{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T07:53:46Z","timestamp":1790063626895,"version":"4.0.1"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"5-6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,5,16]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Despite a wide literature describing the impact of PTSD on military personnel, there is limited information concerning the results of PTSD treatment within military clinics mental health. Having such information is essential for making predictions about service members\u2019 chances of recovery, choosing best treatments, and for understanding if new interventions improve upon the standard of care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>We reviewed data from the Psychological Health Pathways (PHP) database. Psychological Health Pathways is a standardized battery of demographics and psychometric outcome measures, including measurement of PTSD symptom severity, that is collected in military mental health clinics. We examined changes in PTSD symptom severity scores over time and developed logistic regression models to predict who responded to treatment, showed clinical success, or improved to the point that they could likely stay in the military.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>After about 10\u2009weeks in mental health clinics, severity scores for PTSD, sleep, depression, resilience, and disability all improved significantly. Of 681 patients tracked, 38% had clinically significant reductions on the PTSD Checklist (PCL) (i.e., \u201ctreatment response\u201d), 28% no longer met criteria for PTSD on the PCL, and 23% did both (i.e., \u201cclinical treatment success\u201d). For the ultimate end point of \u201cmilitary treatment success,\u201d defined as meeting criteria for both clinical treatment success and reporting that their work-related disability was mild or better, 12.8% of patients succeeded. Depression scores were the most powerful predictor of treatment failure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Recovery from PTSD is possible during military service, but it is less likely in individuals with certain negative prognostic factors, most notably severe depression.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/milmed\/usab454","type":"journal-article","created":{"date-parts":[[2021,11,17]],"date-time":"2021-11-17T21:15:48Z","timestamp":1637183748000},"page":"e1117-e1124","source":"Crossref","is-referenced-by-count":8,"title":["Post-Traumatic Stress Disorder Treatment Outcomes in Military Clinics"],"prefix":"10.1093","volume":"188","author":[{"given":"Robert","family":"Mclay","sequence":"first","affiliation":[{"name":"Naval Center for Combat & Operational Stress Control , San Diego, CA 92134, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"Fesperman","sequence":"additional","affiliation":[{"name":"Naval Center for Combat & Operational Stress Control , San Diego, CA 92134, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Webb-Murphy","sequence":"additional","affiliation":[{"name":"Naval Center for Combat & Operational Stress Control , San Diego, CA 92134, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eileen","family":"Delaney","sequence":"additional","affiliation":[{"name":"Naval Center for Combat & Operational Stress Control , San Diego, CA 92134, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vasudha","family":"Ram","sequence":"additional","affiliation":[{"name":"Naval Center for Combat & Operational Stress Control , San Diego, CA 92134, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bonnie","family":"Nebeker","sequence":"additional","affiliation":[{"name":"Naval Center for Combat & Operational Stress Control , San Diego, CA 92134, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cleo Mae","family":"Burce","sequence":"additional","affiliation":[{"name":"Naval Center for Combat & Operational Stress Control , San Diego, CA 92134, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,11,13]]},"reference":[{"issue":"7","key":"2023051613474867900_R1","doi-asserted-by":"crossref","first-page":"656","DOI":"10.1001\/jama.2019.20825","article-title":"First-line psychotherapies for military-related PTSD","volume":"323","author":"Steenkamp","year":"2020","journal-title":"JAMA"},{"key":"2023051613474867900_R2","article-title":"VA, DoD recommended PTSD therapies don\u2019t help many military patients, review finds","volume-title":"Military Times","author":"Kime","year":"2020"},{"issue":"2","key":"2023051613474867900_R3","doi-asserted-by":"crossref","first-page":"101","DOI":"10.3109\/10401230009147096","article-title":"Lack of efficacy for fluoxetine in PTSD: a placebo controlled trial in combat