{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,3]],"date-time":"2026-04-03T07:41:22Z","timestamp":1775202082953,"version":"3.50.1"},"reference-count":91,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2024,10,24]],"date-time":"2024-10-24T00:00:00Z","timestamp":1729728000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Department of Defense","award":["W81XWH-14-1-0264"],"award-info":[{"award-number":["W81XWH-14-1-0264"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Behavioral Sciences"],"abstract":"<jats:p>Military sexual trauma-related post-traumatic stress disorder (PTSD) is highly prevalent and costly among women veterans, making the need for effective and accessible treatment of critical importance. Access to care is a key mechanism of mental health disparities and might affect differential response to treatment. The goal of this study was to estimate an individualized treatment rule based on readily available individual characteristics related to access to care to optimize allocation to in-person vs. telehealth delivery of prolonged exposure for PTSD in military sexual trauma survivors. The following variables were used as prescriptive factors: age, race, disability status, socioeconomic status, rural vs. urban status, and baseline PTSD level. The rule was estimated using a machine-learning approach, Outcome Weighted Learning. The estimated optimal rule outperformed a one-size-fits-all rule where everyone is universally assigned to telehealth; it led to markedly lower mean PTSD levels following 6 months from treatment (Vdopt \u2212 VTelehealth = \u221214.55, 95% CI: \u221227.24, \u22121.86). However, the rule did not significantly discriminate for in-person therapy (Vdopt \u2212 VIn-person = \u221211.86, 95% CI: \u221225.83, 2.12). Upon further validation with larger and more diverse samples, such a rule may be applied in practice settings to aid clinical decision-making and personalization of treatment assignment.<\/jats:p>","DOI":"10.3390\/bs14110993","type":"journal-article","created":{"date-parts":[[2024,10,24]],"date-time":"2024-10-24T09:11:47Z","timestamp":1729761107000},"page":"993","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Optimizing Allocation to Telehealth and In-Person Prolonged Exposure for Women Veterans with Military Sexual Trauma: A Precision Medicine Approach"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9113-0334","authenticated-orcid":false,"given":"Evangelia","family":"Argyriou","sequence":"first","affiliation":[{"name":"Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN 46202, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3946-6716","authenticated-orcid":false,"given":"Daniel F.","family":"Gros","sequence":"additional","affiliation":[{"name":"Mental Health Service, Ralph H. Johnson VA Healthcare System, Charleston, SC 29401, USA"},{"name":"Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, SC 29425, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0732-1248","authenticated-orcid":false,"given":"Melba A.","family":"Hernandez Tejada","sequence":"additional","affiliation":[{"name":"Faillace Department of Psychiatry, University of Texas Health Science Center at Houston, Houston, TX 77030, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wendy A.","family":"Muzzy","sequence":"additional","affiliation":[{"name":"Mental Health Service, Ralph H. Johnson VA Healthcare System, Charleston, SC 29401, USA"},{"name":"Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, SC 29425, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8799-8210","authenticated-orcid":false,"given":"Ron","family":"Acierno","sequence":"additional","affiliation":[{"name":"Mental Health Service, Ralph H. Johnson VA Healthcare System, Charleston, SC 29401, USA"},{"name":"Faillace Department of Psychiatry, University of Texas Health Science Center at Houston, Houston, TX 77030, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,10,24]]},"reference":[{"key":"ref_1","unstructured":"Veterans Health Administration (2024, September 03). Military Sexual Trauma, Available online: http:\/\/www.mentalhealth.va.gov\/docs\/mst_general_factsheet.pdf."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"584","DOI":"10.1177\/1524838016683459","article-title":"The Prevalence of Military Sexual Trauma: A Meta-Analysis","volume":"19","author":"Wilson","year":"2016","journal-title":"Trauma Violence Abus."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"S82","DOI":"10.1111\/j.1525-1497.2006.00380.x","article-title":"The state of women veterans\u2019 health research. Results of a systematic literature review","volume":"21","author":"Goldzweig","year":"2006","journal-title":"J. Gen. Intern. Med."