A Bifactor Evaluation of Self-Report and Clinician-Administered Measures of PTSD in Veterans.

The PTSD Checklist for (PCL-5) and the Clinician-Administered PTSD Scale for (CAPS-5) are two of the most widely used and well-validated PTSD measures providing total and subscale scores that correspond with PTSD symptoms. However, there is little information about the utility of subscale scores above and beyond the total score for either measure. The current study compared the proposed four-factor model to a bifactor model across both measures using a sample of veterans ( = 1,240) presenting to a Veterans Affairs (VA) PTSD specialty clinic.

Evaluation of implementation facilitation integrated into a national mentoring programme to improve access to evidence-based psychotherapy for post-traumatic stress disorder within the veterans health administration: a quality improvement report.

Despite the resources dedicated to specialised mental healthcare for patients with post-traumatic stress disorder (PTSD) within the US Veterans Health Administration, evidence-based psychotherapies (EBPs) for PTSD have been underutilised, as evidenced by low EBP reach to patients. A research-operation collaboration evaluated whether implementation facilitation delivered by regional PTSD mentors as part of a national mentoring programme improved EBP reach compared with less-intensive quality improvement interventions. We used a non-equivalent comparison-group design that included all PTSD clinics with low EBP reach at baseline (n=51).

Understanding veteran barriers to specialty outpatient PTSD clinical care.

Objective: Veterans seeking treatment for posttraumatic stress disorder (PTSD) commonly report general and veteran-specific barriers to treatment such as stigma and challenges with navigating the Veterans Health Affairs (VHA) system. This study aimed to characterize barriers endorsed by a national sample of veterans seeking care in VHA PTSD specialty outpatient clinics, as well as to examine the impact of demographics on endorsed barriers.

Methods: This study included 17,069 veterans referred to PTSD specialty outpatient clinics in the VHA during Fiscal Year 2019.

Improving engagement and retention to treatment within VHA PTSD specialty care: Evolution of an outpatient program design.

The Veteran's Health Administration (VA) and Department of Defense (DoD) posttraumatic stress disorder (PTSD) clinical practice guidelines (2017) recommend individual, trauma-focused therapy as the gold standard of treatment for PTSD (i.e., evidence-based practices [EBP]).

PTSD networks of veterans with combat versus non-combat types of index trauma.

Background: Network analysis has become popular among PTSD researchers for studying causal structure or interrelationships among symptoms. However, some have noted that results do not seem to be consistent across studies. Preliminary evidence suggests that trauma type may be one source of variability.

Employment outcomes from VA vocational services involving transitional work for veterans with a diagnosis of posttraumatic stress disorder.

Objective: Transitional work (TW) for veterans with psychiatric disabilities is the predominant model of vocational rehabilitation in the Veterans Health Administration (VA). Although, on average, TW employment outcomes have been demonstrated to be inferior to supported employment, little is known about the potential subgroup of veterans for which TW may be most effective. This study of veterans with posttraumatic stress disorder (PTSD) examines differences in competitive employment outcomes and identifies characteristics of veterans who chose to engage in TW compared with those who did not.

Treatment choice among veterans with PTSD symptoms and substance-related problems: Examining the role of preparatory treatments in trauma-focused therapy.

Although common practice in Veterans Affairs (VA) PTSD clinics, it is unclear whether preparatory treatment improves trauma-focused treatment (TFT) completion and outcomes. Furthermore, little is known about whether treatment-seeking veterans in naturalistic settings would chose to prioritize preparatory treatment if given the option of a phase-based approach or direct access to TFT, and how substance-related problems (SRPs) influence this treatment choice. The first aim of this study was to explore how co-occurring SRPs (ranging from none to moderate/severe) influence PTSD treatment choices in a naturalistic setting where veterans were offered a choice between a phase-based approach (i.

Using a Clinician-Administered Interview to Examine the Overlap in Posttraumatic Stress Disorder Criteria D and E.

Although the diagnosis of posttraumatic stress disorder (PTSD) is often criticized for including symptoms that overlap with one another, only one study has explored the impact of symptom reporting. Using a clinician-rated interview for PTSD (N = 558), the current study examined overlap between PTSD criteria D1, D2, and D3 ("target D symptoms") and criterion E symptoms of similar content (i.e.

