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Purpose: The purpose of the current study was to conduct a comprehensive meta-analytic review of Cognitive Processing Therapy (CPT) for PTSD among military personnel and veterans. Additionally, we sought to examine potential moderators of treatment outcomes including type of comparison condition (e.g., active trauma-focused, active non-trauma-focused), CPT version (i.e., CPT with and without the written trauma account), sample type (veteran or military personnel), age, gender, and race. Methods: Nine articles with 1,804 participants were retained for this meta-analysis. Results: CPT, when compared to all comparison conditions, exhibited a medium effect on PTSD symptom reduction (Hedge's g = − 0.48, 95% CI: -1.05, 0.08). Regarding moderators, the effect was larger for non-trauma-focused active comparators versus trauma-focused active comparators (Qbetween = 16.69, pbetween < 0.001, Hedge's g = − 0.57 and − 0.14, respectively). Further, CPT with the written trauma account outperformed CPT without the written trauma account (Qbetween = 4.53, pbetween = 0.03, Hedge's g = − 0.86 and − 0.23, respectively), and veteran samples saw slightly more symptom reduction than military personnel (Qbetween = 15.50, pbetween < 0.001, Hedge's g = − 0.51 and − 0.45, respectively). Notably, age, gender, and race did not moderate the effect of CPT on PTSD. Conclusions: Findings support the continued use of CPT for PTSD symptoms among veterans and military personnel and call into question the removal of the written trauma account. [ABSTRACT FROM AUTHOR]

Women are a growing portion of the U.S. veteran population, and every year the Veterans Health Administration (VHA) serves an increasing number of women seeking obstetrics services. Women veterans experience elevated rates of anxiety, depression, posttraumatic stress disorder (PTSD), and traumatic events, including military sexual trauma, as compared with women in the general population. It is possible that mental health disorders may be associated with birth experiences. We investigated the link between anxiety, depression, PTSD, and military sexual trauma (MST; i.e., rape and sexual harassment) with perceived birth experience (i.e., Negative or Neutral vs. Positive). Participants included 1,005 veterans who had recently given birth and were enrolled in the multisite, mixed methods study known as the Center for Maternal and Infant Outcomes Research in Translation study (COMFORT). Using χ2 tests, we investigated the relationship between mental health conditions including anxiety, depression, and PTSD and MST with birth experience (coded as Negative/Neutral vs. Positive). Findings indicated that participants who endorsed PTSD (39.5%), MST-rape (32.1%), or MST-harassment (51.4%; all p <.05) were significantly more likely to report a Negative/Neutral birth experience (14.7%) versus a Positive birth experience (85.3%). Anxiety and depression were not associated with birth experience. Veterans with PTSD and/or who experienced MST were more likely to report a negative or neutral birth experience. Thus, screening for PTSD and MST during obstetrics services as well as providing trauma-informed obstetrics care during pregnancy, labor, birth, and recovery may be important among veterans seeking obstetric services. [ABSTRACT FROM AUTHOR]

Traumatic events are a serious public health concern, linked cross-sectionally and longitudinally with post-traumatic stress disorder (PTSD) and suicidal ideation (SI). While much research has focused on broadly defined traumatic events as they relate to PTSD and SI, fewer projects have investigated the disparate associations that specific traumatic events have with PTSD and SI. In this study of 1,829 adolescents held at the Cook County Juvenile Temporary Detention Center (measured during adolescence and again nine years later during adulthood), the cross-sectional and prospective links between various traumatic events (i.e. being physically assaulted, threatened with a weapon, sexually assaulted, in a serious accident, seeing someone be killed, experiencing a natural disaster, seeing a dead body, or being forced to fight), PTSD symptoms, and SI were investigated. Findings indicate that every traumatic event endorsed at baseline was cross-sectionally associated with increased PTSD symptoms and SI. Experiencing sexual assault or a serious accident during adolescence predicted greater SI at follow-up. Moreover, the positive association between PTSD symptoms at baseline and SI at follow-up was stronger among individuals who experienced sexual assault or a serious accident versus those who were not trauma exposed. Implications for justice-involved adolescents are discussed. [ABSTRACT FROM AUTHOR]

For HIV-infected patients, experiencing multiple traumas is associated with AIDS-related and all-cause mortality, increased opportunistic infections, progression to AIDS, and decreased adherence to therapy. The impact of intimate partner violence (IPV) on adherence and HIV outcomes is unknown. HIV-infected patients recruited from a public HIV clinic participated in this observational cohort study ( n=251). Participants completed interviews evaluating IPV and covariates. CD4 count <200 (CD4<200), detectable HIV viral load (VL), and engagement in care ('no show rate' [NSR]) were the outcomes of interest. Medication adherence was not measured. Univariate and multivariate regression analyses were performed with covariates included if p<0.3 in the univariate phase. Seventy-four percent of the participants were male, 55% Caucasian, and 52.2% self-identified as 'men who have sex with men.' IPV prevalence was 33.1% with no difference by gender or sexual orientation. In univariate analysis, IPV exposure predicted having a CD4<200 ( p=0.005) and a detectable VL ( p=0.04) but trended toward significance with a high NSR ( p=0.077). Being threatened by a partner was associated with a CD4<200 ( p=0.005), a detectable VL ( p=0.011), and high NSR ( p=0.019) in univariate analysis. In multivariate analysis, IPV predicted having a CD4<200 ( p=0.005) and detectable VL ( p=0.035). Being threatened by a partner predicted having a CD4<200 ( p=0.020), a detectable VL ( p=0.007), and a high NSR ( p=0.020). Our results suggest IPV impacts biologic outcomes and engagement in care for HIV-infected patients. IPV alone predicts worse biologic outcomes, whereas the specific experience of being threatened by a partner was associated with all three outcomes in univariate and multivariate analyses. [ABSTRACT FROM AUTHOR]

Suicide is the second leading cause of death in adolescents; a frequent precursor of suicide is suicidal ideation (SI). Literature indicates that Post-Traumatic Stress Disorder (PTSD) and SI are robust cross-sectional correlates of one another, with PTSD often being conceptualized as a risk factor (i.e., conferring risk) for SI. Indeed, PTSD is a well-established risk factor for SI; however, SI is an understudied risk factor for PTSD. It is possible that, yet unknown if, PTSD and SI promote each other over time in a bidirectional fashion. We investigated the bidirectional longitudinal associations between PTSD and SI in a large, diverse sample, who at baseline were adolescents. Participants were interviewed between 1995 and 1998 and again between 2004 and 2008. We hypothesized that PTSD and SI would be cross-sectionally, longitudinally, and bidirectionally related and that the number of traumas endorsed at baseline would be positively associated with PTSD and SI at baseline and follow-up. Indeed, PTSD and SI were cross-sectionally correlated at baseline, but not follow-up. PTSD predicted SI over nine years; however, SI during adolescence did not predict PTSD in adulthood. Finally, poly-trauma endorsed at baseline was associated with increased risk of SI, but not PTSD, over nine years. • PTSD and suicidal ideation were cross-sectionally related during adolescence. • PTSD and suicidal ideation were not cross-sectionally related during adulthood. • PTSD predicted suicidal ideation over the nine year follow-up period. • Suicidal ideation did not predict suicidal ideation over the nine-year follow-up. [ABSTRACT FROM AUTHOR]