Use and correlates of VHA tobacco cessation counseling services by veterans with post-traumatic stress disorder

2017 ◽  
Vol 16 (1) ◽  
pp. 37-44 ◽  
Author(s):  
Megan Kelly ◽  
Shihwe Wang ◽  
Robert Rosenheck
Keyword(s):  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Tobacco Cessation ◽  
Stress Disorder ◽  
Fiscal Year ◽  
Counseling Services ◽  
Health Administration ◽  
Post Traumatic Stress ◽  
Content Type ◽  
Post Traumatic

Purpose Veterans with post-traumatic stress disorder (PTSD) have high lifetime rates of smoking and often have substantial difficulty quitting. However, relatively little research has focussed on the use of Veterans Health Administration (VHA) intensive tobacco cessation counseling services by veterans with PTSD and the characteristics of veterans with PTSD who do and do not use these services. The paper aims to discuss these issues. Design/methodology/approach The present study is an analysis of national VHA administrative data fiscal year 2012 that identified utilization rates of VHA intensive tobacco cessation counseling among veterans with diagnoses of both PTSD and tobacco use disorder (TUD) (N=144,990) and the correlates of tobacco cessation counseling use. Findings Altogether, 7,921 veterans with PTSD diagnosed with TUD used VHA tobacco cessation services (5.5 percent). Veterans with PTSD who used tobacco cessation counseling services were more likely to have been homeless, to have a comorbid drug use disorder, and had used other VHA services more frequently than their counterparts who did not access tobacco cessation counseling. The use of outpatient mental health and substance use services was the strongest correlate of tobacco cessation counseling use by veterans in this sample. Notably, veterans with PTSD, TUD and HIV were more likely to engage in tobacco cessation services. Originality/value This study demonstrates that future efforts should focus on increasing provider and veteran awareness of and accessibility to VHA intensive tobacco cessation counseling for veterans with PTSD.

Faking it: incentives and malingered PTSD

2014 ◽  
Vol 4 (1) ◽  
pp. 19-32 ◽  
Author(s):  
Kristine A. Peace ◽  
Victoria E.S. Richards
Keyword(s):  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Design Methodology ◽  
Stress Disorder ◽  
Post Traumatic Stress ◽  
Content Type ◽  
Symptom Profiles ◽  
Symptom Reports ◽  
Symptom Scores ◽  
Post Traumatic

Purpose – The purpose of this paper is to address how context for malingering and the provision of incentives influence malingered symptom profiles of post-traumatic stress disorder (PTSD). Design/methodology/approach – A 2 (case context)×3 (incentive) factorial design was utilized. Participants (n=298) were given an incentive (positive, negative, or no incentive), randomly assigned to a criminal or civil context, and asked to provide a fake claim of child abuse with corresponding malingered symptoms of PTSD. Under these conditions, participants completed several questionnaires pertaining to symptoms of trauma and PTSD. Findings – Results indicated that negative incentives were primarily associated with lower symptom scores. Therefore, “having something to lose” may result in more constrained (and realistic) symptom reports relative to exaggeration evidenced with positive incentives. Originality/value – These results have implications for forensic settings where malingered claims of PTSD are common and incentives for such claims (e.g. having something to gain or lose) frequently exist. Previous studies have failed to address incentives (positive and negative) in relation to a crime (i.e. abuse) that can span both criminal and civil contexts.

The prevalence of depression and post-traumatic stress disorder among internally displaced persons in Maiduguri, Nigeria

2019 ◽  
Vol 19 (2) ◽  
pp. 159-168 ◽  
Author(s):  
Deborah Oyine Aluh ◽  
Roland Nnaemeka Okoro ◽  
Adamu Zimboh
Keyword(s):  
Mental Health ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Internally Displaced Persons ◽  
Post Traumatic Stress ◽  
Content Type ◽  
Internally Displaced ◽  
Prevalence Of Depression ◽  
Post Traumatic