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"2160","DOI":"10.2105\/AJPH.2006.092999","article-title":"The Veterans Health Administration and military sexual trauma","volume":"97","author":"Kimerling","year":"2007","journal-title":"Am. J. Public Health"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"e61","DOI":"10.1016\/j.whi.2011.07.010","article-title":"Gender differences in military sexual trauma and mental health diagnoses among Iraq and Afghanistan veterans with posttraumatic stress disorder","volume":"22","author":"Maguen","year":"2012","journal-title":"Womens Health Issues"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1016\/j.addbeh.2017.12.026","article-title":"Influence of military sexual assault and other military stressors on substance use disorder and PTS symptomology in female military veterans","volume":"80","author":"Yalch","year":"2018","journal-title":"Addict. Behav."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1409","DOI":"10.2105\/AJPH.2009.171793","article-title":"Military-related sexual trauma among Veterans Health Administration patients returning from Afghanistan and Iraq","volume":"100","author":"Kimerling","year":"2010","journal-title":"Am. J. Public Health"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1016\/j.psychres.2017.01.009","article-title":"Impact of military trauma exposures on posttraumatic stress and depression in female veterans","volume":"249","author":"Goldstein","year":"2017","journal-title":"Psychiatry Res."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"808","DOI":"10.1002\/eat.22705","article-title":"Military sexual trauma is associated with post-deployment eating disorders among Afghanistan and Iraq veterans","volume":"50","author":"Blais","year":"2017","journal-title":"Int. J. Eat. Disord."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1547","DOI":"10.5665\/sleep.5044","article-title":"Prevalence and Mental Health Correlates of Insomnia in First-Encounter Veterans with and without Military Sexual Trauma","volume":"38","author":"Jenkins","year":"2015","journal-title":"Sleep"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1177\/0886260506295347","article-title":"Mental Health, Quality of Life, and Health Functioning in Women Veterans: Differential Outcomes Associated with Military and Civilian Sexual Assault","volume":"22","author":"Lind","year":"2007","journal-title":"J. Interpers. Violence"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1016\/j.avb.2010.01.005","article-title":"Sexual assault in the U.S. military: A review of the literature and recommendations for the future","volume":"15","author":"Turchik","year":"2010","journal-title":"Aggress. Violent Behav."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1002\/mhp.102","article-title":"The civilian labor market experiences of Vietnam-era veterans: The influence of psychiatric disorders","volume":"3","author":"Savoca","year":"2000","journal-title":"J. Ment. Health Policy Econ."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1023\/A:1024409200155","article-title":"The quality of the intimate relationships of male Vietnam veterans: Problems associated with posttraumatic stress disorder","volume":"11","author":"Riggs","year":"1998","journal-title":"J. Trauma Stress"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1177\/1524838008324419","article-title":"Military sexual trauma: A review of prevalence and associated health consequences in veterans","volume":"9","author":"Suris","year":"2008","journal-title":"Trauma Violence Abus."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"102461","DOI":"10.1016\/j.janxdis.2021.102461","article-title":"A randomized clinical trial of in-person vs. home-based telemedicine delivery of Prolonged Exposure for PTSD in military sexual trauma survivors","volume":"83","author":"Acierno","year":"2021","journal-title":"J. Anxiety Disord."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1016\/j.psychres.2019.04.022","article-title":"Predictors of dropout from a randomized clinical trial of cognitive processing therapy for female veterans with military sexual trauma-related PTSD","volume":"276","author":"Holder","year":"2019","journal-title":"Psychiatry Res."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1016\/j.psychres.2019.02.027","article-title":"Factors associated with completing evidence-based psychotherapy for PTSD among veterans in a national healthcare system","volume":"274","author":"Maguen","year":"2019","journal-title":"Psychiatry Res."},{"key":"ref_19","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"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"419","DOI":"10.1002\/jts.21830","article-title":"Outcomes of Prolonged Exposure Therapy for Veterans with Posttraumatic Stress Disorder","volume":"26","author":"Goodson","year":"2013","journal-title":"J. Trauma. Stress"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"635","DOI":"10.1016\/j.cpr.2010.04.007","article-title":"A meta-analytic review of prolonged exposure for posttraumatic stress disorder","volume":"30","author":"Powers","year":"2010","journal-title":"Clin. Psychol. Rev."