Posttraumatic stress disorder (PTSD) is a significant mental health issue among military service members and veterans. Although the U.S. Department of Veterans Affairs (VA) provides crucial resources for behavioral health care, many veterans seek mental health services through community clinics. Previous research illustrates that military and veteran patients benefit less from evidence-based treatments (EBTs) for PTSD than civilians. However, most PTSD treatment outcome research on military and veteran populations is conducted in VA or military settings. Little is known about outcomes among military-affiliated patients in community settings. The primary aim of this study was to directly compare civilian versus military-affiliated patient outcomes on PTSD and depression symptoms using the PTSD Checklist for DSM-5 (PCL-5) and the nine-item Patient Health Questionnaire (PHQ-9) in a community setting. Participants (N = 502) included military-affiliated (veteran, Guard/Reservist, active duty) and civilian patients who engaged in cognitive processing therapy (CPT) or prolonged exposure (PE) for PTSD in community clinics. Both groups demonstrated significant reductions on the PCL-5, military-affiliated: d = −0.91, civilian: d = -1.18; and PHQ-9, military-affiliated: d = -0.65, civilian: d = -0.88, following treatment. However, military-affiliated patients demonstrated smaller posttreatment reductions on the PCL-5, M_diff = 5.75, p = .003, and PHQ-9, M_diff = 1.71, p = .011, compared to civilians. Results demonstrate that military-affiliated patients benefit from EBTs for PTSD, albeit to a lesser degree than civilians, even in community settings. These findings also highlight the importance of future research on improving EBTs for military personnel with PTSD.

中文翻译：

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社区样本中基于证据的创伤后应激障碍治疗：军事附属患者与平民患者的结果

创伤后应激障碍 (PTSD) 是军人和退伍军人的一个重要心理健康问题。尽管美国退伍军人事务部 (VA) 为行为健康护理提供重要资源，但许多退伍军人通过社区诊所寻求心理健康服务。先前的研究表明，与平民相比，军人和退伍军人患者从 PTSD 循证治疗 (EBT) 中获益更少。然而，大多数针对军人和退伍军人人群的 PTSD 治疗结果研究是在 VA 或军事环境中进行的。关于社区环境中与军队有关的患者的结果知之甚少。本研究的主要目的是使用DSM-5的 PTSD 检查表直接比较平民与军人患者对 PTSD 和抑郁症状的结果（PCL-5）和社区环境中的九项患者健康问卷（PHQ-9）。参与者 ( N = 502) 包括在社区诊所为 PTSD 进行认知加工治疗 (CPT) 或长期暴露 (PE) 的军人（退伍军人、警卫/预备役、现役）和平民患者。两组都显示出对 PCL-5 的显着减少，军事附属：d = -0.91，民用：d = -1.18；和 PHQ-9，军用：d = -0.65，民用：d = -0.88，经过处理。然而，与军方有关联的患者在 PCL-5 上表现出较小的治疗后降低，M _diff = 5.75，p =.003 和 PHQ-9，与平民相比， M _diff = 1.71，p = .011。结果表明，即使在社区环境中，与军队有关联的患者也可以从 EBT 中受益，尽管其程度低于平民。这些发现还强调了未来研究改善 PTSD 军人 EBT 的重要性。