behavior</subject><subject>Humans</subject><subject>Information processing</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Military hospitals</subject><subject>Original Paper</subject><subject>Post traumatic stress disorder</subject><subject>Psychiatry</subject><subject>Public Health</subject><subject>Rehabilitation</subject><subject>Residential care</subject><subject>Residential Treatment</subject><subject>Retrospective Studies</subject><subject>Sensitivity analysis</subject><subject>Sociology</subject><subject>Stress Disorders, Post-Traumatic - psychology</subject><subject>Trauma</subject><subject>Treatment Outcome</subject><subject>Veterans</subject><subject>Veterans - psychology</subject><issn>0033-2720</issn><issn>1573-6709</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>7QJ</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp9kU1P3DAQhi3UqixL_0APlaVeegkdf8XJkS6fEhJVWbhaXmeyNdrY1E6K-PcYForUQ08-zPO-M9ZDyCcGBwxAf8uMMV5XwFkFbSuhanfIjCktqlpD-47MAISouOawS_ZyvgVgrBb8A9kVUgnecDUjafkL6WHO0Xk7-hjodxzvEQO9wvTHO6SLGAK655ENHV0mtOOAYaSX0-jigNQHeoMjJhsyvQ4dpnX0YU1_YvZd4bzd0B_Lq6O35D5539tNxo8v75xcnxwvF2fVxeXp-eLwonISmrHi5Yvy6XjJu1r1SkHd9KxhneqQW6kBCyGs7IVyK4ls5XoJGuqV6qxsdS3m5Ou29y7F3xPm0Qw-O9xsbMA4ZcOVlmWTLi1z8uUf9DZOKZTrDK9lI7hqmCoU31IuxZwT9uYu-cGmB8PAPBkxWyOmGDHPRkxbQp9fqqfVgN3fyKuCAogtkMsorDG97f5P7SMlnpVw</recordid><startdate>20220301</startdate><enddate>20220301</enddate><creator>Rodriguez, Jessica L.</creator><creator>Hale, Andrew C.</creator><creator>Marston, Holloway N.</creator><creator>Sage-Germain, Chelsea E.</creator><creator>Wright, Theodore P.</creator><creator>Driesenga, Scott A.</creator><creator>Martin, Shannon M.</creator><creator>Sripada, Rebecca K.</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>0-V</scope><scope>3V.</scope><scope>7QJ</scope><scope>7TK</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88G</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ALSLI</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>HEHIP</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M2M</scope><scope>M2O</scope><scope>M2S</scope><scope>MBDVC</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-1778-9816</orcidid></search><sort><creationdate>20220301</creationdate><title>The Association Between Service Connection and Treatment Outcome in Veterans Undergoing Residential PTSD Treatment</title><author>Rodriguez, Jessica L. ; Hale, Andrew C. ; Marston, Holloway N. ; Sage-Germain, Chelsea E. ; Wright, Theodore P. ; Driesenga, Scott A. ; Martin, Shannon M. ; Sripada, Rebecca K.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c408t-20074272042d65f55068f181d5de2a470e2003a4f35cb4e1bcf40706b5da49763</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Change agents</topic><topic>Chart reviews</topic><topic>Clinical significance</topic><topic>Cognition</topic><topic>Cognitive ability</topic><topic>Compensation</topic><topic>Coping strategies</topic><topic>Disability</topic><topic>Health services utilization</topic><topic>Help seeking behavior</topic><topic>Humans</topic><topic>Information processing</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Military hospitals</topic><topic>Original Paper</topic><topic>Post traumatic stress disorder</topic><topic>Psychiatry</topic><topic>Public Health</topic><topic>Rehabilitation</topic><topic>Residential care</topic><topic>Residential Treatment</topic><topic>Retrospective Studies</topic><topic>Sensitivity analysis</topic><topic>Sociology</topic><topic>Stress Disorders, Post-Traumatic - 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Academic</collection><jtitle>Psychiatric quarterly</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Rodriguez, Jessica L.</au><au>Hale, Andrew C.</au><au>Marston, Holloway N.</au><au>Sage-Germain, Chelsea E.</au><au>Wright, Theodore P.</au><au>Driesenga, Scott A.</au><au>Martin, Shannon M.</au><au>Sripada, Rebecca K.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The Association Between Service Connection and Treatment Outcome in Veterans Undergoing Residential PTSD Treatment</atitle><jtitle>Psychiatric quarterly</jtitle><stitle>Psychiatr Q</stitle><addtitle>Psychiatr Q</addtitle><date>2022-03-01</date><risdate>2022</risdate><volume>93</volume><issue>1</issue><spage>285</spage><epage>296</epage><pages>285-296</pages><issn>0033-2720</issn><eissn>1573-6709</eissn><abstract>The Department of Veterans Affairs has invested significant time and resources into the treatment of posttraumatic stress disorder (PTSD). Despite concerted efforts, a significant portion of patients do not respond optimally to trauma-focused treatment. One of the factors that has been hypothesized to be associated with treatment response is participation in the Veterans Benefits Administration service-connected disability process. This factor may be particularly relevant in the residential treatment setting, where most participants are engaged in the compensation seeking process. We conducted a retrospective chart review of 105 veterans who completed Cognitive Processing Therapy (CPT) in a residential rehabilitation program. ANCOVAs that adjusted for baseline PTSD severity compared symptom change between those who were and were non-compensation seeking at the time of treatment. Compensation seeking status was associated with significantly less symptom improvement over the course of CPT after adjusting for baseline PTSD severity (
F
(1, 102) = 4.29,
p
< .001, η
2
= .03). Sensitivity analyses did not detect a similar effect during a prior coping skills phase of treatment. During CPT, clinically significant change was met by 66.7% of non-compensation seeking veterans (
M
= –15,
SD
= 14.56) and by 40.1% of the compensation seeking group (
M
= –7.1,
SD
= 12.24). Compensation-seeking may be associated with reduced response to trauma-focused treatment in certain settings. Future research is needed to better understand the mechanisms underlying this effect.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>34532825</pmid><doi>10.1007/s11126-021-09940-9</doi><tpages>12</tpages><orcidid>https://orcid.org/0000-0002-1778-9816</orcidid></addata></record> |
| fulltext | fulltext |
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| ispartof | Psychiatric quarterly, 2022-03, Vol.93 (1), p.285-296 |
| issn | 0033-2720 1573-6709 |
| language | eng |
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| source | MEDLINE; Applied Social Sciences Index & Abstracts (ASSIA); SpringerLink Journals - AutoHoldings |
| subjects | Change agents Chart reviews Clinical significance Cognition Cognitive ability Compensation Coping strategies Disability Health services utilization Help seeking behavior Humans Information processing Medicine Medicine & Public Health Military hospitals Original Paper Post traumatic stress disorder Psychiatry Public Health Rehabilitation Residential care Residential Treatment Retrospective Studies Sensitivity analysis Sociology Stress Disorders, Post-Traumatic - psychology Trauma Treatment Outcome Veterans Veterans - psychology |
| title | The Association Between Service Connection and Treatment Outcome in Veterans Undergoing Residential PTSD Treatment |
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