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1043","DOI":"10.1002\/da.20907","article-title":"Prolonged exposure therapy: Past, present, and future","volume":"28","author":"Foa","year":"2011","journal-title":"Depress. Anxiety"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1002\/jts.20380","article-title":"Prolonged exposure for PTSD in a Veterans Health Administration PTSD clinic","volume":"22","author":"Rauch","year":"2009","journal-title":"J. Trauma. Stress"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1174","DOI":"10.4088\/JCP.09m05682blu","article-title":"Prolonged exposure therapy for combat- and terror-related posttraumatic stress disorder: A randomized control comparison with treatment as usual","volume":"72","author":"Nacasch","year":"2011","journal-title":"J. Clin. Psychiatry"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"330","DOI":"10.1037\/0022-006X.71.2.330","article-title":"Comparative efficacy, speed, and adverse effects of three PTSD treatments: Exposure therapy, EMDR, and relaxation training","volume":"71","author":"Taylor","year":"2003","journal-title":"J. Consult. Clin. Psychol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"2439","DOI":"10.1177\/0886260515625909","article-title":"The Association Between Military Sexual Trauma and Use of VA and Non-VA Health Care Services among Female Veterans with Military Service in Iraq or Afghanistan","volume":"33","author":"Calhoun","year":"2016","journal-title":"J. Interpers. Violence"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1056\/NEJMoa040603","article-title":"Combat Duty in Iraq and Afghanistan, Mental Health Problems, and Barriers to Care","volume":"351","author":"Hoge","year":"2004","journal-title":"N. Engl. J. Med."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1111\/j.1748-0361.2003.tb00645.x","article-title":"Southern Rural Access Program: An Overview","volume":"19","author":"Beachler","year":"2003","journal-title":"J. Rural Health"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1467","DOI":"10.1176\/appi.ps.54.11.1467","article-title":"New Freedom Commission Report: The President\u2019s New Freedom Commission: Recommendations to Transform Mental Health Care in America","volume":"54","author":"Hogan","year":"2003","journal-title":"Psychiatr. Serv."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"693","DOI":"10.1016\/S2215-0366(15)00122-4","article-title":"Psychotherapy for depression in older veterans via telemedicine: A randomised, open-label, non-inferiority trial","volume":"2","author":"Egede","year":"2015","journal-title":"Lancet Psychiatry"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"e258","DOI":"10.2196\/jmir.2564","article-title":"Comparing In-Person to Videoconference-Based Cognitive Behavioral Therapy for Mood and Anxiety Disorders: Randomized Controlled Trial","volume":"15","author":"Stubbings","year":"2013","journal-title":"J. Med. Internet Res."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1089\/153056204773644535","article-title":"Delivering Cognitive-Behavior Therapy for Panic Disorder with Agoraphobia in Videoconference","volume":"10","author":"Bouchard","year":"2004","journal-title":"Telemed. J. E-Health"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1016\/j.brat.2016.11.009","article-title":"A non-inferiority trial of Prolonged Exposure for posttraumatic stress disorder: In person versus home-based telehealth","volume":"89","author":"Acierno","year":"2017","journal-title":"Behav. Res. Ther."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"238","DOI":"10.1177\/1357633X15596109","article-title":"Randomized controlled equivalence trial comparing videoconference and in person delivery of cognitive processing therapy for PTSD","volume":"22","author":"Maieritsch","year":"2015","journal-title":"J. Telemed. Telecare"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"101997","DOI":"10.1016\/j.nicl.2019.101997","article-title":"Addressing heterogeneity (and homogeneity) in treatment mechanisms in depression and the potential to develop diagnostic and predictive biomarkers","volume":"24","author":"Fu","year":"2019","journal-title":"NeuroImage Clin."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1016\/j.biopsych.2020.02.015","article-title":"Methods and Challenges for Assessing Heterogeneity","volume":"88","author":"Feczko","year":"2020","journal-title":"Biol. Psychiatry"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"579","DOI":"10.1111\/acer.12669","article-title":"Heterogeneity of alcohol use disorder: Understanding mechanisms to advance personalized treatment","volume":"39","author":"Litten","year":"2015","journal-title":"Alcohol. Clin. Exp. Res."