Journal of traumatic stress
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In recent years, there has been increased interest in trauma-related shame and guilt and their relationship to mental health. Little is known, however, about shame and guilt following mass traumas, such as terrorism. This study investigates the potential associations of trauma-related shame and guilt with posttraumatic stress (PTS) reactions after the terrorist attack of July 22, 2011 on Utøya Island in Norway. ⋯ In the month previous to the interview, 44.1% (n = 143) of participants had experienced at least some guilt for what happened during the attack, and 30.5% (n = 99) had experienced at least some shame. Shame and guilt were both uniquely associated with PTS reactions after adjusting for terror exposure, gender, and other potential confounders (frequent shame: B = 0.54, frequent guilt: B = 0.33). We concluded that trauma-related shame and guilt are related to mental health after mass trauma.
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Multiple studies have reported the prevalence of posttraumatic stress disorder (PTSD) in Operation Enduring Freedom and Operation Iraqi Freedom (OEF/OIF) veterans; however, these studies have been limited to populations who use the Department of Veterans Affairs (VA) for health care, specialty clinic populations, or veterans who deployed. The 3 aims of this study were to report weighted prevalence estimates of a positive screen for PTSD among OEF/OIF and nondeployed veterans, demographic subgroups, and VA health care system users and nonusers. The study analyzed data from the National Health Study for a New Generation of U. ⋯ Among OEF/OIF veterans, there was increased risk of a positive screen for PTSD among VA health care users (OR = 2.71), African Americans (OR = 1.61), those who served in the Army (OR = 2.67), and those on active duty (OR = 1.69). The same trend with decreased magnitude was observed in nondeployed veterans. PTSD is a significant public health problem in OEF/OIF-era veterans, and should not be considered an outcome solely related to deployment.
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Comparative Study
PTSD diagnoses among Iraq and Afghanistan veterans: comparison of administrative data to chart review.
To guide budgetary and policy-level decisions, the U. S. Department of Veterans Affairs (VA) produces quarterly reports that count the number of Iraq and Afghanistan veterans with International Classification of Diseases, 9(th) Revision, Clinical Modification (ICD-9-CM) codes for posttraumatic stress disorder (PTSD; 309.81) in their electronic medical record administrative data. ⋯ VA treatment notes for the 12 months preceding chart review showed that 661 veterans sampled received a VA PTSD diagnosis during that 12-month timeframe, and of these 555 were diagnosed by a mental health provider (83.9%). Thus, the presence of an ICD-9-CM code for PTSD approximated diagnoses by VA mental health providers across time points (89.6% for entire treatment history and 83.9% for 12 months prior to chart review). Administrative data offer large-scale means to track diagnoses and treatment utilization; however, their limitations are many, including the inability to detect false-negatives.