摘要 :
Over the course of the last year, the study team received IRB approval and began recruiting participants at five of the six study sites (Joint Base Lewis-McChord, Ft. Bliss, Ft. Campbell, Ft. Carson, and Ft. Stewart). As of August...
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Over the course of the last year, the study team received IRB approval and began recruiting participants at five of the six study sites (Joint Base Lewis-McChord, Ft. Bliss, Ft. Campbell, Ft. Carson, and Ft. Stewart). As of August 31, 2012, 368 total referrals across the five active sites had been received; 179 participants had been enrolled and randomized into the study (86 participants into the STEPS UP arm; 93 participants into the optimized usual care arm); 53 participants completed the 3-month follow-up assessment; and 6 participants completed the 6-month follow-up. We are awaiting HRPO approval of our final site (Ft. Bragg); we anticipate beginning recruitment at Ft. Bragg in September 2012. Multiple amendments have been approved by the WRNMMC IRB, including an amendment that revised eligibility criteria and updated data collection forms. The study intervention has been refined to include a web-based care management support tool; nurse-assisted web- based cognitive-behavioral therapy options for PTSD and depression; a modularized telephonic cognitive-behavioral therapy option for PTSD and depression; and a preference-based stepped care approach to primary care PTSD and depression treatment sequencing. We have continued to hire and train site and centralized personnel.
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摘要 :
Posttraumatic stress disorder (PTSD) has been associated with comorbidity of many somatic and mental disorders. Such psychiatric comorbidity poses increased treatment challenges for a military population that already tends to unde...
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Posttraumatic stress disorder (PTSD) has been associated with comorbidity of many somatic and mental disorders. Such psychiatric comorbidity poses increased treatment challenges for a military population that already tends to underutilize treatment services. Further, the prevalence and pattern of these comorbidities within the total force are unknown. Although some of these comorbidities may be associated with combat-related traumas, others may be more associated with separate noncombat risk and protective factors such as childhood trauma, cognitive abilities, sociodemographic factors, or genetic factors. Because different patterns may represent different underlying etiologies, optimal intervention and treatment efforts need to take them into account. These efforts require two concurrent lines of investigation: (a) identification of multiple patterns of disorders, and (b) examination of risk and protective factors for each disorder pattern. This study is the first to examine both critical lines of investigation in the total force. To conduct this unique investigation, we conducted in-depth secondary analyses of two comprehensive parallel datasets that together provide key information on PTSD symptoms and other risk behaviors for the total force, both active duty and reserve components. Findings from the analyses were presented at professional association meetings, in annual reports, in briefings to military leadership, and in several peer-reviewed papers.
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