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Webermann AR, Nester MS, Gianoli MO, Black AC, Rosen MI, Mattocks KM, Portnoy GA. Compensation and Pension Exams for Military Sexual Trauma-Related Posttraumatic Stress Disorder: Examiner Perspectives, Clinical Impacts on Veterans, and Strategies. Womens Health Issues 2023; 33:428-434. [PMID: 37003918 DOI: 10.1016/j.whi.2023.02.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 02/06/2023] [Accepted: 02/24/2023] [Indexed: 04/01/2023]
Abstract
BACKGROUND It is estimated that in one in three women veterans experience military sexual trauma (MST), which is strongly associated with posttraumatic stress disorder (PTSD). A 2018 report indicated the Veterans Benefits Administration (VBA) processed approximately 12,000 disability claims annually for PTSD related to MST, most of which are filed by women. Part of the VBA adjudication process involves reviewing information from a Compensation and Pension (C&P) exam, a forensic diagnostic evaluation that helps determine the relationship among military service, diagnoses, and current psychosocial functioning. The quality and outcome of these exams may affect veteran well-being and use of Veterans Health Administration (VHA) mental health care, but no work has looked at examiner perspectives of MST C&P exams and their potential clinical impacts on veteran claimants. METHODS Thirteen clinicians ("examiners") who conduct MST C&P exams through VHA were interviewed. Data were analyzed using rapid qualitative methods. RESULTS Examiners described MST exams as more clinically and diagnostically complex than non-MST PTSD exams. Examiners noted that assessing "markers" of MST (indication that MST occurred) could make veterans feel disbelieved; others raised concerns related to malingered PTSD symptoms. Examiners identified unique challenges for veterans who underreport MST (e.g., men and lesbian, gay, bisexual, transgender, and queer [LGBTQ+] veterans), and saw evaluations as a conduit to psychotherapy referrals and utilization of VHA mental health care. Last, examiners used strategies to convey respect and minimize retraumatization, including a standardized process and validating the difficulty of the process. CONCLUSIONS Examiners' responses offer insight into a process entered by thousands of veterans annually with PTSD. Strengthening the MST C&P process is a unique opportunity to enhance trust in the VBA claims process and increase likelihood of using VHA mental health care, especially for women veterans.
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Affiliation(s)
- Aliya R Webermann
- VA Connecticut Healthcare System, West Haven, Connecticut; Yale School of Medicine, New Haven, Connecticut.
| | - M Shae Nester
- University of North Carolina at Greensboro, Greensboro, North Carolina
| | - Mayumi O Gianoli
- VA Connecticut Healthcare System, West Haven, Connecticut; Yale School of Medicine, New Haven, Connecticut; University of Connecticut School of Medicine, Farmington, Connecticut
| | - Anne C Black
- VA Connecticut Healthcare System, West Haven, Connecticut; Yale School of Medicine, New Haven, Connecticut
| | - Marc I Rosen
- VA Connecticut Healthcare System, West Haven, Connecticut; Yale School of Medicine, New Haven, Connecticut
| | - Kristin M Mattocks
- VA Central Western Massachusetts Healthcare System, Leeds, Massachusetts; University of Massachusetts Chan Medical School, Worcester, Massachusetts
| | - Galina A Portnoy
- VA Connecticut Healthcare System, West Haven, Connecticut; Yale School of Medicine, New Haven, Connecticut
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2
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The “trauma pitch”: How stigma emerges for Iraq and Afghanistan veterans seeking disability compensation. PLoS One 2022; 17:e0267424. [PMID: 36044465 PMCID: PMC9432745 DOI: 10.1371/journal.pone.0267424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 08/16/2022] [Indexed: 11/21/2022] Open
Abstract
Posttraumatic Stress Disorder continues to be a highly stigmatized disease for the veteran population and stigma, experienced as a mark of discredit or shame, continues to be identified as the main deterrent in treatment seeking. Little attention has been paid to how the process of obtaining service-connected disability status can amplify veterans’ perceptions of being stigmatized. The following ethnographic study identified how combat veterans experienced stigma in processing through Veterans Affairs care and the effects of linking a Posttraumatic Stress Disorder diagnosis with disability compensation. Stigma was identified in two inter-related areas: 1) the structural level in the Veterans Affairs disability claims process and 2) the individual level in interactions with Veterans Affairs service providers. Findings based on veterans’ narratives suggest that the disability claims process, requiring multiple repetitions of personal trauma, coupled with perceptions of institutional stigmas of malingering, created bureaugenic effects: a worsening of symptoms caused by bureaucratic protocols intended to help veterans. This process influenced first time treatment users of the Veterans Affairs by deterring treatment-seeking behavior but was not found to affect veterans who had already initiated treatment. Despite the experience of stigma and commodification of their suffering through disability and diagnostic screening, veterans still sought disability compensation. Veterans viewed this compensation as acknowledgment of their loss and validation of their sacrifice.
