RESUMO
OBJECTIVE: During the COVID-19 pandemic, restrictions imposed on residential treatment programs necessitated rapid implementation of virtual treatment delivery. Posttraumatic stress disorder (PTSD) Residential Rehabilitation Treatment Programs (P-RRTP) are a key mental health treatment for Veterans with PTSD who require more intensive interventions than outpatient care. During the pandemic, the W. G. (Bill) Hefner VA Healthcare System developed and implemented a Virtual Intensive Outpatient Program for PTSD (VIOPP) to meet the needs of the Veteran population. The purpose of this analysis was to compare the effectiveness of VIOPP to P-RRTP. METHOD: Analyses included N = 370 Veterans, n = 193 who completed P-RRTP between January 2018 to April 2020 and n = 177 who completed VIOPP between June 2020 and November 2022 and provided pre- and posttreatment scores. Pre- and posttreatment scores of the PTSD Checklist for DSM-5 (PCL-5) were available for all patients. Pre- and posttreatment depressive symptom scores from the Nine-item Patient Health Questionnaire (PHQ-9) were available for n = 254 Veterans. Paired and independent samples t tests evaluated differences in change scores overall and by treatment modality (residential vs. virtual). RESULTS: Results indicated a significant decrease in PCL-5 scores regardless of treatment modality, p < .001. Despite beginning VIOPP with significantly higher PCL-5 scores than P-RRTP, there were no significant differences in PCL-5 change scores between virtual (M = -16.94) and residential treatment (M = -17.10), p = .910. PHQ-9 scores also decreased significantly for both treatment groups. CONCLUSION: These analyses suggest that intensive virtual treatment has similar effectiveness to residential treatment for PTSD. This supports the development of intensive virtual interventions as viable alternatives to residential treatments and a valuable component within the continuum of PTSD care. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
RESUMO
The purpose of this study was to evaluate psychiatric diagnosis and symptom comorbidity in veterans diagnosed with attention-deficit/hyperactivity disorder (ADHD). Study design was retrospective chart review from an ADHD evaluation clinic at a Veterans Affairs hospital. Participants were 227 military veterans who completed a standardized ADHD assessment and produced valid Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) profiles. There were no differences in rates of internalizing or externalizing psychiatric conditions diagnosed in inattentive compared to combined ADHD presentations. However, compared to a subsample with no psychiatric diagnoses, individuals diagnosed with ADHD endorsed significantly more internalizing symptom burden, with combined ADHD veterans also endorsing significantly greater levels of negative emotions and neuroticism. Base rates of comorbid classes of psychiatric diagnoses were not increased in individuals with ADHD, though higher rates of trauma disorders were seen in the combined group compared to the inattentive group. Multivariate base rates of MMPI-2-RF Restructured Clinical scales across various subgroups are presented. There was evidence for differential phenotypes of psychiatric symptoms across ADHD presentations in clinically referred veterans, predominantly related to higher rates of internalizing symptoms.