Veterans experience a number of challenges when they return home from war. They must reintegrate into society, both socially and emotionally. Often, they face barriers to employment because of injuries sustained during deployment. And veterans sometimes have psychological problems that make it difficult for them to smoothly transition back into family life. The most common mental health issues that veterans face are posttraumatic stress (PTSD) and depression. Because a majority of veterans receive their health care services from the Veterans Administration, it is imperative that PTSD and depression are treated in the most effective manner through these facilities. Sara L. Kornfield of the Mental Illness Research, Education and Clinical Center at the Philadelphia VA Medical Center recently conducted a study based on the new model of care for veterans, the Primary Care-Mental Health Integration (PC-MHI) model. She wanted to see if the current methods used in this model were the most beneficial options for veterans with PTSD and depression.
Kornfield evaluated 141 veterans who had subclinical levels of PTSD. The veterans were categorized into two groups: those from the recent wars in Iraq and Afghanistan (recent war veterans, or RWV), and those who were not deployed in those wars (nonrecent war veterans, or non-RWV). Kornfield found that the most common symptom exhibited by the RWV was arousal, while the most common symptom among the non-RWV participants was avoidance. Both groups demonstrated high levels of depression. This raised concern for Kornfield because the first course of treatment for subclinical symptoms of PTSD in the new model is to target avoidance. Because the most distressed veterans—those who recently returned from war—exhibited arousal symptoms more often than avoidance symptoms, Kornfield believes the current treatment approach may not be adequately meeting their needs.
Although avoidance may not have set in as a symptom in the RWV participants, the fact arousal presented the biggest problem for them should make it the primary target of intervention and treatment. Kornfield notes that strategies that work to minimize avoidance, such as prolonged exposure, take several weeks to produce effects. This may not be the best course of action for many of the veterans receiving brief treatments in this new model of primary and mental health care integration. “For these veterans, treatments that target reexperiencing symptoms and/or comorbid depression may be more effective,” Kornfield said. She suggests that future work look at mindfulness and behavior activation as alternative, and potentially more beneficial, avenues of treatment for veterans of recent wars who are experiencing subclinical levels of PTSD.
Kornfield, Sara L., Johanna Klaus, Caroline McKay, Amy Helstrom, and David Oslin. Subsyndromal posttraumatic stress disorder symptomatology in primary care military veterans: Treatment implications. Psychological Services 9.4 (2012): 383-89. Print.
© Copyright 2012 GoodTherapy.org. All rights reserved.
The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by GoodTherapy.org. Questions or concerns about the preceding article can be directed to the author or posted as a comment below.