Individual and group cognitive processing therapy: Effectiveness across two Veterans Affairs posttraumatic stress disorder treatment clinics.

Objective: In accordance with Veterans Affairs (VA) policy, VA posttraumatic stress disorder (PTSD) clinics offer evidence-based treatments including cognitive processing therapy (CPT). To facilitate access to care, CPT is offered in both group and individual formats in many VA PTSD clinics. Group and individual delivery of CPT have been directly compared in active duty samples, but these findings have not been extended to VA populations.

Examining various subthreshold definitions of PTSD using the Clinician Administered PTSD Scale for DSM-5.

Background: The Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5; American Psychiatric Association [APA], 2013) includes Other- and Unspecified- Trauma and Stressor-Related Disorders to capture subthreshold Posttraumatic Stress Disorder (PTSD) symptoms. However, the DSM-5 does not specify the number or type of symptoms needed to assign them. The purpose of the current study was to extend our understanding of subthreshold PTSD by comparing four commonly used definitions adapted to the DSM-5 PTSD criteria in an outpatient treatment-seeking sample.

27 ways to meet PTSD: Using the PTSD-checklist for DSM-5 to examine PTSD core criteria.

Posttraumatic stress disorder (PTSD) has been criticized for including symptoms that substantially overlap with other depression and anxiety disorders. To address this concern, Brewin et al. (2009) reformulated the diagnosis around a core symptom set.

Sometimes Less is More: Establishing the Core Symptoms of PTSD.

Historically, the symptoms of posttraumatic stress disorder (PTSD) have garnered attention and controversy due to symptom overlap with other disorders. To improve diagnostic specificity, researchers have proposed to reformulate PTSD symptoms into a parsimonious set of core criteria. The core symptoms consisted of recurrent distressing dreams or flashbacks; internal or external avoidance; and hypervigilance or exaggerated startle.

Trauma-Related Pain, Reexperiencing Symptoms, and Treatment of Posttraumatic Stress Disorder: A Longitudinal Study of Veterans.

Research has demonstrated a strong positive association between posttraumatic stress disorder (PTSD) symptoms and physical pain. However, few studies have explored the impact of pain problems on the symptoms and treatment of PTSD, and results remain inconsistent. This longitudinal study examined whether trauma-related and trauma-unrelated pain differentially and uniquely predicted reexperiencing symptoms.

Examining potential overlap of DSM-5 PTSD criteria D and E.

The Diagnostic and Statistical Manual, Fifth Edition-5 (DSM-5) has adopted a four-factor symptom model for Posttraumatic Stress Disorder (PTSD) that includes new symptom additions in criterion D (D2, D3, D4), negative alterations in cognition and mood. This article examines potential overlapping endorsement of these symptoms amongst one another and with the behavioral symptoms within PTSD criterion E (E1 and E3; alterations in arousal and reactivity), through the lenses of cognitive-behavioral theory. Responses of veteran participants (N=320) completing the PTSD Checklist-5 were used to determine overlap in symptom reporting.

Fear of Losing Emotional Control Is Associated With Cognitive Processing Therapy Outcomes in U.S. Veterans of Afghanistan and Iraq.

Evidence-based treatments for posttraumatic stress disorder (PTSD) can reduce symptoms and improve veterans' psychological health. Unfortunately, many veterans leave treatment before receiving maximum benefit. Fear of emotions is related to severity of PTSD, and changes in fear of emotions are correlated with changes in PTSD symptoms.

Randomized controlled equivalence trial comparing videoconference and in person delivery of cognitive processing therapy for PTSD.

Introduction: In an effort to improve access to and utilization of health care, the Veterans Health Administration (VHA) continues to investigate the effectiveness of video-teleconferencing (VTC) technologies for service delivery. While previous research focused on the efficacy of VTC treatment for post-traumatic stress disorder (PTSD) in Vietnam era veterans, few studies have evaluated the efficacy of this modality and treatment for the Iraq/Afghanistan era veterans. The aim of this randomized clinical trial was to evaluate equivalence between in person and VTC psychotherapy for PTSD in this newer cohort.