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Trauma Exposure in Anxious Primary Care Patients

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Abstract

The present study examined rates of trauma exposure, clinical characteristics associated with trauma exposure, and the effect of trauma exposure on treatment outcome in a large sample of primary care patients without posttraumatic stress disorder (PTSD). Individuals without PTSD (N = 1,263) treated as part of the CALM program (Roy-Byrne et al., Journal of the American Medical Association 303(19)1921–1928, 2010) were assessed for presence of trauma exposure. Those with and without trauma exposure were compared on baseline demographic and diagnostic information, symptom severity, and responder status six months after beginning treatment. Trauma-exposed individuals (N = 662, 53 %) were more likely to meet diagnostic criteria for Obsessive Compulsive Disorder and had higher levels of somatic symptoms at baseline. Individuals with and without trauma exposure did not differ significantly on severity of anxiety, depression, or mental health functioning at baseline. Trauma exposure did not significantly impact treatment response. Findings suggest that adverse effects of trauma exposure in those without PTSD may include OCD and somatic anxiety symptoms. Treatment did not appear to be adversely impacted by trauma exposure. Thus, although trauma exposure is prevalent in primary care samples, results suggest that treatment of the presenting anxiety disorder is effective irrespective of trauma history.

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Notes

  1. Note: Because of the statistical trend indicating a greater proportion of females in the trauma exposed group analyses comparing baseline severity and outcome at 6-months were also conducted with gender as a covariate. This did not change the pattern of results.

  2. Results of analyses using continuous BSI-12 scores as the dependent variable produced equivalent results.

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Authors and Affiliations

  1. Joint Doctoral Program in Clinical Psychology, San Diego State University, San Diego, CA, USA

    J. Bomyea

  2. Joint Doctoral Program in Clinical Psychology, University of California, San Diego, San Diego, CA, USA

    J. Bomyea

  3. Department of Psychiatry, University of California, San Diego, 8939 Villa La Jolla Dr. Suite 200, San Diego, CA, 92037, USA

    A. J. Lang, D. A. Chavira, L. Campbell-Sills & M. B. Stein

  4. VA San Diego Health Care System Center of Excellence for Stress and Mental Health, San Diego, CA, USA

    A. J. Lang

  5. RAND Corporation, 1776 Main Street, Santa Monica, CA, 90401, USA

    D. Golinelli, C. D. Sherbourne & G. Sullivan

  6. Department of Psychology, UCLA Anxiety Disorders Research Center, Franz Hall - Box 951563, Los Angeles, CA, 90094-1563, USA

    M. G. Craske & R. D. Rose

  7. Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine and Harborview Center for Healthcare Improvement for Addictions, Mental Illness, and Medically Vulnerable Populations (CHAMMP), 1200 5th Avenue Suite 800, Seattle, WA, 92101, USA

    S. S. Welch & P. Roy-Byrne

  8. Department of Psychiatry, University of Arkansas for Medical Sciences, 4301 W. Markham # 554, Little Rock, AR, 72205, USA

    G. Sullivan

  9. VA South Central Mental Illness Research, Education, and Clinical Center University of Arkansas for Medical Sciences, 4301 W. Markham # 554, Little Rock, AR, 72205, USA

    G. Sullivan

  10. Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, Box 956969 200, Medical Plaza Ste 2200, Los Angeles, CA, 90095, USA

    A. Bystritsky

  11. Family and Preventive Medicine, University of California, San Diego, San Diego, CA, USA

    M. B. Stein

  12. Department of Psychiatry, University of California, San Diego, 8939 Villa La Jolla Dr. Suite 200, San Diego, CA, 92037, USA

    J. Bomyea

  13. 325 9th Ave PSB – 5020, Box 359911, Seattle, WA, 98104, USA

    P. Roy-Byrne

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  1. J. Bomyea
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This grand supported by funding from the National Institute of Mental Health, clinicaltrials.gov Identifier NCT00347269

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Bomyea, J., Lang, A.J., Golinelli, D. et al. Trauma Exposure in Anxious Primary Care Patients. J Psychopathol Behav Assess 35, 254–263 (2013). https://doi.org/10.1007/s10862-012-9327-0

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