Clinical Edge

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Mapping Unique PTSD Symptom Clusters in Veterans

Psychiatry Res; ePub 2017 Jun 5; Smith, Tsai, et al

When considering treatment approaches for trauma-exposed veterans, it is important to map the severity of unique posttraumatic stress disorder (PTSD) symptom clusters, a recent study found. This may have implications on the selection of treatment that best fits veterans’ needs and preferences (eg, exposure therapy vs cognitive processing therapy). This study utilized national VA administrative data from Iraq and Afghanistan veterans following an initial diagnosis of PTSD and a self-report measure of PTSD symptoms between Fiscal Years 2008–2012 (n=52,456; 91.7% male; 59.7% Caucasian; mean age 30.6, SD=8.3). They found:

  • Accounting for demographic/clinical variables, PTSD symptom clusters were related to psychotherapy initiation (re-experiencing, odds ratio [OR]=1.23; numbing, OR=1.15), combination treatment (medication and psychotherapy; re-experiencing, OR=1.14; avoidance, OR=1.07; dysphoric arousal, OR=1.06), number of psychotherapy visits (re-experiencing, incidence rate ratio [IRR]=1.08; numbing, IRR=1.09), and adequate dose of therapy (eg, 8 visits/14 weeks; re-experiencing: OR= 1.07).


Smith NB, Tsai J, Pietrzak RH, Cook JM, Hoff R, Harpaz-Rotem I. Simplifying profiles of comorbidity in bipolar disorder. [Published online ahead of print June 5, 2017]. Psychiatry Res. doi: 10.1016/j.jad.2017.05.045.