True Evidence Based Care for Posttraumatic Stress Disorder in Military Personnel and Veterans.
The relationships of posttraumatic stress disorder and depression symptoms with health related quality of life and the role of social support among Veterans. Sleep disorders related to deployment in active duty service members and veterans. The impact of proposed changes to ICD 11 on estimates of PTSD prevalence and comorbidity. Personal space of war veterans with PTSD some characteristics and comparison with healthy individuals. Soldier, civilian, criminal: identifying pathways to offending of ex armed forces personnel in prison. Roles of inter individual differences and intra individual acute elevations in early smoking lapse in people with posttraumatic stress disorder. Are all psychotherapies equally effective in the treatment of adult depression? The lack of statistical power of comparative outcome studies. This Viewpoint discusses true evidence based practice and using it to personalize treatment for military veterans and servicemembers with posttraumatic stress disorder. As the longest wars in US history draw to a close, treating the psychosocial sequelae of military trauma has become an important public health challenge. In contrast to previous wars, mental health care is for the first time leveraging science to treat deployment related conditions such as posttraumatic stress disorder (PTSD) Evidence based practice has become a driving principle behind the treatment of military related PTSD and is considered a necessary safeguard against the use of unproven and ineffective interventions. However, a truly evidence based approach to treating military related PTSD differs from what it has come to mean in the recent clinical and research literature. This Viewpoint suggests that the assertion that prolonged exposure or cognitive processing therapy should be the dominant evidence based treatments for war related PTSD is simplistic and may at times be unhelpful or contraindicated. Steenkamp's Viewpoint reminds us that " evidence based " psychotherapy for posttraumatic stress disorder (PTSD) encompasses clinical judgment and patient preferences as much as it does evidence from randomized clinical trials. This is a welcome perspective for clinicians working in settings such as Veterans Affairs (VA) where they are mandated by policy to provide prolonged exposure or cognitive processing therapy (CPT) as first line treatments for veterans with PTSD. This Viewpoint reports that the direction of suicide prevention research must change if more lives are to be saved. Suicide rates in most Western countries have not decreased in the last decade, a finding that compares unfavorably with the progress made in other areas, such as breast and skin cancers, human immunodeficiency virus, and automobile accidents, for which the rates
JAMA psychiatry