Gender Differences in Outcomes Following Specialized Intensive PTSD Treatment in the Veterans Health Administration
被引:11
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作者:
Stefanovics, Elina A.
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机构:
New England Mental Illness Res & Educ Clin Ctr, Dept Vet Affairs, West Haven, CT USA
Yale Univ, Sch Med, Dept Psychiat, West Haven, CT 06516 USANew England Mental Illness Res & Educ Clin Ctr, Dept Vet Affairs, West Haven, CT USA
Stefanovics, Elina A.
[1
,2
]
Rosenheck, Robert A.
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机构:
New England Mental Illness Res & Educ Clin Ctr, Dept Vet Affairs, West Haven, CT USA
Yale Univ, Sch Med, Dept Psychiat, West Haven, CT 06516 USANew England Mental Illness Res & Educ Clin Ctr, Dept Vet Affairs, West Haven, CT USA
Rosenheck, Robert A.
[1
,2
]
机构:
[1] New England Mental Illness Res & Educ Clin Ctr, Dept Vet Affairs, West Haven, CT USA
[2] Yale Univ, Sch Med, Dept Psychiat, West Haven, CT 06516 USA
Objectives: Posttraumatic stress disorder (PTSD) among female veterans is a problem of growing importance. Comparison of treatment outcomes and measures of program participation between female and male veterans receiving treatment in specialized intensive Veterans Health Administration (VHA) programs may identify potential gaps in service. Method: National program evaluation data were collected at program entry and 4 months after discharge. The study sample consists of N = 3,370 veterans who were successfully followed up. With adjustment for differences in baseline characteristics outcomes of women and men were compared on changes in PTSD symptoms. substance use, and other outcomes using Cohen's d to evaluate effect sizes. Further analyses examined gender differences in program participation and their effect on differences in outcomes by gender. Results: Compared to males, females showed greater improvement (i.e., greater reduction) in total PTSD symptom scores (p < .001, Cohen's d = -.29) and in several subscales including Numbness (p < .001, d = -.34), Arousal (p = .01, d = -.22), Reexperiencing Past Traumas (p < .01, d = -.23), and Irritability (p = .01, d = -.18), with small to medium effect size differences. These gender-based differences were partially explained by differences in program participation such as greater length of stay among women. Conclusions: In spite of the predominantly male environment of these VHA PTSD programs, women experienced greater improvement than men in PTSD symptoms and subscales. The differences were partially explained by positive indicators of program participation. Further studies are needed to better understand these differences.
机构:
Natl Ctr PTSD VA Boston Healthcare Syst, Behav Sci Div, Boston, MA 02130 USA
Boston Univ, Sch Med, Dept Psychiat, Boston, MA 02118 USANatl Ctr PTSD VA Boston Healthcare Syst, Behav Sci Div, Boston, MA 02130 USA
Thompson-Hollands, Johanna
Rando, Alora A.
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Suffolk Univ, Boston, MA 02114 USANatl Ctr PTSD VA Boston Healthcare Syst, Behav Sci Div, Boston, MA 02130 USA
Rando, Alora A.
Stoycos, Sarah A.
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机构:
Natl Ctr PTSD VA Boston Healthcare Syst, Behav Sci Div, Boston, MA 02130 USA
Boston Univ, Sch Med, Dept Psychiat, Boston, MA 02118 USANatl Ctr PTSD VA Boston Healthcare Syst, Behav Sci Div, Boston, MA 02130 USA
Stoycos, Sarah A.
Meis, Laura A.
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机构:
Minneapolis VA Hlth Care Syst, Ctr Care Delivery & Outcomes Res, Minneapolis, MN USA
Univ Minnesota, Sch Med, Dept Med, Minneapolis, MN 55455 USANatl Ctr PTSD VA Boston Healthcare Syst, Behav Sci Div, Boston, MA 02130 USA
Meis, Laura A.
Iverson, Katherine M.
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机构:
Boston Univ, Sch Med, Dept Psychiat, Boston, MA 02118 USA
Natl Ctr PTSD VA Boston Healthcare Syst, Womens Hlth Sci Div, Boston, MA USANatl Ctr PTSD VA Boston Healthcare Syst, Behav Sci Div, Boston, MA 02130 USA
机构:
Bedford VAMC 152, Ctr Hlth Qual Outcomes & Econ Res, Dept Hlth Policy & Management, Bedford, MA 01730 USA
Boston Univ, Sch Publ Hlth, Dept Hlth Policy & Management, Boston, MA USABedford VAMC 152, Ctr Hlth Qual Outcomes & Econ Res, Dept Hlth Policy & Management, Bedford, MA 01730 USA
Chatterjee, Sharmila
Rath, Maria E.