Purpose The purpose of this paper is to assess the prevalence of depression and post-traumatic stress disorder (PTSD) among internally displaced persons (IDPs) in Maiduguri. Design/methodology/approach The study was a cross-sectional study that took place among the six IDP camps located in Maiduguri metropolis in Borno State. A non-randomized technique was used to sample 1,200 respondents. Face-to-face interviews with selected members of households were carried out confidentially. The study used the Patient Health Questionnaire (PHQ-9) and Impact of Event Scale-6 which were translated to Kanuri. Descriptive and inferential statistics were employed using SPSS version 21. Findings The response rate was 100 percent. In total, 96.1 percent (1,153) of the respondents were depressed, while 78 percent (936) of the respondents were symptomatic for PTSD. The prevalence rate of comorbid PTSD with depression was 68.1 percent (817). About one-third of the respondents had moderately severe depression (29.6 percent, n=355) while about one in ten of them were severely depressed (11.3 percent, n=136). The odds of being depressed was 3.308 higher in people aged 51–60 years compared to people between 18 and 20 years. Significant predictors of depression in the sampled population were screening positive for PTSD and being unemployed. Practical implications The high prevalence of depression and PTSD among the sampled population calls for structured interventions to deal with mental health problems. The study findings suggest the need for more research (preferably qualitative) on the mental health issues in this population. Originality/value This study contributes to the sparse available literature on the mental health of IDPs in Nigeria.

Pharmacy considerations in tobacco cessation for patients suffering from posttraumatic stress disorder

2013 ◽  
Vol 2 (7) ◽  
pp. 195-201
Author(s):  
Allen Ayala ◽  
Melanie Geer
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Posttraumatic Stress ◽  
Tobacco Use ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Tobacco Cessation ◽  
Stress Disorder ◽  
Post Traumatic Stress ◽  
Post Traumatic ◽  
Different Populations

Multiple studies have associated post traumatic stress disorder (PTSD) with variable and high rates of smoking documented in different populations. This article will cover the neurobiology behind tobacco use, and its implications in those with PTSD. Discussion on cessation programs (e.g., effectiveness, drug interactions), and controversy over the use of varenicline will also be discussed.

scholarly journals Risk and protective factors for the course of post-traumatic stress disorder in frontline workers after the Christchurch, New Zealand earthquake

2018 ◽  
Vol 27 (2) ◽  
pp. 193-206 ◽  
Author(s):  
David McBride ◽  
Nancy Porter ◽  
Kirsten Lovelock ◽  
Daniel Shepherd ◽  
Maria Zubizaretta ◽  
...  
Keyword(s):  
Social Support ◽  
New Zealand ◽  
Protective Factors ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Post Traumatic Stress ◽  
Content Type ◽  
Post Traumatic ◽  
Over Time

Purpose The purpose of this paper is to describe risk and protective factors for symptoms of post-traumatic stress disorder (PTSD) experienced over a 1.5-year period among both frontline and “non-traditional” responders to the 2010 and 2011 earthquakes in Christchurch, New Zealand. Design/methodology/approach A longitudinal survey administered to Christchurch workers with referents from the city of Hamilton at 6, 12 and 18 months after the 2011 earthquake. Potential risk and protective determinants were assessed by questionnaire items at baseline and over time, the outcome being PTSD as assessed by the PTSD Checklist-Civilian version. A longitudinal latent class analysis identified groups with similar trajectories of PTSD. Findings A total of 226 individuals, 140 (26 per cent) from Christchurch and 86 (16 per cent) from Hamilton, participated at baseline, 180 at 12 and 123 at 18 months, non-traditional responders forming the largest single group. Two latent classes emerged, with PTSD (21 per cent) and without PTSD (79 per cent), with little change over the 18-month period. Class membership was predicted by high scores in the Social Support and Impact of Events scale items, Health-related Quality of Life scores being protective. PTSD scores indicative of distress were found in females, and predicted by burnout risk, behavioural disengagement and venting. Practical implications Non-traditional responders should be screened for PTSD. Social support should be considered with the promotion of adaptive coping mechanisms. Originality/value The strength was longitudinal follow-up over an 18-month period, with demonstration of how the potential determinants influenced the course of PTSD over time.

scholarly journals Post traumatic stress disorder in incarcerated populations: current clinical considerations and recommendations

2020 ◽  
Vol 10 (1) ◽  
pp. 30-42
Author(s):  
Clare S. Allely ◽  
Bob Allely
Keyword(s):  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Post Traumatic Stress ◽  
Content Type ◽  
Literature Reviews ◽  
Incarcerated Populations ◽  
Post Traumatic ◽  
Clinical Considerations ◽  
Detrimental Impact

