Health Services Research & Development

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2017 HSR&D/QUERI National Conference Abstract

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1011 — Posttraumatic Stress Disorder in a Representative National Sample: Prevalence, Correlates, and Treatment Utilization by Gender and Veteran Status

Lead/Presenter: Keren Lehavot, COIN - Seattle/Denver
All Authors: Lehavot K (VA Puget Sound Health Care System) Katon JG (VA Puget Sound Health Care System) Chen JA (VA Puget Sound Health Care System) Fortney JC (VA Puget Sound Health Care System) Simpson TL (VA Puget Sound Health Care System)

Objectives:
Population-based data on the prevalence of traumatic event exposures, posttraumatic stress disorder (PTSD), correlates of PTSD, and treatment utilization by gender and Veteran status is limited. Given the lack of studies comparing PTSD prevalence between civilians and Veterans and changes in PTSD diagnostic criteria in 2013, current information from a single, uniform data source is needed. We present nationally representative findings on prevalence, correlates, and treatment of DSM-V PTSD between men and women Veterans and civilians.

Methods:
In-person, cross-sectional interviews were conducted with a representative sample of US adults in the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions-III. The Alcohol Use Disorder and Associated Disabilities Interview Schedule-DSM-5 Version was used to assess past year and lifetime PTSD among men and women Veterans (n = 3,119) and civilians (n = 32,982).

Results:
Veterans were more likely than civilians to be exposed to at least one traumatic event, and women were more likely than men to experience childhood abuse and interpersonal violence. Adjusting for age and race/ethnicity, women Veterans reported the highest rates of both lifetime and past year PTSD (13.4%, 95% CI 8.8-17.9%, and 11.7%, 95% CI 7.1-16.4%) compared to women civilians (8.0%, 95% CI 7.4-8.6%, and 6.0%, 95% CI 5.5-6.6%), men Veterans (7.7%, 95% CI 6.5-8.8%, and 6.7%, 95% CI 5.7-7.8%), and men civilians (3.4%, 95% CI 3.0-3.9%, and 2.6%, 95% CI 2.2-2.9%). Men and women Veterans were more likely than civilians to use a variety of treatment sources, with men civilians being least likely to seek treatment and men Veterans exhibiting the longest delay in seeking treatment.

Implications:
Women Veterans had the highest prevalence of PTSD, a finding that is frequently hypothesized in the literature but until now has not been confirmed in a nationally representative sample. Men Veterans and civilians were at risk for delaying or failing to seek treatment, indicating the potential importance of destigmatizing treatment for men.

Impacts:
PTSD is a common mental health disorder that varies by gender and veteran status. Women Veterans' high PTSD rates highlight a critical target for prevention and intervention, whereas understanding treatment barriers for men Veterans and civilians is necessary.