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Boston Univ, Sch Publ Hlth, Dept Biostat, Boston, MA USABedford VAMC 152, Ctr Hlth Qual Outcomes & Econ Res, Dept Hlth Policy & Management, Bedford, MA 01730 USA
Rath, Maria E.
Spiro, Avron, III
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Boston VA Healthcare Syst, Massachusetts Vet Epidemiol Res & Informat Ctr, Boston, MA USA
Boston Univ, Sch Publ Hlth, Dept Epidemiol, Boston, MA USABedford VAMC 152, Ctr Hlth Qual Outcomes & Econ Res, Dept Hlth Policy & Management, Bedford, MA 01730 USA
Spiro, Avron, III
Eisen, Susan
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Boston Univ, Sch Publ Hlth, Dept Hlth Policy & Management, Boston, MA USABedford VAMC 152, Ctr Hlth Qual Outcomes & Econ Res, Dept Hlth Policy & Management, Bedford, MA 01730 USA
Eisen, Susan
Sloan, Kevin L.
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VA Puget Sound Healthcare Syst, Seattle, WA USA
Univ Washington, Dept Psychiat & Behav Sci, Seattle, WA 98195 USABedford VAMC 152, Ctr Hlth Qual Outcomes & Econ Res, Dept Hlth Policy & Management, Bedford, MA 01730 USA
Sloan, Kevin L.
Rosen, Amy K.
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Boston Univ, Sch Publ Hlth, Dept Hlth Policy & Management, Boston, MA USABedford VAMC 152, Ctr Hlth Qual Outcomes & Econ Res, Dept Hlth Policy & Management, Bedford, MA 01730 USA
机构:
Univ Michigan, Dept Internal Med, Div Geriatr & Palliat Med, 300 N Ingalls Bldg,Floor 9, Ann Arbor, MI 48109 USAUniv Michigan, Dept Internal Med, Div Geriatr & Palliat Med, 300 N Ingalls Bldg,Floor 9, Ann Arbor, MI 48109 USA
Ha, Jin-Kyung
Hofer, Timothy P.
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VA Ctr Clin Management Res, Hlth Serv Res & Dev Ctr Innovat, Ann Arbor, MI USA
Univ Michigan, Inst Healthcare Policy & Innovat, Ann Arbor, MI 48109 USA
Univ Michigan, Dept Internal Med, Div Gen Internal Med, Ann Arbor, MI 48109 USAUniv Michigan, Dept Internal Med, Div Geriatr & Palliat Med, 300 N Ingalls Bldg,Floor 9, Ann Arbor, MI 48109 USA
Hofer, Timothy P.
Sussman, Jeremy
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VA Ctr Clin Management Res, Hlth Serv Res & Dev Ctr Innovat, Ann Arbor, MI USA
Univ Michigan, Inst Healthcare Policy & Innovat, Ann Arbor, MI 48109 USA
Univ Michigan, Dept Internal Med, Div Gen Internal Med, Ann Arbor, MI 48109 USAUniv Michigan, Dept Internal Med, Div Geriatr & Palliat Med, 300 N Ingalls Bldg,Floor 9, Ann Arbor, MI 48109 USA
Sussman, Jeremy
Langa, Kenneth
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VA Ann Arbor Med Ctr, Geriatr Res Educ & Clin Ctr, Ann Arbor, MI USA
Univ Michigan, Inst Healthcare Policy & Innovat, Ann Arbor, MI 48109 USA
Univ Michigan, Dept Internal Med, Div Gen Internal Med, Ann Arbor, MI 48109 USA
Univ Michigan, Inst Social Res, Ann Arbor, MI 48109 USAUniv Michigan, Dept Internal Med, Div Geriatr & Palliat Med, 300 N Ingalls Bldg,Floor 9, Ann Arbor, MI 48109 USA
Langa, Kenneth
Cushman, William C.