},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Olbert, C.M., Gala, G.J., and Tupler, L.A. (2014). Quantifying Heterogeneity Attributable to Polythetic Diagnostic Criteria: Theoretical Framework and Empirical Application, American Psychological Association.","DOI":"10.1037\/a0036068"},{"key":"ref_39","unstructured":"The National Institutes of Health (2015). NIH-Wide Strategic Plan: Fiscal Years 2016\u20132020."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1146\/annurev-clinpsy-050817-084746","article-title":"Treatment Selection in Depression","volume":"14","author":"Cohen","year":"2018","journal-title":"Annu. Rev. Clin. Psychol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1146\/annurev-clinpsy-032511-143152","article-title":"A \u201cSMART\u201d Design for Building Individualized Treatment Sequences","volume":"8","author":"Lei","year":"2012","journal-title":"Annu. Rev. Clin. Psychol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"901","DOI":"10.1111\/add.13743","article-title":"A SMART data analysis method for constructing adaptive treatment strategies for substance use disorders","volume":"112","author":"Ertefaie","year":"2017","journal-title":"Addiction"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1146\/annurev-statistics-030718-105251","article-title":"Precision Medicine","volume":"6","author":"Kosorok","year":"2019","journal-title":"Annu. Rev. Stat. Appl."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"3371","DOI":"10.1017\/S0033291721000027","article-title":"An individualized treatment rule to optimize probability of remission by continuation, switching, or combining antidepressant medications after failing a first-line antidepressant in a two-stage randomized trial","volume":"52","author":"Kessler","year":"2022","journal-title":"Psychol. Med."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"466","DOI":"10.1016\/j.jad.2024.05.028","article-title":"A machine learning personalized treatment rule to optimize assignment to psychotherapies for grief among veterans","volume":"358","author":"Argyriou","year":"2024","journal-title":"J. Affect. Disord."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"397","DOI":"10.1176\/appi.ajp.21100972","article-title":"Innovative Directions to Advance Mental Health Disparities Research","volume":"179","author":"Barksdale","year":"2022","journal-title":"Am. J. Psychiatry"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1037\/rmh0000179","article-title":"The relationship between access to mental health counseling and interest in rural telehealth","volume":"45","author":"Weinzimmer","year":"2021","journal-title":"J. Rural Ment. Health"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1007\/s11414-012-9299-6","article-title":"Using Technology in the Delivery of Mental Health and Substance Abuse Treatment in Rural Communities: A Review","volume":"40","author":"Strode","year":"2013","journal-title":"J. Behav. Health Serv. Res."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"1308","DOI":"10.2105\/AJPH.2020.305657","article-title":"Telemental Health and US Rural\u2013Urban Differences in Specialty Mental Health Use, 2010\u20132017","volume":"110","author":"Patel","year":"2020","journal-title":"Am. J. Public Health"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1016\/j.dhjo.2010.05.003","article-title":"Health disparities among adults with physical disabilities or cognitive limitations compared to individuals with no disabilities in the United States","volume":"4","author":"Reichard","year":"2011","journal-title":"Disabil. Health J."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"e6402","DOI":"10.5195\/ijt.2021.6402","article-title":"Telehealth Use By Persons with Disabilities During the COVID-19 Pandemic","volume":"13","author":"Friedman","year":"2021","journal-title":"Int. J. Telerehabil."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"815","DOI":"10.2105\/AJPH.2020.305579","article-title":"Transportation Barriers to Health Care in the United States: Findings From the National Health Interview Survey, 1997\u20132017","volume":"110","author":"Wolfe","year":"2020","journal-title":"Am. J. Public Health"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"348","DOI":"10.1037\/int0000224","article-title":"Navigating uncharted waters: Considerations for training clinics in the rapid transition to telepsychology and telesupervision during COVID-19","volume":"30","author":"Hames","year":"2020","journal-title":"J. Psychother. Integr."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"1020","DOI":"10.1016\/j.jgo.2019.12.015","article-title":"eHealth literacy in older adults with cancer","volume":"11","author":"Hoogland","year":"2020","journal-title":"J. Geriatr. Oncol."