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Naturalistic comparison of models of programmatic interventions for combat-related post-traumatic stress disorder.
Aust N Z J Psychiatry. 2008 Dec; 42(12):1051-9.AN

Abstract

OBJECTIVES

Post-traumatic stress disorder (PTSD) is a difficult-to-treat sequel of combat. Data on effectiveness of alternate treatment structures are important for planning veterans' psychiatric services. The present study compared clinical presentations and treatment outcomes for Australian veterans with PTSD who participated in a range of models of group-based treatment.

METHOD

Participants consisted of 4339 veterans with combat-related PTSD who participated in one of five types of group-based cognitive behavioural programmes of different intensities and settings. Data were gathered at baseline (intake), as well as at 3 and 9 month follow up, on measures of PTSD, anxiety, depression and alcohol misuse. Analyses of variance and effect size analyses were used to investigate differences at intake and over time by programme type.

RESULTS

Small baseline differences by programme intensity were identified. Although significant improvements in symptoms were evident over time for each programme type, no significant differences in outcome were evident between programmes. When PTSD severity was considered, veterans with severe PTSD performed less well in the low-intensity programmes than in the moderate- or high-intensity programmes. Veterans with mild PTSD improved less in high-intensity programmes than in moderate- or low-intensity programmes.

CONCLUSION

Comparable outcomes are evident across programme types. Outcomes may be maximized when veterans participate in programme intensity types that match their level of PTSD severity. When such matching is not feasible, moderate-intensity programmes appear to offer the most consistent outcomes. For regionally based veterans, delivering treatment in their local environment does not detract from, and may even enhance, outcomes. These findings have implications for the planning and purchasing of mental health services for sufferers of PTSD, particularly for veterans of more recent combat or peacekeeping deployments.

Authors+Show Affiliations

Australian Centre for Posttraumatic Mental Health, Department of Psychiatry, University of Melbourne, Melbourne, Victoria, Australia. dforbes@unimelb.edu.auNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

19016093

Citation

Forbes, David, et al. "Naturalistic Comparison of Models of Programmatic Interventions for Combat-related Post-traumatic Stress Disorder." The Australian and New Zealand Journal of Psychiatry, vol. 42, no. 12, 2008, pp. 1051-9.
Forbes D, Lewis V, Parslow R, et al. Naturalistic comparison of models of programmatic interventions for combat-related post-traumatic stress disorder. Aust N Z J Psychiatry. 2008;42(12):1051-9.
Forbes, D., Lewis, V., Parslow, R., Hawthorne, G., & Creamer, M. (2008). Naturalistic comparison of models of programmatic interventions for combat-related post-traumatic stress disorder. The Australian and New Zealand Journal of Psychiatry, 42(12), 1051-9. https://doi.org/10.1080/00048670802512024
Forbes D, et al. Naturalistic Comparison of Models of Programmatic Interventions for Combat-related Post-traumatic Stress Disorder. Aust N Z J Psychiatry. 2008;42(12):1051-9. PubMed PMID: 19016093.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Naturalistic comparison of models of programmatic interventions for combat-related post-traumatic stress disorder. AU - Forbes,David, AU - Lewis,Virginia, AU - Parslow,Ruth, AU - Hawthorne,Graeme, AU - Creamer,Mark, PY - 2008/11/19/pubmed PY - 2009/2/28/medline PY - 2008/11/19/entrez SP - 1051 EP - 9 JF - The Australian and New Zealand journal of psychiatry JO - Aust N Z J Psychiatry VL - 42 IS - 12 N2 - OBJECTIVES: Post-traumatic stress disorder (PTSD) is a difficult-to-treat sequel of combat. Data on effectiveness of alternate treatment structures are important for planning veterans' psychiatric services. The present study compared clinical presentations and treatment outcomes for Australian veterans with PTSD who participated in a range of models of group-based treatment. METHOD: Participants consisted of 4339 veterans with combat-related PTSD who participated in one of five types of group-based cognitive behavioural programmes of different intensities and settings. Data were gathered at baseline (intake), as well as at 3 and 9 month follow up, on measures of PTSD, anxiety, depression and alcohol misuse. Analyses of variance and effect size analyses were used to investigate differences at intake and over time by programme type. RESULTS: Small baseline differences by programme intensity were identified. Although significant improvements in symptoms were evident over time for each programme type, no significant differences in outcome were evident between programmes. When PTSD severity was considered, veterans with severe PTSD performed less well in the low-intensity programmes than in the moderate- or high-intensity programmes. Veterans with mild PTSD improved less in high-intensity programmes than in moderate- or low-intensity programmes. CONCLUSION: Comparable outcomes are evident across programme types. Outcomes may be maximized when veterans participate in programme intensity types that match their level of PTSD severity. When such matching is not feasible, moderate-intensity programmes appear to offer the most consistent outcomes. For regionally based veterans, delivering treatment in their local environment does not detract from, and may even enhance, outcomes. These findings have implications for the planning and purchasing of mental health services for sufferers of PTSD, particularly for veterans of more recent combat or peacekeeping deployments. SN - 1440-1614 UR - https://www.unboundmedicine.com/medline/citation/19016093/Naturalistic_comparison_of_models_of_programmatic_interventions_for_combat_related_post_traumatic_stress_disorder_ L2 - https://journals.sagepub.com/doi/10.1080/00048670802512024?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -