Trauma Exposure in Anxious Primary Care Patients

Published In: Journal of Psychopathology and Behavioral Assessment, v. 35, no. 2, June 2013, p. 254-263

Posted on RAND.org on January 01, 2012

by Jessica A. Bomyea, Ariel J. Lang, Daniela Golinelli, Michelle G. Craske, Denise A. Chavira, Cathy D. Sherbourne, Raphael D. Rose, Laura Campbell-Sills, Stacy Shaw Welch, Greer Sullivan, Alexander Bystritsky, Peter Roy-Byrne, Murray Stein

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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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