Purpose Post-traumatic stress disorder (PTSD) may have a detrimental impact on the individual’s ability to benefit from rehabilitative prison-based programmes, and studies have also found that there is an association between PTSD and higher rates of re-offending. Studies have also found that a significant number of cases of trauma and PTSD go undetected and therefore untreated in individuals who are incarcerated. Design/methodology/approach A literature review was carried out exploring studies that have investigated PTSD in incarcerated populations to identify current clinical considerations and recommendations. Findings This paper explores the key findings from the literature and highlights the important clinical implications and recommendations. Originality/value To the authors’ knowledge, this is the first paper focusing specifically on how the findings from the literature can inform clinical practice and also what factors need to be given greater consideration, going beyond the current systematic and literature reviews in the field.

scholarly journals The use of second generation antipsychotics for post-traumatic stress disorder in a US Veterans Health Administration Medical Center

2013 ◽  
Vol 23 (3) ◽  
pp. 281-288 ◽  
Author(s):  
E. Hermes ◽  
M. Sernyak ◽  
R. Rosenheck
Keyword(s):  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Second Generation ◽  
Stress Disorder ◽  
Medical Center ◽  
Veterans Health ◽  
Health Administration ◽  
Post Traumatic Stress ◽  
Chi Square ◽  
Post Traumatic

Background.Prior studies of antipsychotic use in individuals with post-traumatic stress disorder (PTSD) are limited because administrative data lacks information on why providers choose particular medications.Methods.This study examined 2613 provider surveys completed at the time any second generation antipsychotic (SGA) was prescribed over a 20-month period at a single Veterans Affairs medical center. Clinical correlates and reasons for SGA selection among individuals with PTSD compared to those with other psychiatric disorders were identified using chi-square.Results.PTSD was the sole diagnosis in n = 339 (13%) and one of several psychiatric diagnoses in n = 236 (9%) surveys. ‘Efficacy’ was the most common reason given for the prescriptions of SGAs in all surveys (51%) and among individuals with PTSD (46%). ‘Sleep/sedation’ was the only reason cited, significantly more frequently among those with PTSD (39% with PTSD only, 35% with PTSD plus another diagnosis, and 31% without PTSD [χ2 = 12.86, p < 0.0016)]. The proportion identifying ‘efficacy’ as a reason for SGA use was smaller in patients with PTSD (44% with PTSD only, 49% with PTSD and another diagnosis, and 53% without PTSD [χ2 = 8.78, p < 0.0125)]. Quetiapine was the most frequently prescribed SGA in the entire sample and among veterans with PTSD (47%).Conclusions.Clinician use of SGAs is often driven by efficacy, for which there is limited evidence, and distinctly driven by the goal of sedation among patients with PTSD.

scholarly journals Veterans’ experiences of successfully managing post-traumatic stress disorder

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Gemma Parry ◽  
Suzanne Margaret Hodge ◽  
Alan Barrett
Keyword(s):  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Armed Forces ◽  
Post Traumatic Stress ◽  
Structured Interviews ◽  
Civilian Life ◽  
Content Type ◽  
Post Traumatic ◽  
The Military

Purpose Prevalence of post-traumatic stress disorder (PTSD) among UK veterans is higher than in the general population. However, prevalence figures do not reflect the complexity of this phenomenon and ways in which it may be bound up with veterans’ experiences of adjusting to civilian life. The purpose of this study is to explore veterans’ experiences of successfully managing PTSD. Design/methodology/approach Semi-structured interviews were conducted with six veterans who had served in the UK armed forces and analysed using interpretative phenomenological analysis. Findings Three themes were developed: accepting the problem, taking responsibility and gaining control; talking to the right people; and strategies, antidotes and circling back around. Managing PTSD appeared to be bound up with veterans’ experience of renegotiating their identity, where positive aspects of identity lost on leaving the military were rebuilt and problematic aspects were challenged. Participants sought to speak about their difficulties with others who understood the military context. They felt that their experiences made them a valuable resource to others, and they connected this with a positive sense of identity and value. Practical implications The findings suggest the importance of wider provision of peer support and education for civilian health services on veterans’ needs. Originality/value This study adds to the understanding of what meaningful recovery from PTSD may involve for veterans, in particular its potential interconnectedness with the process of adjusting to civilian life.

scholarly journals Initiation of pharmacotherapy for post-traumatic stress disorder among veterans from Iraq and Afghanistan: a dimensional, symptom cluster approach

