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Gepubliceerd in: Journal of Psychopathology and Behavioral Assessment 4/2012

01-12-2012

A Prospective Investigation of Changes in Avoidant and Active Coping and Posttraumatic Stress Disorder Symptoms among Military Veteran

Auteurs: Matthew Tyler Boden, Marcel O. Bonn-Miller, Anka A. Vujanovic, Kent D. Drescher

Gepubliceerd in: Journal of Psychopathology and Behavioral Assessment | Uitgave 4/2012

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Abstract

The present investigation utilized a prospective design to investigate associations between changes in self-reported avoidant and active coping occurring during residential treatment for posttraumatic stress disorder (PTSD) and PTSD symptom severity at treatment discharge. Participants were 636 military Veteran patients (91.4 % male; M age = 51.7 years) admitted to a Veterans Affairs (VA) residential rehabilitation program for PTSD, between 2000 and 2008. Results indicated that increases in avoidant coping and decreases in active coping from treatment intake to discharge were simultaneously and incrementally predictive of total PTSD symptom severity at treatment discharge, after accounting for PTSD symptom severity at treatment intake. These findings hold particular relevance for treatment-seeking populations with severe PTSD and researchers and clinicians attempting to understand and treat these populations.
Voetnoten
1
Significant gender differences were found for avoidant coping at intake (M Male  = 2.1, SD = 0.8, M Female  = 1.8, SD = 0.7; t(634) = −3.0, p < .01) and discharge (M Male  = 2.1, SD = 0.8, M Female  = 1.8, SD = 0.7; t(634) = −2.8, p < .01), active coping at discharge (M Male  = 2.7, SD = 0.8, M Female  = 2.9, SD = 0.7; t(634) = 2.1, p < .05), and PTSD severity at discharge (M Male  = 59.5, SD = 14.0, M Female  = 54.1, SD = 17.1; t(634) = −2.7, p < .01), but not in active coping at intake or PTSD severity at intake (all p’s > .08).
 
2
We formed a four-item version of the avoidant coping scale that didn’t include items assessing substance use, and found that all results reported below are similar in magnitude and significance when using this scale.
 
3
We note that results were similar for each PTSD symptom cluster (i.e., re-experiencing, avoidant/numbing, hyperarousal) when examined separately (all Δr 2  = .04, p’s < .01).
 
4
When removing shared variance with gender, age, length of treatment stay and trauma severity measured at treatment intake using the 7-item Combat Exposure Scale (Keane, et al., 1989), the addition of avoidant and active coping scores on Step 2 significantly and substantially improved the prediction of total PTSD symptom severity (Δr 2  = .04, p < .01), and both change in avoidant and active coping significantly predicted PTSD symptom severity.
 
5
Calculation of the RCI revealed that 36.3 % of participants (N = 231) experienced improvements in PTSD symptoms at rates greater than could be attributable to measurement error alone. These participants had significantly greater increases in active coping (t(634) = −4.5, p < .01) and significantly greater decreases avoidant coping (t(634) = 4.2, p < .01) compared to those who did not improve at rates greater than could be attributable to measurement error alone.
 
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Metagegevens
Titel
A Prospective Investigation of Changes in Avoidant and Active Coping and Posttraumatic Stress Disorder Symptoms among Military Veteran
Auteurs
Matthew Tyler Boden
Marcel O. Bonn-Miller
Anka A. Vujanovic
Kent D. Drescher
Publicatiedatum
01-12-2012
Uitgeverij
Springer US
Gepubliceerd in
Journal of Psychopathology and Behavioral Assessment / Uitgave 4/2012
Print ISSN: 0882-2689
Elektronisch ISSN: 1573-3505
DOI
https://doi.org/10.1007/s10862-012-9293-6