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"e2022302","DOI":"10.1001\/jamanetworkopen.2020.22302","article-title":"Prevalence and Characteristics of Telehealth Utilization in the United States","volume":"3","author":"Fischer","year":"2020","journal-title":"JAMA Netw. Open"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"16304","DOI":"10.4088\/JCP.16m10951","article-title":"Psychotherapy for depression in older veterans via telemedicine: Effect on quality of life, satisfaction, treatment credibility, and service delivery perception","volume":"77","author":"Egede","year":"2016","journal-title":"J. Clin. Psychiatry"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"e52317","DOI":"10.2196\/52317","article-title":"Adoption and Use of Telemedicine and Digital Health Services among Older Adults in Light of the COVID-19 Pandemic: Repeated Cross-Sectional Analysis","volume":"7","author":"Haimi","year":"2024","journal-title":"JMIR Aging"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"e240131","DOI":"10.1001\/jamahealthforum.2024.0131","article-title":"Racial and Ethnic Differences in Telemedicine Use","volume":"5","author":"Marcondes","year":"2024","journal-title":"JAMA Health Forum"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"e52124","DOI":"10.2196\/52124","article-title":"Prevalence and Disparities in Telehealth Use among US Adults Following the COVID-19 Pandemic: National Cross-Sectional Survey","volume":"26","author":"Spaulding","year":"2024","journal-title":"J. Med. Internet Res."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"S222","DOI":"10.1037\/tra0000871","article-title":"Rural\u2013urban mental health disparities in the United States during COVID-19","volume":"12","year":"2020","journal-title":"Psychol. Trauma Theory Res. Pract. Policy"},{"key":"ref_61","unstructured":"VHA (2017). VHA Directive 1115.01. Military Sexual Trauma (MST) Mandatory Training and Reporting Requirements for VHA Mental Health and Primary Care Providers."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"501","DOI":"10.1037\/a0029730","article-title":"The prevalence and latent structure of proposed DSM-5 posttraumatic stress disorder symptoms in US national and veteran samples","volume":"5","author":"Miller","year":"2013","journal-title":"Psychol. Trauma Theory Res. Pract. Policy"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1037\/pas0000486","article-title":"The Clinician-Administered PTSD Scale for DSM\u20135 (CAPS-5): Development and initial psychometric evaluation in military veterans","volume":"30","author":"Weathers","year":"2018","journal-title":"Psychol. Assess."},{"key":"ref_64","unstructured":"Foa, E., Hembree, E., and Rothbaum, B. (2007). PE for PTSD: Emotional Processing of Traumatic Events: Therapist Guide, Oxford University Press New York."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"214","DOI":"10.1176\/appi.ajp.162.2.214","article-title":"A Multidimensional Meta-Analysis of Psychotherapy for PTSD","volume":"162","author":"Bradley","year":"2005","journal-title":"Am. J. Psychiatry"},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"224","DOI":"10.1016\/j.janxdis.2010.09.006","article-title":"Multicomponent behavioral treatment for chronic combat-related posttraumatic stress disorder: A randomized controlled trial","volume":"25","author":"Beidel","year":"2011","journal-title":"J. Anxiety Disord."},{"key":"ref_67","unstructured":"Veteran Affairs (2017). VA\/DoD Clinical Practice Guideline for the Management of Posttraumatic Stress Disorder and Acute Stress Disorder."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"1379","DOI":"10.1037\/pas0000254","article-title":"Psychometric properties of the PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders\u2013Fifth Edition (PCL-5) in veterans","volume":"28","author":"Bovin","year":"2016","journal-title":"Psychol. Assess."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1002\/da.1029","article-title":"Clinician-administered PTSD scale: A review of the first ten years of research","volume":"13","author":"Weathers","year":"2001","journal-title":"Depress. Anxiety"},{"key":"ref_70","unstructured":"Proctor, B.D., Semega, J.L., and Kollar, M.A. (2016). Income and Poverty in the United States: 2015, U.S. Census Bureau, Current Population Reports, P60-256(RV)."},{"key":"ref_71","unstructured":"Semega, J.L., Fontenot, K.R., and Kollar, M.A. (2017). Income and Poverty in the United States: 2016, U.S. Census Bureau, Current Population Reports, P60-259."},{"key":"ref_72","unstructured":"Jessica Semega, M.K., Creamer, J., and Mohanty, A. (2020). Income and Poverty in the United States: 2018, U.S. Census Bureau, Current Population Reports, P60-266(RV)."},{"key":"ref_73","unstructured":"Semega, J., Kollar, M., Shrider, E.A., and Creamer, J.F. (2020). Income and Poverty in the United States: 2019."