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Do morally injurious experiences and index events negatively impact intensive PTSD treatment outcomes among combat veterans?

Background: It has been suggested that current frontline posttraumatic stress disorder (PTSD) treatments are not effective for the treatment of moral injury and that individuals who have experienced morally injurious events may respond differently to treatment than those who have not. However, these...

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Autores principales: Held, Philip, Klassen, Brian J., Steigerwald, Victoria L., Smith, Dale L., Bravo, Karyna, Rozek, David C., Van Horn, Rebecca, Zalta, Alyson
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Taylor & Francis 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8128118/
https://www.ncbi.nlm.nih.gov/pubmed/34025919
http://dx.doi.org/10.1080/20008198.2021.1877026
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author Held, Philip
Klassen, Brian J.
Steigerwald, Victoria L.
Smith, Dale L.
Bravo, Karyna
Rozek, David C.
Van Horn, Rebecca
Zalta, Alyson
author_facet Held, Philip
Klassen, Brian J.
Steigerwald, Victoria L.
Smith, Dale L.
Bravo, Karyna
Rozek, David C.
Van Horn, Rebecca
Zalta, Alyson
author_sort Held, Philip
collection PubMed
description Background: It has been suggested that current frontline posttraumatic stress disorder (PTSD) treatments are not effective for the treatment of moral injury and that individuals who have experienced morally injurious events may respond differently to treatment than those who have not. However, these claims have yet to be empirically tested. Objective: This study evaluated the rates of morally injurious event exposure and morally injurious index trauma and their impact on PTSD (PCL-5) and depression symptom (PHQ-9) reductions during intensive PTSD treatment. Method: Data from 161 USA military combat service members and veterans (91.3% male; mean age = 39.94 years) who participated in a 3-week Cognitive Processing Therapy (CPT)-based intensive PTSD treatment programme (ITP) was utilized. Morally injurious event exposure was established via the Moral Injury Event Scale (MIES). Index traumas were also coded by the treating clinician. Linear mixed effects regression analyses were conducted to examine if differences in average effects or trends over the course of treatment existed between veterans with morally injurious event exposure or index trauma and those without. Results: Rates of morally injurious event exposure in this treatment sample were high (59.0%-75.2%). Morally injurious event exposure and the type of index trauma did not predict changes in symptom outcomes from the ITP and veterans reported large reductions in PTSD (d = 1.35–1.96) and depression symptoms (d = 0.95–1.24) from pre- to post-treatment. Non-inferiority analyses also demonstrated equivalence across those with and without morally injurious event exposure and index events. There were no significant gender differences. Conclusions: The present study suggests that PTSD and depression in military veterans with morally injurious event exposure histories may be successfully treated via a 3-week CPT-based ITP.
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spelling pubmed-81281182021-05-21 Do morally injurious experiences and index events negatively impact intensive PTSD treatment outcomes among combat veterans? Held, Philip Klassen, Brian J. Steigerwald, Victoria L. Smith, Dale L. Bravo, Karyna Rozek, David C. Van Horn, Rebecca Zalta, Alyson Eur J Psychotraumatol Clinical Research Article Background: It has been suggested that current frontline posttraumatic stress disorder (PTSD) treatments are not effective for the treatment of moral injury and that individuals who have experienced morally injurious events may respond differently to treatment than those who have not. However, these claims have yet to be empirically tested. Objective: This study evaluated the rates of morally injurious event exposure and morally injurious index trauma and their impact on PTSD (PCL-5) and depression symptom (PHQ-9) reductions during intensive PTSD treatment. Method: Data from 161 USA military combat service members and veterans (91.3% male; mean age = 39.94 years) who participated in a 3-week Cognitive Processing Therapy (CPT)-based intensive PTSD treatment programme (ITP) was utilized. Morally injurious event exposure was established via the Moral Injury Event Scale (MIES). Index traumas were also coded by the treating clinician. Linear mixed effects regression analyses were conducted to examine if differences in average effects or trends over the course of treatment existed between veterans with morally injurious event exposure or index trauma and those without. Results: Rates of morally injurious event exposure in this treatment sample were high (59.0%-75.2%). Morally injurious event exposure and the type of index trauma did not predict changes in symptom outcomes from the ITP and veterans reported large reductions in PTSD (d = 1.35–1.96) and depression symptoms (d = 0.95–1.24) from pre- to post-treatment. Non-inferiority analyses also demonstrated equivalence across those with and without morally injurious event exposure and index events. There were no significant gender differences. Conclusions: The present study suggests that PTSD and depression in military veterans with morally injurious event exposure histories may be successfully treated via a 3-week CPT-based ITP. Taylor & Francis 2021-03-08 /pmc/articles/PMC8128118/ /pubmed/34025919 http://dx.doi.org/10.1080/20008198.2021.1877026 Text en © 2021 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) ), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Clinical Research Article
Held, Philip
Klassen, Brian J.
Steigerwald, Victoria L.
Smith, Dale L.
Bravo, Karyna
Rozek, David C.
Van Horn, Rebecca
Zalta, Alyson
Do morally injurious experiences and index events negatively impact intensive PTSD treatment outcomes among combat veterans?
title Do morally injurious experiences and index events negatively impact intensive PTSD treatment outcomes among combat veterans?
title_full Do morally injurious experiences and index events negatively impact intensive PTSD treatment outcomes among combat veterans?
title_fullStr Do morally injurious experiences and index events negatively impact intensive PTSD treatment outcomes among combat veterans?
title_full_unstemmed Do morally injurious experiences and index events negatively impact intensive PTSD treatment outcomes among combat veterans?
title_short Do morally injurious experiences and index events negatively impact intensive PTSD treatment outcomes among combat veterans?
title_sort do morally injurious experiences and index events negatively impact intensive ptsd treatment outcomes among combat veterans?
topic Clinical Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8128118/
https://www.ncbi.nlm.nih.gov/pubmed/34025919
http://dx.doi.org/10.1080/20008198.2021.1877026
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