veterans","volume":"12","author":"Hertzberg","year":"2000","journal-title":"Ann Clin Psychiatry"},{"issue":"5","key":"2023051613474867900_R4","doi-asserted-by":"crossref","first-page":"711","DOI":"10.4088\/JCP.v68n0508","article-title":"Randomized, double-blind comparison of sertraline and placebo for posttraumatic stress disorder in a Department of Veterans Affairs setting","volume":"68","author":"Friedman","year":"2007","journal-title":"J Clin Psychiatry"},{"issue":"5","key":"2023051613474867900_R5","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1001\/jama.2015.8370","article-title":"Psychotherapy for military-related PTSD: a review of randomized clinical trials","volume":"314","author":"Steenkamp","year":"2015","journal-title":"JAMA"},{"issue":"18","key":"2023051613474867900_R6","doi-asserted-by":"crossref","first-page":"2141","DOI":"10.1001\/jama.298.18.2141","article-title":"Longitudinal assessment of mental health problems among active and reserve component soldiers returning from the Iraq war","volume":"298","author":"Milliken","year":"2007","journal-title":"JAMA"},{"issue":"1","key":"2023051613474867900_R7","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1017\/S0033291717001404","article-title":"Key patterns and predictors of response to treatment for military veterans with post-traumatic stress disorder: a growth mixture modelling approach","volume":"48","author":"Phelps","year":"2018","journal-title":"Psychol Med"},{"issue":"9","key":"2023051613474867900_R8","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2016-011667","article-title":"Long-term responses to treatment in UK veterans with military-related PTSD: an observational study","volume":"6","author":"Murphy","year":"2016","journal-title":"BMJ Open"},{"issue":"9","key":"2023051613474867900_R9","doi-asserted-by":"crossref","first-page":"949","DOI":"10.1001\/jamapsychiatry.2013.36","article-title":"Effectiveness of national implementation of prolonged exposure therapy in Veterans Affairs care","volume":"70","author":"Eftekhari","year":"2013","journal-title":"JAMA Psychiatry"},{"key":"2023051613474867900_R10","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1016\/j.janxdis.2015.10.003","article-title":"Treatment of active duty military with PTSD in primary care: a follow-up report","volume":"36","author":"Cigrang","year":"2015","journal-title":"J Anxiety Disord"},{"issue":"5","key":"2023051613474867900_R11","doi-asserted-by":"crossref","first-page":"530","DOI":"10.1080\/10926771.2011.588149","article-title":"Characteristics and effectiveness of an intensive military outpatient treatment program for PTSD","volume":"20","author":"Lande","year":"2011","journal-title":"J Aggress Maltreat Trauma"},{"key":"2023051613474867900_R12","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1016\/j.genhosppsych.2019.02.006","article-title":"Discrepancies in diagnostic records of military service members with self-reported PTSD: healthcare use and longitudinal symptom outcomes","volume":"58","author":"Morgan","year":"2019","journal-title":"Gen Hosp Psychiatry"},{"issue":"4","key":"2023051613474867900_R13","doi-asserted-by":"crossref","first-page":"348","DOI":"10.7205\/MILMED-D-13-00471","article-title":"Casualties of the Global War on Terror and their future impact on health care and society: a looming public health crisis","volume":"179","author":"Baker","year":"2014","journal-title":"Mil Med"},{"issue":"6","key":"2023051613474867900_R14","doi-asserted-by":"crossref","first-page":"897","DOI":"10.1177\/0145445512450733","article-title":"Technological advances in the treatment of trauma: a review of promising practices","volume":"36","author":"Paul","year":"2012","journal-title":"Behav Modif"},{"key":"2023051613474867900_R15","first-page":"373","volume-title":"Brain Injury Medicine: Principles and Practice","author":"Iverson","year":"2007"},{"issue":"2","key":"2023051613474867900_R16","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1207\/s15327876mp1802_1","article-title":"Deployment risk and resilience inventory: a collection of measures for studying deployment-related experiences of military personnel and veterans","volume":"18","author":"King","year":"2006","journal-title":"Mil Psychol"},{"issue":"8","key":"2023051613474867900_R17","doi-asserted-by":"crossref","first-page":"669","DOI":"10.1016\/0005-7967(96)00033-2","article-title":"Psychometric properties of the PTSD Checklist (PCL)","volume":"34","author":"Blanchard","year":"1996","journal-title":"Behav Res Ther"},{"issue":"2","key":"2023051613474867900_R18","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1037\/1040-3590.20.2.131","article-title":"Change in posttraumatic stress disorder symptoms: do clinicians and patients