},{"key":"ref_74","unstructured":"Fontenot, K., Semega, J., and Kollar, M. (2018). Income and Poverty in the United States: 2017, U.S. Census Bureau, Current Population Reports, P60-263."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"1106","DOI":"10.1080\/01621459.2012.695674","article-title":"Estimating Individualized Treatment Rules Using Outcome Weighted Learning","volume":"107","author":"Zhao","year":"2012","journal-title":"J. Am. Stat. Assoc."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"2830","DOI":"10.1111\/biom.13864","article-title":"Estimating optimal individualized treatment rules with multistate processes","volume":"79","author":"Bakoyannis","year":"2023","journal-title":"Biometrics"},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"278","DOI":"10.1177\/0962280210395740","article-title":"Review of inverse probability weighting for dealing with missing data","volume":"22","author":"Seaman","year":"2011","journal-title":"Stat. Methods Med. Res."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"470","DOI":"10.1002\/da.20694","article-title":"Barriers to treatment and service utilization in an internet sample of individuals with obsessive\u2013compulsive symptoms","volume":"27","author":"Marques","year":"2010","journal-title":"Depress. Anxiety"},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"254","DOI":"10.1207\/s15324796abm3203_12","article-title":"Barriers to psychotherapy among depressed and nondepressed primary care patients","volume":"32","author":"Mohr","year":"2006","journal-title":"Ann. Behav. Med."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"33","DOI":"10.2190\/PM.48.1.d","article-title":"Early Treatment Withdrawal from Evidence-Based Psychotherapy for PTSD: Telemedicine and in-Person Parameters","volume":"48","author":"Zoller","year":"2014","journal-title":"Int. J. Psychiatry Med."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"e10","DOI":"10.2196\/jmir.8.2.e10","article-title":"Why Are Health Care Interventions Delivered Over the Internet? A Systematic Review of the Published Literature","volume":"8","author":"Griffiths","year":"2006","journal-title":"J. Med. Internet Res."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1016\/j.jad.2020.09.135","article-title":"Selecting the optimal treatment for a depressed individual: Clinical judgment or statistical prediction?","volume":"279","author":"Lemmens","year":"2021","journal-title":"J. Affect. Disord."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1080\/00050060802550023","article-title":"Clinical judgements: Research and practice","volume":"44","author":"Bell","year":"2009","journal-title":"Aust. Psychol."},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1007\/s12207-015-9235-1","article-title":"The Dirty Dozen: 12 Sources of Bias in Forensic Neuropsychology with Ways to Mitigate","volume":"8","author":"Richards","year":"2015","journal-title":"Psychol. Inj. Law"},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1080\/17410541.2024.2341606","article-title":"Improving resource allocation in the precision medicine Era: A simulation-based approach using R","volume":"21","author":"Kamal","year":"2024","journal-title":"Pers. Med."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1037\/cps0000056","article-title":"The efficacy of synchronous teletherapy versus in-person therapy: A meta-analysis of randomized clinical trials","volume":"29","author":"Lin","year":"2022","journal-title":"Clin. Psychol. Sci. Pract."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"703","DOI":"10.1176\/appi.ps.201800408","article-title":"Factors Associated with Receipt of Cognitive-Behavioral Therapy or Prolonged Exposure Therapy among Individuals with PTSD","volume":"70","author":"Moore","year":"2019","journal-title":"Psychiatr. Serv."},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"714","DOI":"10.1037\/ort0000306","article-title":"Individual and systemic barriers to health care: Perspectives of lesbian, gay, bisexual, and transgender adults","volume":"87","author":"Romanelli","year":"2017","journal-title":"Am. J. Orthopsychiatry"},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1177\/1524838013511540","article-title":"Unseen battles: The recognition, assessment, and treatment issues of men with military sexual trauma (MST)","volume":"15","author":"Morris","year":"2014","journal-title":"Trauma Violence Abus."},{"key":"ref_90","first-page":"16","article-title":"Initial steps in treating the male patient","volume":"24","author":"Kakhnovets","year":"2007","journal-title":"Fed. Pract."},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1177\/0361684318791154","article-title":"The Phenomenology of Military Sexual Trauma among Women Veterans","volume":"42","author":"Brownstone","year":"2018","journal-title":"Psychol. 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