Skip to main content
SpringerLink
Log in

Posttraumatic Stress Disorder and Treatment Seeking in a National Screening Sample

  • Published:
Journal of Traumatic Stress

Abstract

The behavioral model of service use was employed to identify predictors of mental health treatment seeking and treatment readiness among individual with PTSD (N = 2,713) in data from the 1996 National Anxiety Disorders Screening Day (NADSD). This model examines the contribution of predisposing (age, sex, marital status, race/ethnicity, education), enabling (employment, geographic location), perceived need (interference of symptoms with daily life), and evaluated need (other diagnoses) factors to treatment seeking and treatment readiness for individuals with PTSD. Results indicate that although need factors (interference by anxiety symptoms with daily life, diagnosis of panic disorder) are related to both receiving and readiness for treatment, predisposing (age, marital status, minority race) factors influence which individuals receive treatment for PTSD.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Amaya-Jackson, L., Davidson, J. R., Hughes, D. C., Swartz, M., Reynolds, V., George, L. K., et al. (1999). Functional impairment and utilization of services associated with posttraumatic stress disorder in the community. Journal of Traumatic Stress, 12, 709–724.

    Google Scholar 

  • American Psychiatric Association. (1994). Diagnostic and Statistical Manual for Mental Disorders Version IV. Washington, DC: Author.

    Google Scholar 

  • Andersen, R. M. (1995). Revisiting the behavioral model and access to medical care: Does it matter? Journal of Health and Social Behavior, 36, 1–10.

    Google Scholar 

  • Andersen, R. M., & Newman, J. F. (1973). Societal and individual determinants of medical care utilization in the United States. Milbank Memorial Fund Quarterly—Health and Society, 51, 95–124.

    Google Scholar 

  • Andersen, R. M., Rice, T. H., & Kominski, G. F. (Eds.). (1996). Changing the US health care system. San Francisco, CA: Jossey-Bass.

    Google Scholar 

  • Breslau, N., Davis, G. C., Andreski, P., & Peterson, E. (1991). Traumatic events and posttraumatic stress disorder in an urban population of young adults. Archives of General Psychiatry, 48, 216–222.

    Google Scholar 

  • Bromet, E., Sonnega, A., & Kessler, R. C. (1998). Risk factors for DSM-III-R posttraumatic stress disorder: Findings from the National Comorbidity Survey. American Journal of Epidemiology, 147, 353–358.

    Google Scholar 

  • Brown, P. J., Recupero, P. R., & Stout, R. (1995). PTSD substance abuse comorbidity and treatment utilization. Addictive Behaviors, 20, 251–254.

    Google Scholar 

  • Brown, P. J., Stout, R. L., & Mueller, T. (1999). Substance use disorder and posttraumatic stress disorder comorbidity: Addiction and psychiatric treatment rates. Psychology of Addictive Behaviors, 13, 115–122.

    Google Scholar 

  • Davidson, J. R. T. (1991). Post-traumatic stress disorder in the community: An epidemiological study. Psychological Medicine, 21, 713–721.

    Google Scholar 

  • Falsetti, S. A., & Resnick, H. S. (1997). Frequency and severity of panic attacks in a treatment seeking sample of trauma victims. Journal of Traumatic Stress, 10, 683–689.

    Google Scholar 

  • Ferrada-Noli, M., Asberg, M., Ormstad, K., Lundin, T., & Sundbom, E. (1998). Suicidal behavior after severe trauma. Part 1: PTSD diagnoses, psychiatric comorbidity, and assessments of suicidal behavior. Journal of Traumatic Stress, 11, 103–112.

    Google Scholar 

  • Fifer, S. K., Mathias, S. D., Patrick, D. L., Mazonson, P. D., Lubeck, D. P., & Buesching, D. P. (1994). Untreated anxiety among adult primary care patients in a health maintenance organization. Archives of General Psychiatry, 51, 740–750.

    Google Scholar 

  • First, M. B., Spitzer, R. L., Gibbon, M., & Williams, J. B. W. (1995). Structured Clinical Interview for DSM-IV Axis I Disorders—Patient Edition (SCID-P), version 2. New York: New York State Psychiatric Institute, Biometrics Research.

    Google Scholar 

  • Fleiss, J. L. (1981). Statistical methods for rates and proportions. New York: Wiley.

    Google Scholar 

  • Friedman, M. J. (2000). A guide to the literature on pharmacotherapy for PTSD. PTSD Research Quarterly, 11(1), 1–7.

