RESUMO
This study examined whether gender and military sexual assault (MSA) were associated with psychiatric severity differences at initiation of treatment for posttraumatic stress disorder (PTSD) and whether MSA and gender predicted psychiatric treatment outcomes. Male (n = 726) and female (n = 111) patients were recruited from 7 U.S. Department of Veterans Affairs (VA) PTSD specialty intensive treatment programs and completed an intake survey; 69% (n = 574) of the participants completed a 4-month postdischarge follow-up survey. Measures included current PTSD and depressive symptoms, aggressive/violent behaviors, alcohol and drug use severity, and quality of life. Multilevel multivariate regression analyses were conducted to examine the main and interaction effects of gender and MSA on psychiatric treatment outcomes at 4-month follow-up, including demographics, baseline severity, hostile fire, and treatment length of stay. Baseline PTSD severity did not differ by gender or MSA status, but women had more severe depressive symptoms (d = 0.40) and less aggressive/violent symptoms (d = -0.46) than men. Gender, MSA status, and the interaction between gender and MSA did not predict treatment outcomes as hypothesized. Male and female veterans with and without MSA responded equally well to treatment in VA PTSD intensive treatment programs.
Assuntos
Militares/psicologia , Delitos Sexuais/psicologia , Transtornos de Estresse Pós-Traumáticos/terapia , Veteranos/psicologia , Adulto , Agressão , Depressão/etiologia , Feminino , Seguimentos , Humanos , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Qualidade de Vida/psicologia , Índice de Gravidade de Doença , Fatores Sexuais , Transtornos de Estresse Pós-Traumáticos/psicologia , Transtornos Relacionados ao Uso de Substâncias/etiologia , Resultado do Tratamento , Estados UnidosRESUMO
The fit of patient coping style and psychotherapy focus has been suggested as improving treatment outcome. This article reviews the definitions, measures, and previous research surrounding this hypothesis. An original meta-analysis of 12 carefully selected studies (N = 1,291 patients) resulted in a weighted, mean effect size (d) of .55 in favor of a fit between externalizing patients and symptom-focused treatment or, alternatively, internalizing patients and insight-focused treatment. This medium-size effect indicates that nondiagnostic patient factors, like coping style, are important considerations in the selection of effective therapies. Clinical examples and clinical recommendations are provided.