agree?","volume":"20","author":"Monson","year":"2008","journal-title":"Psychol Assess"},{"issue":"10","key":"2023051613474867900_R19","doi-asserted-by":"crossref","first-page":"1092","DOI":"10.1001\/archinte.166.10.1092","article-title":"A brief measure for assessing generalized anxiety disorder: the GAD-7","volume":"166","author":"Spitzer","year":"2006","journal-title":"Arch Intern Med"},{"issue":"2","key":"2023051613474867900_R20","doi-asserted-by":"crossref","first-page":"161","DOI":"10.7205\/MILMED-D-10-00258","article-title":"Development and initial validation of the response to stressful experiences scale","volume":"176","author":"Johnson","year":"2011","journal-title":"Mil Med"},{"issue":"2","key":"2023051613474867900_R21","doi-asserted-by":"crossref","first-page":"93","DOI":"10.2190\/T8EM-C8YH-373N-1UWD","article-title":"Assessing psychiatric impairment in primary care with the Sheehan Disability Scale","volume":"27","author":"Leon","year":"1997","journal-title":"Int J Psychiatry Med"},{"issue":"2","key":"2023051613474867900_R22","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1016\/0165-1781(89)90047-4","article-title":"The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research","volume":"28","author":"Buysse","year":"1989","journal-title":"Psychiatry Res"},{"issue":"3","key":"2023051613474867900_R23","doi-asserted-by":"crossref","first-page":"413","DOI":"10.1023\/A:1024444410595","article-title":"Effects of psychotherapeutic treatments for PTSD: a meta-analysis of controlled clinical trials","volume":"11","author":"Sherman","year":"1998","journal-title":"J Trauma Stress"},{"issue":"12","key":"2023051613474867900_R24","doi-asserted-by":"crossref","first-page":"1612","DOI":"10.1176\/ps.2009.60.12.1612","article-title":"Health care utilization and its costs for depressed veterans with and without comorbid PTSD symptoms","volume":"60","author":"Chan","year":"2009","journal-title":"Psychiatr Serv"},{"issue":"4","key":"2023051613474867900_R25","doi-asserted-by":"crossref","first-page":"439","DOI":"10.1016\/S0005-7967(01)00024-9","article-title":"Prolonged exposure in patients with chronic PTSD: predictors of treatment outcome and dropout","volume":"40","author":"van Minnen","year":"2002","journal-title":"Behav Res Ther"},{"issue":"2","key":"2023051613474867900_R26","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1007\/s10597-010-9359-4","article-title":"Effect of depression on recovery from PTSD","volume":"48","author":"Tural","year":"2012","journal-title":"Comm Ment Health J"},{"issue":"7","key":"2023051613474867900_R27","doi-asserted-by":"crossref","first-page":"1024","DOI":"10.1176\/ajp.150.7.1024","article-title":"Predicting response to amitriptyline in posttraumatic stress disorder","volume":"150","author":"Davidson","year":"1993","journal-title":"Am J Psychiatry"},{"issue":"7","key":"2023051613474867900_R28","doi-asserted-by":"crossref","first-page":"883","DOI":"10.1016\/j.cpr.2012.09.008","article-title":"Why many clinical psychologists are resistant to evidence-based practice: root causes and constructive remedies","volume":"33","author":"Lilienfeld","year":"2013","journal-title":"Clin Psychol Rev"},{"issue":"6","key":"2023051613474867900_R29","doi-asserted-by":"crossref","first-page":"702","DOI":"10.1037\/tra0000120","article-title":"Outcomes from eye movement desensitization and reprocessing in active-duty service members with posttraumatic stress disorder","volume":"8","author":"McLay","year":"2016","journal-title":"Psychol Trauma"},{"issue":"1","key":"2023051613474867900_R30","doi-asserted-by":"crossref","DOI":"10.1176\/ps.2009.60.1.112","article-title":"Measuring outcomes makes good sense","volume":"60","author":"Blais","year":"2009","journal-title":"Psychiatric Services"}],"container-title":["Military Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/milmed\/article-pdf\/188\/5-6\/e1117\/50342175\/usab454.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/milmed\/article-pdf\/188\/5-6\/e1117\/50342175\/usab454.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,5,16]],"date-time":"2023-05-16T09:48:23Z","timestamp":1684230503000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/milmed\/article\/188\/5-6\/e1117\/6427527"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,11,13]]},"references-count":30,"journal-issue":{"issue":"5-6","published-online":{"date-parts":[[2021,11,13]]},"published-print":{"date-parts":[[2023,5,16]]}},"URL":"https:\/\/doi.org\/10.1093\/milmed\/usab454","relation":{},"ISSN":["0026-4075","1930-613X"],"issn-type":[{"value":"0026-4075","type":"print"},{"value":"1930-613X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2023,5,1]]},"published":{"date-parts":[[2021,11,13]]}}}