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Anger and predictors of drop-out from PTSD treatment of veterans and first responders

Published online by Cambridge University Press:  27 September 2021

Emily Hinton ,
Zachary Steel ,
Dominic Hilbrink  and
David Berle Open the ORCID record for David Berle [Opens in a new window]
Emily Hinton
Affiliation:
Discipline of Clinical Psychology, University of Technology Sydney, Ultimo, Australia
Zachary Steel
Affiliation:
School of Psychiatry, University of New South Wales, Sydney, Australia St John of God Health Care, Richmond Hospital, Australia Black Dog Institute, Randwick, Australia
Dominic Hilbrink
Affiliation:
St John of God Health Care, Richmond Hospital, Australia
David Berle*
Affiliation:
Discipline of Clinical Psychology, University of Technology Sydney, Ultimo, Australia School of Psychiatry, University of New South Wales, Sydney, Australia
*
*Corresponding author. Email: david.berle@uts.edu.au
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Abstract

Background:

Drop-out is an important barrier in treating post-traumatic stress disorder (PTSD) with consequences that negatively impact clients, clinicians and mental health services as a whole. Anger is a common experience in people with PTSD and is more prevalent in military veterans. To date, no research has examined if anger may predict drop-out in military veterans or first responders.

Aims:

The present study aimed to determine the variables that predict drop-out among individuals receiving residential treatment for PTSD.

Method:

Ninety-five military veterans and first responders completed pre-treatment measures of PTSD symptom severity, depression, anxiety, anger, and demographic variables. Logistic regression analyses were used to determine if these variables predicted drop-out from treatment or patterns of attendance.

Results:

Female gender was predictive of drop-out. However, when analysed by occupation female gender was predictive of drop-out among first responders and younger age was predictive of drop-out in military participants. Anger, depression, anxiety and PTSD symptom severity were not predictive of drop-out in any of the analyses. No variables were found to predict attendance patterns (consistent or inconsistent) or early versus late drop-out from the programme.

Conclusion:

These results suggest that although anger is a relevant issue for treating PTSD, other factors may be more pertinent to drop-out, particularly in this sample. In contrast with other findings, female gender was predictive of drop-out in this study. This may indicate that in this sample, there are unique characteristics and possible interacting variables that warrant exploration in future research.

Keywords

angerCBTgroup psychotherapypost-traumatic stress disorderPTSDtreatment discontinuation
Type
Main
Information
Behavioural and Cognitive Psychotherapy , Volume 50 , Issue 2 , March 2022 , pp. 237 - 251
Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of the British Association for Behavioural and Cognitive Psychotherapies

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