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Rodriguez JL, Hale AC, Marston HN, Sage-Germain CE, Wright TP, Driesenga SA, Martin SM, Sripada RK. The Association Between Service Connection and Treatment Outcome in Veterans Undergoing Residential PTSD Treatment. Psychiatr Q 2022; 93:285-296. [PMID: 34532825 DOI: 10.1007/s11126-021-09940-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/05/2021] [Indexed: 11/26/2022]
Abstract
The Department of Veterans Affairs has invested significant time and resources into the treatment of posttraumatic stress disorder (PTSD). Despite concerted efforts, a significant portion of patients do not respond optimally to trauma-focused treatment. One of the factors that has been hypothesized to be associated with treatment response is participation in the Veterans Benefits Administration service-connected disability process. This factor may be particularly relevant in the residential treatment setting, where most participants are engaged in the compensation seeking process. We conducted a retrospective chart review of 105 veterans who completed Cognitive Processing Therapy (CPT) in a residential rehabilitation program. ANCOVAs that adjusted for baseline PTSD severity compared symptom change between those who were and were non-compensation seeking at the time of treatment. Compensation seeking status was associated with significantly less symptom improvement over the course of CPT after adjusting for baseline PTSD severity (F(1, 102) = 4.29, p < .001, η2 = .03). Sensitivity analyses did not detect a similar effect during a prior coping skills phase of treatment. During CPT, clinically significant change was met by 66.7% of non-compensation seeking veterans (M = -15, SD = 14.56) and by 40.1% of the compensation seeking group (M = -7.1, SD = 12.24). Compensation-seeking may be associated with reduced response to trauma-focused treatment in certain settings. Future research is needed to better understand the mechanisms underlying this effect.
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Affiliation(s)
- Jessica L Rodriguez
- Psychology Service, Battle Creek VA Medical Center, 5500 Armstrong Road, Battle Creek, MI, 49037, USA.
| | - Andrew C Hale
- VA Center for Clinical Management Research, VA Ann Arbor Healthcare System/Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Holloway N Marston
- Psychology Service, Battle Creek VA Medical Center, 5500 Armstrong Road, Battle Creek, MI, 49037, USA
| | - Chelsea E Sage-Germain
- Psychology Service, Battle Creek VA Medical Center, 5500 Armstrong Road, Battle Creek, MI, 49037, USA
| | - Theodore P Wright
- Psychology Service, Battle Creek VA Medical Center, 5500 Armstrong Road, Battle Creek, MI, 49037, USA
| | - Scott A Driesenga
- Psychology Service, Battle Creek VA Medical Center, 5500 Armstrong Road, Battle Creek, MI, 49037, USA
| | - Shannon M Martin
- Department of Psychology, Converse College, Spartanburg, SC, USA
| | - Rebecca K Sripada
- VA Center for Clinical Management Research, VA Ann Arbor Healthcare System/Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
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Spinola S, Fenton BT, Meshberg-Cohen S, Black AC, Rosen MI. Comparison of attitudes towards the service connection claims process among veterans filing for PTSD and veterans filing for musculoskeletal disorders. Medicine (Baltimore) 2021; 100:e27068. [PMID: 34477140 PMCID: PMC8415949 DOI: 10.1097/md.0000000000027068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 03/15/2021] [Accepted: 08/05/2021] [Indexed: 01/05/2023] Open
Abstract
ABSTRACT Many veterans have negative views about the service connection claims process for posttraumatic stress disorder (PTSD), which likely impacts willingness to file service connection claims, re-file claims, and use Veterans Healthcare Administration care. Nevertheless, veterans have reported that PTSD claims are important to them for the financial benefits, validation of prior experience and harm, and self-other issues such as pleasing a significant other. It is unknown if reported attitudes are specific to PTSD claimants or if they would be similar to those submitting claims for other disorders, such as musculoskeletal disorders. Therefore, the purpose of this study was to compare attitudes and beliefs about service connection processes between veterans submitting service connection claims for PTSD and musculoskeletal disorders.Participants were Operation Enduring Freedom, Operation Iraqi Freedom, and Operation New Dawn veterans