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机构:
Memphis VA Med Ctr, Prevent Med Sect, Memphis, TN USA
Univ Tennessee, Ctr Hlth Sci, Hlth Sci Ctr, Memphis, TN 38163 USAUniv Michigan, Dept Internal Med, Div Geriatr & Palliat Med, 300 N Ingalls Bldg,Floor 9, Ann Arbor, MI 48109 USA
Cushman, William C.
Tinetti, Mary
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Yale Sch Med, Dept Med, Sect Geriatr, New Haven, CT USAUniv Michigan, Dept Internal Med, Div Geriatr & Palliat Med, 300 N Ingalls Bldg,Floor 9, Ann Arbor, MI 48109 USA
Tinetti, Mary
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Kim, Hyungjin Myra
Maciejewski, Matthew L.
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VA Hlth Care Syst, Accelerate Discovery & Practice Transformat Ctr I, Durham, NC USA
Duke Univ, Dept Populat Hlth Sci, Durham, NC USAUniv Michigan, Dept Internal Med, Div Geriatr & Palliat Med, 300 N Ingalls Bldg,Floor 9, Ann Arbor, MI 48109 USA
Maciejewski, Matthew L.
Gillon, Leah
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VA Ctr Clin Management Res, Hlth Serv Res & Dev Ctr Innovat, Ann Arbor, MI USAUniv Michigan, Dept Internal Med, Div Geriatr & Palliat Med, 300 N Ingalls Bldg,Floor 9, Ann Arbor, MI 48109 USA
Gillon, Leah
Larkin, Angela
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VA Ctr Clin Management Res, Hlth Serv Res & Dev Ctr Innovat, Ann Arbor, MI USAUniv Michigan, Dept Internal Med, Div Geriatr & Palliat Med, 300 N Ingalls Bldg,Floor 9, Ann Arbor, MI 48109 USA
Larkin, Angela
Chan, Chiao-Li
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Univ Michigan, Dept Internal Med, Div Geriatr & Palliat Med, 300 N Ingalls Bldg,Floor 9, Ann Arbor, MI 48109 USAUniv Michigan, Dept Internal Med, Div Geriatr & Palliat Med, 300 N Ingalls Bldg,Floor 9, Ann Arbor, MI 48109 USA
Chan, Chiao-Li
Kerr, Eve
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机构:
VA Ctr Clin Management Res, Hlth Serv Res & Dev Ctr Innovat, Ann Arbor, MI USA
Univ Michigan, Inst Healthcare Policy & Innovat, Ann Arbor, MI 48109 USA
Univ Michigan, Dept Internal Med, Div Gen Internal Med, Ann Arbor, MI 48109 USAUniv Michigan, Dept Internal Med, Div Geriatr & Palliat Med, 300 N Ingalls Bldg,Floor 9, Ann Arbor, MI 48109 USA
机构:
New England Mental Illness Res Educ & Clin Ctr, West Haven, CT USA
Yale Univ, Sch Med, New Haven, CT USANew England Mental Illness Res Educ & Clin Ctr, West Haven, CT USA
机构:
Providence Vet Affairs Med Ctr, Dermatoepidemiol Unit, Room 512A,830 Chalkstone Ave, Providence, RI 02908 USA
Brown Univ, Sch Publ Hlth, Providence, RI 02912 USAProvidence Vet Affairs Med Ctr, Dermatoepidemiol Unit, Room 512A,830 Chalkstone Ave, Providence, RI 02908 USA
Bertrand, Sylvie E.
Weinstock, Martin A.
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机构:
Providence Vet Affairs Med Ctr, Dermatoepidemiol Unit, Room 512A,830 Chalkstone Ave, Providence, RI 02908 USA
Brown Univ, Sch Publ Hlth, Providence, RI 02912 USA
Brown Univ, Dept Dermatol, Warren Alpert Med Sch, Providence, RI 02912 USAProvidence Vet Affairs Med Ctr, Dermatoepidemiol Unit, Room 512A,830 Chalkstone Ave, Providence, RI 02908 USA
Weinstock, Martin A.
Landow, Shoshana M.
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机构:
Providence Vet Affairs Med Ctr, Dermatoepidemiol Unit, Room 512A,830 Chalkstone Ave, Providence, RI 02908 USA
Brown Univ, Dept Dermatol, Warren Alpert Med Sch, Providence, RI 02912 USAProvidence Vet Affairs Med Ctr, Dermatoepidemiol Unit, Room 512A,830 Chalkstone Ave, Providence, RI 02908 USA