Addressing Diversity in PTSD Treatment: Disparities in Treatment Engagement and Outcome Among Patients of Color
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PTSD (SK Creech and LM Sippel, Section Editors)
Addressing Diversity in PTSD Treatment: Disparities in Treatment Engagement and Outcome Among Patients of Color Juliette McClendon, Ph.D.1,* Kimberlye E. Dean, Ph.D.2 Tara Galovski, Ph.D.1 Address *,1 Women’s Health Sciences Division, National Center for PTSD (116B-3), VA Boston Healthcare System and Department of Psychiatry, Boston University School of Medicine, 150 S. Huntington Avenue, Boston, MA, USA Email: [email protected] 2 Department of Psychiatry, Massachusetts General Hospital and Department of Psychiatry, Harvard Medical School, Boston, MA, USA
* This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply 2020
This article is part of the Topical Collection on PTSD Keywords Posttraumatic stress disorder I Race I Ethnicity I Treatment outcome I Treatment engagement I Evidence-based treatment
Abstract Purpose Posttraumatic stress disorder (PTSD) is a prevalent mental disorder characterized by difficulty recovering from exposure to a traumatic event. The prevalence of PTSD varies by race/ethnicity, with studies in US samples indicating higher prevalence and lower treatment use among some racial and ethnic minority groups compared with Whites. Clarifying the extent to which race and ethnicity influence PTSD treatment outcomes is crucial to delivering treatments that are equitably effective and culturally relevant. Recent findings There are few rigorous studies of racial/ethnic differences in PTSD treatment-related outcomes, making it difficult to draw conclusions. Evidence suggests that, compared with Whites, there may be lower treatment initiation and retention among Black/African American and Hispanic/Latino/a individuals. The bulk of evidence does not support racial/ethnic differences in treatment-related symptom reduction, though findings are contradictory. Cultural adaptations of evidence-based treatments for PTSD warrant further research.
PTSD (SK Creech and LM Sippel, Section Editors) Summary There is a critical need for research that is designed to answer questions about racial/ethnic differences and the experiences of People of Color in PTSD treatment. In clinical settings, widely implementing culturally relevant assessment and treatment, enhancing cultural competence of clinicians, and increasing representation of clinicians of Color are crucial steps toward improving PTSD treatment for People of Color.
Introduction Posttraumatic stress disorder (PTSD) is a mental disorder characterized by difficulty recovering from exposure to a traumatic event resulting in psychological, social, and behavioral reactions that interfere in an individual’s daily functioning [1]. PTSD symptoms fall into four clusters: re-experiencing (e.g., nightmares, flashbacks), avoidance of reminders of the trauma, negative alterations in cognition and mood (e.g., exaggerated self-blame, negative affect), and alterations in arousal and reactivity (e.g., irritability, hypervigilance) [2]. The prevalence of
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