    Google Scholar 

  • Greenley, J. R., Mechanic, D., & Cleary, P. D. (1987). Seeking help for psychological problems: A replication and extension. Medical Care, 25, 1113–1128.

    Google Scholar 

  • Helzer, J. E., Robins, L. N., & McEvoy, L. (1987). Post-traumatic stress disorder in the general population: Findings of the epidemiological catchment area survey. New England Journal of Medicine, 317, 1630–1634.

    Google Scholar 

  • Kessler, R. C., Frank, R. G., Edlund, M., Katz, S. J., Lin, E., & Leaf, P. (1997). Differences in the use of psychiatric outpatient services between the United States and Ontario. New England Journal of Medicine, 336, 551–557.

    Google Scholar 

  • Kessler, R. C., Sonnega, A., Bromet, E., Hughes, M., & Nelson, C. (1995). Posttraumatic stress disorder in the National Comorbidity Survey. Archives of General Psychiatry, 52, 1048–1060.

    Google Scholar 

  • Klerman, G. L., Weissman, M. M., Ouellette, R., Johnson, J., & Greenwald, S. (1991). Panic attacks in the community. Social morbidity and health care utilization. Journal of the American Medical Association, 265, 742–746.

    Google Scholar 

  • Kulka, R. A., Schlenger, W. E., Fairbank, J. A., Hough, R. L., Jordan, B. K., Marmar, C. R., et al. (1990). Trauma and the Vietnam war generation: Report of the findings from the National Vietnam Veterans Readjustment Study. New York: Brunner/Mazel.

    Google Scholar 

  • Leaf, P. J., Livingston, M. M., Tischler, G. L., Freedman, D. H., Weissman, M. M., & Myers, J. K. (1988). Factors affecting the utilization of specialty and general medical mental health services. Medical Care, 26, 9–26.

    Google Scholar 

  • Leaf, P. J., Livingston, M. M., Tischler, G. L., Weissman, M. M., Holzer, C. E., & Myers, J. K. (1985). Contact with health professionals for the treatment of psychiatric and emotional problems. Medical Care, 23, 1322–1337.

    Google Scholar 

  • Magee, W. J. Eaton, W. W., Wittchen, H. U., McGonagle, K. A., & Kessler, R. C. (1996). Agoraphobia, simple phobia, and social phobia in the National Comorbidity Survey. Archives of General Psychiatry, 53, 159–167.

    Google Scholar 

  • McFarlane, A. C., Atchinson, M., Rafalowicz, E., & Papay, P. (1994). Physical symptoms in post-traumatic stress disorder. Journal of Psychosomatic Research, 38, 715–726.

    Google Scholar 

  • Mechanic, D. (1975). Sociocultural and social psychological factors affecting personal responses to psychological disorder. Journal of Health and Social Behavior, 16, 393–405.

    Google Scholar 

  • Norris, R. (1992). Epidemiology of trauma: Frequency and impact of different potentially traumatic events on different demographic groups. Journal of Consulting and Clinical Psychology, 60, 409–418.

    Google Scholar 

  • Norris, F. H., Kaniasty, K. Z., & Scheer, D. A. (1990). Use of mental health services among victims of crime: Frequency, correlates, and subsequent recovery. Journal of Consulting and Clinical Psychology, 58, 538–547.

    Google Scholar 

  • North, C. S., Nixon, S. J., Shariat, S., Mallonee, S., McMillen, J. C. Spitznagel, E. L., et al. (1999). Psychiatric disorders among survivors of the Oklahoma City Bombing. Journal of the American Medical Association, 282, 755–762.

    Google Scholar 

  • Olfson, M., Guardino, M., Struening, E., Schneier, F., Hellman, F., & Klein, D. (2000). Barriers to the treatment of social anxiety. American Journal of Psychiatry, 157, 521–527.

    Google Scholar 

  • Prochaska, J., Velicer, W., DiClemente, C., & Fava, J. (1988). Measuring processes of change: Applications to the cessations of smoking. Journal of Consulting and Clinical Psychology, 56, 520–528.

    Google Scholar 

  • Resnick, H. S., Kilpatrick, D. G., Dansky, B. S., Saunders, B. E., & Best, C. L. (1993). Prevalence of civilian trauma and posttraumatic stress disorder in a representative national sample of women. Journal of Consulting and Clinical Psychology, 61, 984–991.