filing service connection claims for PTSD (n = 218) or musculoskeletal disorder (n = 257) who completed a modified Disability Application Appraisal Inventory. This secondary data analysis using multiple regression models tested the effect of demographics, clinical characteristics, and claim type on 5 Disability Application Appraisal Inventory subscales: Knowledge about service connection claims, Negative Expectations about the process, and importance of Financial Benefits, importance of Validation of veteran's experience/condition, and importance of Self-Other attitudes.The PTSD group assigned significantly less importance to financial benefits than the musculoskeletal disorder group. In addition, the subset of the PTSD group without depression had significantly more Negative Expectations than musculoskeletal disorder claimants without depression. Negative Expectations did not differ between the PTSD and musculoskeletal disorder groups with depression. Depression was significantly positively associated with Negative Expectations, importance of Financial Benefits, and importance of Validation.Most perceptions around seeking service connection are not specific to PTSD claimants. Depression is associated with having negative expectations about service connection claims and motivations to file claims. Addressing depression and negative expectations during the compensation and pension process might help veterans at this important point of contact with Veterans Healthcare Administration services.
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Affiliation(s)
- Suzanne Spinola
- VA Connecticut Healthcare System, West Haven, CT
- Yale University School of Medicine, Department of Psychiatry, CT
| | - Brenda T. Fenton
- VA Connecticut Healthcare System, West Haven, CT
- Yale University School of Medicine, Department of Neurology, CT
| | - Sarah Meshberg-Cohen
- VA Connecticut Healthcare System, West Haven, CT
- Yale University School of Medicine, Department of Psychiatry, CT
| | - Anne C. Black
- VA Connecticut Healthcare System, West Haven, CT
- Yale University School of Medicine, Department of Internal Medicine, CT
| | - Marc I. Rosen
- VA Connecticut Healthcare System, West Haven, CT
- Yale University School of Medicine, Department of Psychiatry, CT
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5
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Bettmann JE, Anstadt G, Kolaski AZ. Therapeutic Adventure for Military Veterans with Mental Illness: A Conceptual Argument. ECOPSYCHOLOGY 2020. [DOI: 10.1089/eco.2019.0045] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
| | - Gretchen Anstadt
- College of Social Work, University of Utah, Salt Lake City, Utah, USA
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Redd AM, Gundlapalli AV, Suo Y, Pettey WBP, Brignone E, Chin DL, Walker LE, Poltavskiy EA, Janak JC, Howard JT, Sosnov JA, Stewart IJ. Exploring Disparities in Awarding VA Service-Connected Disability for Post-Traumatic Stress Disorder for Active Duty Military Service Members from Recent Conflicts in Iraq and Afghanistan. Mil Med 2020; 185:296-302. [PMID: 32074380 DOI: 10.1093/milmed/usz208] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
INTRODUCTION We explore disparities in awarding post-traumatic stress disorder (PTSD) service-connected disability benefits (SCDB) to veterans based on gender, race/ethnicity, and misconduct separation. METHODS Department of Defense data on service members who separated from October 1, 2001 to May 2017 were linked to Veterans Administration (VA) administrative data. Using adjusted logistic regression models, we determined the odds of receiving a PTSD SCDB conditional on a VA diagnosis of PTSD. RESULTS A total of 1,558,449 (79% of separating service members) had at least one encounter in VA during the study period (12% female, 4.5% misconduct separations). Females (OR 0.72) and Blacks (OR 0.93) were less likely to receive a PTSD award and were nearly equally likely to receive a PTSD diagnosis (OR 0.97, 1.01). Other racial/ethnic minorities were more likely to receive an award and diagnosis, as were those with misconduct separations (award OR 1.3, diagnosis 2.17). CONCLUSIONS Despite being diagnosed with PTSD at similar rates to their referent categories, females and Black veterans are less likely to receive PTSD disability awards. Other racial/ethnic minorities and those with misconduct separations were more likely to receive PTSD diagnoses and awards. Further study is merited to explore variation in awarding SCDB.
