Sayer NA (Minneapolis COE), Noorbaloochi S
(Minneapolis COE), Frazier P
(University of Minnesota), Murdoch M
(Minneapolis COE), Carlson K
(Minneapolis COE), Gravely A
(Minneapolis COE), Baines A
Primary: Describe the relationship between PTSD and community reintegration problems among veterans returning from Operation Enduring Freedom and Operation Iraqi Freedom (OEF/OIF). Secondary: Describe treatment preferences among OEF/OIF veterans.
Survey based on a national, stratified sample of OEF/OIF veterans who used the Department of Veterans Affairs (VA) at least once since military discharge. The population was stratified by gender, race, and geographic region and a simple random sample was obtained from each stratum. The survey assessed reintegration problems and treatment preferences, as well as physical and mental health using standardized instruments. Weighted estimates (e.g. prevalence and proportions) were constructed for the corresponding population values among OEF/OIF veterans based on responders and adjusted for non-response bias. Bonferroni adjustments were used to report the significant differences by PTSD status.
754 of the 1,227 (61 percent) veterans surveyed returned study material, 291 (39 percent) of whom met survey criteria for probable PTSD. Probable PTSD was strongly associated with both the prevalence and severity of re-integration problems in all domains assessed (social/marital, occupational, community, leisure, spiritual, recreational, self-care, anger control, legal, drinking and drug use, dangerous driving) (Ps < .0001). However, community re-integration problems were not absent in those without probable PTSD. Between 10% and 35% of participants without PTSD endorsed at least some difficulty across functional domains. Most participants, regardless of PTSD status, were interested in services or information to promote re-integration, with information on service connection benefits, schooling, and employment being the most popular. The majority of participants indicated interest in receiving services or information at a VA (61 to 71 percent) or through the Internet (58 to 68 percent).
The prevalence of PTSD among OEF/OIF veterans enrolled in VA may be higher than previously estimated and PTSD is associated with prevalence and severity of community re-integration problems. Services and information OEF/OIF veterans want may extend beyond what is typically provided through VA health care settings, such as help achieving educational and occupational goals.
VA needs to determine whether existing services and interventions improve re-integration outcomes among OEF/OIF veterans with and without PTSD and to evaluate these services in light of patients’ preferences and information needs.