    Google Scholar 

  • Ritsher, J. B., Struening, E., Hellman, F., & Guardino, M. (2000, May). Factorial invariance of a screening scale among five ethnic groups. Paper presented at the Psychiatric Epidemiology Training Program, Mailman School of Public Health, Columbia University, New York.

    Google Scholar 

  • Ronis, D. L., Bates, E. W., Garfein, A. J., Buit, B. K., Falcon, S. P., & Liberzon, I. (1996). Longitudinal patterns of care for patients with posttraumatic stress disorder. Journal of Traumatic Stress, 9, 763–781.

    Google Scholar 

  • Rosenheck, R., Fontana, A., & Cottrol, C. (1995). Effect of clinician-veteran racial pairing in the treatment of posttraumatic stress disorder. American Journal of Psychiatry, 152, 555–563.

    Google Scholar 

  • Rothbaum, B. O., & Foa, E. B. (1999). Exposure therapy for PTSD. PTSD Research Quarterly, 10(2), 1–6.

    Google Scholar 

  • Schonfeld, W. H., Verboncoeur, C. J., Fifer, S. K., Lipschutz, R. C., Lubeck, D. P., & Buesching, D. P. (1997). The functioning and well-being of patients with unrecognized anxiety disorders and major depressive disorder. Journal of Affective Disorders, 43, 105–119.

    Google Scholar 

  • Shapiro, S., Skinner, E. A., Kessler, L. G., Von Korff, M., German, P. S., Tischler, G. L., et al. (1984). Utilization of health and mental health services. Three epidemiologic catchment area sites. Archives of General Psychiatry, 41, 971–978.

    Google Scholar 

  • Sorenson, S. B., & Siegel J. M. (1992). Gender, ethnicity, and sexual assault: Findings from a Los Angeles study. Journal of Social Issues, 48, 93–104.

    Google Scholar 

  • Spitzer, R. L., Williams, J. B. W., Gibbon, M., & First, M. B. (1992). The Structured Clinical Interview for DSM-III-R (SCID), I: History, rationale, and description. Archives of General Psychiatry, 49, 624–629.

    Google Scholar 

  • Stein, M. B., Walker, J. R., Hazen, A. L., & Forde, D. R. (1997). Full and partial posttraumatic stress disorder: Findings from a community survey. American Journal of Psychiatry, 154, 1114–1119.

    Google Scholar 

  • Struening, E. L., Pittman, J., Welkowitz, L., Guardino, M., & Hellman, F. (1998). Characteristics of participants in the 1995–1996 National Anxiety Disorders Screening Day. New York: New York State Psychiatric Institute.

    Google Scholar 

  • Switzer, G. E., Dew, M. A., Thompson, K., Goycoolea, J. M., Derricott, T., & Mullins, S. D. (1999). Posttraumatic stress disorder and service utilization among urban mental health center clients. Journal of Traumatic Stress, 12, 25–39.

    Google Scholar 

  • Whaley, A. L. (1998). Racism in the provision of mental health services: A social–cognitive analysis. American Journal of Orthopsychiatry, 68, 47–57.

    Google Scholar 

  • Zatzick, D. F., Marmar, C. R., Weiss, D. S., Metzler, T. J., Golding, J. M., Steward, A., et al. (1999). Posttraumatic stress disorder and functioning and quality of life outcomes in a nationally representative sample of male veterans. American Journal of Psychiatry, 154, 1690–1695.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Epidemiology, The Joseph L. Mailman School of Public Health, Columbia University, New York

    Renee Goodwin, Elmer Struening & Fred Hellman

  2. Women's Health Sciences Division (116B-3), National Center for PTSD, VA Boston Healthcare System, Boston, Massachusetts, 02130

    Karestan C. Koenen

  3. Department of Epidemiology of Mental Disorders, New York State Psychiatric Institute, New York

    Renee Goodwin

  4. Freedom From Fear, New York

    Mary Guardino

Authors
  1. Karestan C. Koenen
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Renee Goodwin
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Elmer Struening
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Fred Hellman
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Mary Guardino
    View author publications

    You can also search for this author in PubMed Google Scholar

About this article

Cite this article

Koenen, K.C., Goodwin, R., Struening, E. et al. Posttraumatic Stress Disorder and Treatment Seeking in a National Screening Sample. J Trauma Stress 16, 5–16 (2003). https://doi.org/10.1023/A:1022051009330

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1023/A:1022051009330

Search

Navigation