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Affiliation(s)
- Andrew M Redd
- Informatics, Decision Enhancement, and Analytic Sciences (IDEAS 2.0) Center, VA Salt Lake City Health Care System, 500 Foothill Dr, Salt Lake City, UT 84148.,Department of Internal Medicine, University of Utah School of Medicine, 30 N 1900 E, Salt Lake City, UT 84132
| | - Adi V Gundlapalli
- Informatics, Decision Enhancement, and Analytic Sciences (IDEAS 2.0) Center, VA Salt Lake City Health Care System, 500 Foothill Dr, Salt Lake City, UT 84148.,Department of Internal Medicine, University of Utah School of Medicine, 30 N 1900 E, Salt Lake City, UT 84132
| | - Ying Suo
- Informatics, Decision Enhancement, and Analytic Sciences (IDEAS 2.0) Center, VA Salt Lake City Health Care System, 500 Foothill Dr, Salt Lake City, UT 84148.,Department of Internal Medicine, University of Utah School of Medicine, 30 N 1900 E, Salt Lake City, UT 84132
| | - Warren B P Pettey
- Informatics, Decision Enhancement, and Analytic Sciences (IDEAS 2.0) Center, VA Salt Lake City Health Care System, 500 Foothill Dr, Salt Lake City, UT 84148.,Department of Internal Medicine, University of Utah School of Medicine, 30 N 1900 E, Salt Lake City, UT 84132
| | - Emily Brignone
- VA Pittsburgh Healthcare System, University Drive, Pittsburgh, PA 15240
| | - David L Chin
- Department of Health Promotion and Policy, School of Public Health, University of Massachusetts Amherst, 715 N Pleasant St, Amherst, MA 01003
| | - Lauren E Walker
- David Grant USAF Medical Center, Clinical Investigation Facility, 101 Bodin Circle, Travis AFB, CA 94535
| | - Eduard A Poltavskiy
- David Grant USAF Medical Center, Clinical Investigation Facility, 101 Bodin Circle, Travis AFB, CA 94535
| | - Jud C Janak
- Department of Defense Joint Trauma System, Defense Health Agency, Joint Base San Antonio-Fort Sam Houston, 3698 Chambers Pass, San Antonio, TX 78234
| | - Jeffrey T Howard
- Department of Kinesiology, Health and Nutrition, University of Texas at San Antonio, One UTSA Circle, San Antonio, TX 78249
| | - Jonathan A Sosnov
- 375th Medical Group, Scott AFB, IL 62225.,Uniformed Services University of the Health Sciences, 4301 Jones Bridge Rd, Bethesda, MD 20814
| | - Ian J Stewart
- David Grant USAF Medical Center, Clinical Investigation Facility, 101 Bodin Circle, Travis AFB, CA 94535.,Uniformed Services University of the Health Sciences, 4301 Jones Bridge Rd, Bethesda, MD 20814
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Fyffe DC, Williams J, Tobin P, Gibson-Gill C. Spinal Cord Injury Veterans' Disability Benefits, Outcomes, and Health Care Utilization Patterns: Protocol for a Qualitative Study. JMIR Res Protoc 2019; 8:e14039. [PMID: 31588906 PMCID: PMC6800461 DOI: 10.2196/14039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2019] [Revised: 07/26/2019] [Accepted: 07/28/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND An estimated 42,000 people currently living with chronic spinal cord injury (SCI) are veterans. SCI was a common combat-related injury in the World Wars and Vietnam era and now affects more than 11% of military personnel injured in Operation Iraqi Freedom and Operation Enduring Freedom. The Veterans Benefits Administration primarily offers financial compensation for disabilities sustained or re-aggravated during military service, called service-connected disability compensation. With the overwhelming cost of living with an SCI, this monthly financial compensation can provide service-connected veterans and their families with access to additional supportive resources (eg, assistive devices and personal aide) and maintain their quality of life (QOL). Little is known about personal, health, functional, and QOL outcomes associated with service-connected and nonservice-connected status for veterans living with an SCI. OBJECTIVE The aim of this study is to compare the ways in which Veterans Affairs' (VA) service-connected and nonservice-connected status may be associated with health and functional outcomes, choice of health care provider, and overall QOL for veterans living with an SCI and their caregivers. METHODS This cross-sectional qualitative study will gather data using retrospective chart reviews, semistructured interviews, and focus groups. After obtaining institutional review board (IRB) approval, purposeful sampling techniques will be used to recruit and enroll the following key stakeholders: veterans living with an SCI, family caregivers, and SCI health care providers. Concurrent data collection will take place at 2 sites: Veterans Administration New Jersey Healthcare System and Northern New Jersey Spinal Cord Injury System. RESULTS This study was funded in July 2015. IRB approval was obtained by November 2016 at both sites. Enrollment and data collection for phase 1 to phase 4 are complete. A total of 69 veterans, 18 caregivers, and 19 SCI clinicians enrolled in the study. Data analyses for these phases are underway. In phase 5, the follow-up focus group activities are scheduled. The final results are expected by the end of 2019. CONCLUSIONS The factors that contribute to veterans living with SCI seeking and not seeking VA disability compensation benefits are not well understood in rehabilitation research. Triangulation of these data sources will allow us to compare, contrast, and integrate the results, which can be used to develop clinical guidelines, caregiver training, and patient education programs. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/14039.