BJPsych Open ◽  
2016 ◽  
Vol 2 (5) ◽  
pp. 286-293 ◽  
Author(s):  
Ilan Harpaz-Rotem ◽  
Robert Rosenheck ◽  
Somaia Mohamed ◽  
Robert Pietrzak ◽  
Rani Hoff
Keyword(s):  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Symptom Cluster ◽  
Prescribing Patterns ◽  
Health Administration ◽  
Post Traumatic Stress ◽  
Ptsd Diagnosis ◽  
Post Traumatic ◽  
Us Veterans

BackgroundThe pharmacological treatment of post-traumatic stress disorder (PTSD) is extremely challenging, as no specific agent has been developed exclusively to treat this disorder. Thus, there are growing concerns among the public, providers and consumers associated with its use as the efficacy of some agents is still in question.AimsWe applied a dimensional and symptom cluster-based approach to better understand how the heterogeneous phenotypic presentation of PTSD may relate to the initiation of pharmacotherapy for PTSD initial episode.MethodUS veterans who served in the conflicts in Iraq and Afghanistan and received an initial PTSD diagnosis at the US Veterans Health Administration between 2008 and 2011 were included in this study. Veterans were followed for 365 days from initial PTSD diagnosis to identify initiation for antidepressants, anxiolytics/sedatives/hypnotics, antipsychotics and prazosin. Multivariable analyses were used to assess the relationship between the severity of unique PTSD symptom clusters and receiving prescriptions from each medication class, as well as the time from diagnosis to first prescription.ResultsIncreased severity of emotional numbing symptoms was independently associated with the prescription of antidepressants, and they were prescribed after a substantially shorter period of time than other medications. Anxiolytics/sedatives/hypnotics prescription was associated with heightened re-experiencing symptoms and sleep difficulties. Antipsychotics were associated with elevated re-experiencing and numbing symptoms and prazosin with reported nightmares.ConclusionsPrescribing practices for military-related PTSD appear to follow US VA/DoD clinical guidelines. Results of this study suggest that a novel dimensional and symptom cluster-based approach to classifying the phenotypic presentation of military-related PTSD symptoms may help inform prescribing patterns for PTSD.

Factors associated with post-traumatic stress disorder (PTSD) following natural disaster among Indonesian elderly

2019 ◽  
Vol 24 (1) ◽  
pp. 27-38
Author(s):  
Gading Ekapuja Aurizki ◽  
Ferry Efendi ◽  
Retno Indarwati
Keyword(s):  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
The Elderly ◽  
Post Traumatic Stress ◽  
Content Type ◽  
Factors Associated ◽  
Post Traumatic ◽  
Post Disaster ◽  
Elder People

Purpose The purpose of this paper is to analyze factors associated with post-traumatic stress disorder (PTSD) among elderly who live in a post-earthquake area. Design/methodology/approach This was a cross-sectional study involving 152 elder people who survived the disaster and were selected conveniently. The study was conducted in two worst-affected districts of Lombok Utara regency. PTSD was diagnosed using a modified version of the Clinician-Administered PTSD Scale version 5 (CAPS-5). The demographic data were assessed using a self-developed questionnaire consisting of 13 items. All data were analyzed by descriptive analysis, χ2 test and binary logistic regression with p<0.05. Findings Out of the 152 elder people, 91 (59.9 percent) suffered PTSD. Intrusion symptoms were the most common symptoms experienced by the respondents (94.1 percent). The factors associated with the PTSD in the elderly after the earthquake were having chronic illnesses (OR=2.490; 95% CI=1.151–5.385), public health center utilization (OR=2.200; 95% CI=1.068–4.535) and occupational status before the disaster (OR=2.726; 95% CI=1.296–5.730). These findings highlight that individual factors and access to health care services remain an important aspect of stress identification among the elderly following the disaster event. Social implications Elder people constitute a vulnerable group that is often forgotten and neglected during post-disaster recovery, though they have potentially higher psychosocial distress than younger age groups. This study was conducted to raise awareness about mental health problems suffered by the elderly. Originality/value This is the first study to apply CAPS-5 to assess PTSD among Indonesian elderly people following a natural disaster. This paper also provides insights that can be used by governments and other relevant parties to address PTSD problems suffered by many elderly people in a post-disaster area.

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