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PTSD Symptom Severity, but Not Trauma Type, Predicts Mental Health Help-seeking in the Military


Journal of Psychiatric Practice®: September 2018 - Volume 24 - Issue 5 - p 310–316
doi: 10.1097/PRA.0000000000000331

Objective: Although veterans with posttraumatic stress disorder (PTSD) have been reported to have high rates of inadequate treatment, to our knowledge this is the first study to evaluate associations between each individual PTSD symptom and treatment-seeking, and the first PTSD help-seeking study to evaluate variables across all—rather than specific—types of trauma.

Methods: This case-control study surveyed a consecutive sample of active duty military outpatients with trauma histories (N=211), comparing those attending voluntary mental health services (help-seeking cases, n=128) or mandatory dental services required for all active duty personnel (general military population controls, n=83). We used logistic regression to estimate associations between help-seeking and demographics, PTSD symptoms, trauma type, suicide attempts, substance use problems, and chronic pain, with each variable adjusted for sex, age, and race.

Results: Significant associations were found between help-seeking and PTSD diagnosis (adjusted odds ratio=4.15, P<0.001) and between help-seeking and severities of PTSD symptoms (total, clusters, all individual symptoms except recklessness; each adjusted odds ratio>1, P<0.05).

Conclusions: In this clinical sample, a clear positive relationship was found between help-seeking and PTSD symptom severity, but not with trauma type, suicide attempts, substance use problems, or pain, after adjusting for multiple testing. Possible explanations and implications of these findings are discussed.

GUINA: Wright-Patterson Medical Center, Wright-Patterson Air Force Base, OH; and Wright State University Boonshoft School of Medicine, Dayton, OH

NAHHAS and NGUYEN: Wright State University Boonshoft School of Medicine, Dayton, OH

FARNSWORTH: Misawa Air Base Medical Center, Misawa Air Base, Misawa, Japan

The authors declare no conflicts of interest.

Please send correspondence to: Jeffrey Guina, MD, Department of Psychiatry, Wright State University School of Medicine, 627 S. Edwin C. Moses Blvd, Dayton, OH 45417 (e-mail:

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