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Affiliation(s)
- Denise C Fyffe
- Kessler Foundation, Spinal Cord Injury/Outcomes and Assessment Research Center, West Orange, NJ, United States.,Rutgers, New Jersey Medical School, Newark, NJ, United States
| | - Joyce Williams
- VA New Jersey Health Care System, Spinal Cord Injury and Disorders Service (128), East Orange, NJ, United States
| | - Paul Tobin
- Quality of Life Advisors, Fort Myers, FL, United States
| | - Carol Gibson-Gill
- Rutgers, New Jersey Medical School, Newark, NJ, United States.,VA New Jersey Health Care System, Spinal Cord Injury and Disorders Service (128), East Orange, NJ, United States
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8
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Sripada RK, Hannemann CM, Schnurr PP, Marx BP, Pollack SJ, McCarthy JF. Mental Health Service Utilization before and after Receipt of a Service-Connected Disability Award for PTSD: Findings from a National Sample. Health Serv Res 2018; 53:4565-4583. [PMID: 29667171 DOI: 10.1111/1475-6773.12859] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE To determine patterns of mental health service use before and after VA disability compensation awards for posttraumatic stress disorder (PTSD). DATA SOURCES A 10 percent random sample of VHA-enrolled Veterans with new or increased PTSD service connection between 2012 and 2014 (n = 22,249). STUDY DESIGN We used latent trajectory analysis to identify utilization patterns and multinomial logistic regression to assess associations between Veteran characteristics and trajectory membership. DATA EXTRACTION METHODS We assessed receipt of VHA mental health encounters in each of the 52 weeks prior to and following PTSD disability rating or rating increase. PRINCIPAL FINDINGS The best fitting model had five groups: No Use (36.6 percent), Low Use (37.7 percent), Increasing Use (9.4 percent), Decreasing Use (11.2 percent), and High Use (5.1 percent). Adjusting for demographic characteristics and compared with the No Use group, Veterans in the other groups were more likely to reside closer to a VHA facility, receive a higher PTSD disability rating, and screen positive for military sexual trauma. CONCLUSIONS Service use remained stable (80 percent) or increased (9 percent) for the vast majority of Veterans. Service utilization declined for only 11 percent. Data did not indicate substantial service discontinuation following rating. Low VHA service utilization suggests opportunities to enhance outreach for Veterans with PTSD-related disability benefits.
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Affiliation(s)
- Rebecca K Sripada
- Veterans Affairs Center for Clinical Management Research, Ann Arbor, MI.,Veterans Affairs Ann Arbor Health Care System, Ann Arbor, MI.,Department of Psychiatry, University of Michigan, Ann Arbor, MI.,Veterans Affairs Serious Mental Illness Treatment Resource and Evaluation Center, Ann Arbor, MI
| | - Claire M Hannemann
- Veterans Affairs Serious Mental Illness Treatment Resource and Evaluation Center, Ann Arbor, MI.,Office of Mental Health and Suicide Prevention, VA Central Office, Department of Veterans Affairs, Washington, DC
| | - Paula P Schnurr
- Executive Division, National Center for PTSD, White River Junction, VT.,Department of Psychiatry, Geisel School of Medicine at Dartmouth, Hanover, NH
| | - Brian P Marx
- Behavioral Science Division, National Center for PTSD, Boston, MA.,Veterans Affairs Boston Healthcare System, Boston, MA.,Department of Psychiatry, School of Medicine, Boston University, Boston, MA
| | - Stacey J Pollack
- Office of Mental Health and Suicide Prevention, VA Central Office, Department of Veterans Affairs, Washington, DC
| | - John F McCarthy
- Veterans Affairs Center for Clinical Management Research, Ann Arbor, MI.,Department of Psychiatry, University of Michigan, Ann Arbor, MI.,Veterans Affairs Serious Mental Illness Treatment Resource and Evaluation Center, Ann Arbor, MI.,Office of Mental Health and Suicide Prevention, VA Central Office, Department of Veterans Affairs, Washington, DC
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9
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Preliminary evidence for the use and efficacy of mobile health applications in managing posttraumatic stress disorder symptoms. Health Syst (Basingstoke) 2017. [DOI: 10.1057/hs.2016.2] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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10
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Pedersen ER, Naranjo D, Marshall GN. Recruitment and retention of young adult veteran drinkers using Facebook. PLoS One 2017; 12:e0172972. [PMID: 28249027 PMCID: PMC5332067 DOI: 10.1371/journal.pone.0172972] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Accepted: 02/08/2017] [Indexed: 11/18/2022] Open
Abstract
The objective of this study was to describe the feasibility of using Facebook as a platform to recruit and retain young adult veteran drinkers into an online-alcohol use intervention study. Facebook's wide accessibility and popularity among the age group that comprises the majority of veterans from the conflicts in Iraq and Afghanistan make it a compelling resource through which research can extend its reach to this otherwise hard-to-reach group. We developed a series of Facebook advertisement campaigns to reach veteran drinkers not specifically searching for alcohol treatment. In doing so, we recruited 793 valid veteran participants in approximately two weeks for an advertising cost of $4.53 per obtained participant. The study sample consisted primarily of male veterans, between 19 and 34 years of age, who were drinking at moderate to heavy levels. Although about half of the sample reported mental health comorbidity, few had received any mental health or substance use treatment in the past year. Facebook appears to be a valuable mechanism through which to recruit young veterans with unmet behavioral health needs, although more specific efforts may be needed to engage certain types of veterans after initial study enrollment.
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Affiliation(s)
- Eric R. Pedersen
- RAND Corporation, Department of Behavioral and Policy Sciences, Santa Monica, CA, United States of America
| | - Diana Naranjo
- RAND Corporation, Department of Behavioral and Policy Sciences, Santa Monica, CA, United States of America
| | - Grant N. Marshall
- RAND Corporation, Department of Behavioral and Policy Sciences, Santa Monica, CA, United States of America
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11
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Wu L. US media representation of post-traumatic stress disorder: a comparative study of regional newspapers and national newspapers. J Ment Health 2016; 26:225-231. [PMID: 27053417 DOI: 10.3109/09638237.2016.1167849] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND News media play an important role in introducing and defining PTSD-related issues to the general public as well as framing their social importance and analyzing solutions for policymakers. AIMS Compare how coverage of PTSD by larger papers serving general audiences differed from smaller papers catering to communities likely to be affected by the issue. METHOD A content analysis of frames and subtopics about PTSD in all newspaper articles published by selected national newspapers and regional newspapers between the year of 2003 and 2014 (N = 426). RESULTS National newspapers engaged in higher-level policy discussion with greater frequency than regional newspapers, while regional newspapers were more likely to publish stories highlighting the impact of PTSD on individuals and local communities. Furthermore, coverage by regional newspapers used significantly more episodic frames than thematic frames. CONCLUSION Both national and regional newspapers increased the amount of coverage on PTSD significantly after the beginning of the Iraq War in 2003. National newspapers and regional newspapers shared similarities in recognizing dominant issues with PTSD but varied in the way of presenting the topics to the public.
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Affiliation(s)
- Lu Wu
- a School of Media and Journalism , University of North Carolina at Chapel Hill , Chapel Hill, NC , USA
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