Hostname: page-component-586b7cd67f-tf8b9 Total loading time: 0 Render date: 2024-11-21T05:46:33.089Z Has data issue: false hasContentIssue false
  • English
  • Français

Posttraumatic Stress Disorder, Supported Employment, and Outcomes in People with Severe Mental Illness

Published online by Cambridge University Press:  07 November 2014

Kim T. Mueser ,
Susan M. Essock ,
Michael Haines ,
Rosemarie Wolfe  and
Haiyi Xie
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective: To evaluate whether posttraumatic stress disorder (PTSD) is related to outcomes in persons with severe mental illness (SMI) participating in a study of vocatinal rehabilitation programs

Background: PTSD is a common comorbid disorder in people with SMI, but it is unknown whether PTSD interferes with the ability to benefit from rehabilitation programs such as supported employment.

Methods: The relationships between PTSD and symptoms, health, quality of life, and work outcomes was examined in 176 clients with SMI participating in a 2-year randomized controlled trial of three vocational rehabilitation programs: supported employment based on the Individual Placement and Support model, a psychosocial rehabilitation program based on transitional employment, and standard services.

Results: The overall rate of current PTSD in the sample was 16%. Compared with clients without PTSD, clients with PTSD had more severe psychiatric symptoms, worse reported health, lower self-esteem, and lower subjective quality of life. Clients with PTSD who participated in the Individual Placement and Support model (the most effective vocational model of the three studied) also had worse employment outcomes over the 2-year study period than clients without PTSD, with lower rates of compeitive work, fewer hours worked, and fewer wages earned. Employment outcomes did not differ between clients with PTSD versus without PTSD in the other two vocational rehabilitation approaches.

Conclusion: The findings suggest that PTSD may contribute to worse work outcomes in clients participating in supported employment programs. Effective treatment of these clients with PTSD may improve their ability to benefit from supported employment.

Type
Original Research
Information
CNS Spectrums , Volume 9 , Issue 12 , December 2004 , pp. 913 - 925
Copyright
Copyright © Cambridge University Press 2004

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

1.Goodman, LA, Rosenberg, SD, Mueser, KT, Drake, RE. Physical and sexual assault history in women with serious mental illness: prevalence, correlates, treatment, and future research directions. Schizophr Bull. 1997;23:685–696.CrossRefGoogle ScholarPubMed
2.Goodman, LA, Salyers, MP, Mueser, KT, et al.Recent victimization in women and men with severe mental illness: prevalence and correlates. J Trauma Stress. 2001;14:615–632.CrossRefGoogle ScholarPubMed
3.Cascardi, M, Mueser, KT, DeGiralomo, J, Murrin, M. Physical aggression against psychiatric inpatients by family members and partners. Psychiatr Serv. 1996;47:531–533.Google ScholarPubMed
4.Craine, LS, Henson, CE, Colliver, JA, MacLean, DG. Prevalence of a history of sexual abuse among female psychiatric patients in a state hospital system. Hosp Community Psychiatry. 1988;39:300–304.Google Scholar
5.McFarlane, AC, Bookless, C, Air, T. Posttraumatic stress disorder in a general psychiatric inpatient population. J Trauma Stress. 2001;14:633–645.CrossRefGoogle Scholar
6.Mueser, KT, Goodman, LA, Trumbetta, SL, et al.Trauma and posttraumatic stress disorder in severe mental illness. J Consult Clin Psychol. 1998;66:493–499.CrossRefGoogle ScholarPubMed
7.Mueser, KT, Salyers, MP, Rosenberg, SD, et al.Interpersonal trauma and posttraumatic stress disorder in patients with severe mental illness: demographic, clinical, and health correlates. Schizophr Bull. 2004;30:45–57.CrossRefGoogle ScholarPubMed
8.Switzer, GE, Dew, MA, Thompson, K, Goycoolea, JM, Derricott, T, Mullins, SD. Posttraumatic stress disorder and service utilization among urban mental health center clients. J Trauma Stress. 1999;12:25–39.CrossRefGoogle ScholarPubMed
9.Breslau, N, Davis, GC, Andreski, P, Peterson, E. Traumatic events and posttraumatic stress disorder in an urban population of young adults. Arch Gen Psychiatry. 1991;48:216–222.CrossRefGoogle Scholar
10.Kessler, RC, Sonnega, A, Bromet, E, Hughes, M, Nelson, CB. Posttraumatic stress disorder in the National Comorbidity Survey. Arch Gen Psychiatry. 1995;52:1048–1060.CrossRefGoogle ScholarPubMed
11.Resnick, HS, Kilpatrick, DG, Dansky, BS, Saunders, BE, Best, CE. Prevalence of civilian trauma and posttraumatic stress disorder in a representative national sample of women. J Consult Clin Psychol. 1993;61:984–991.CrossRefGoogle Scholar
12.Lange, A, Kooiman, K, Huberts, L, van Oostendorp, E. Childhood unwanted sexual events and degree of psychopathology of psychiatric patients: Research with a new anamnestic questionnaire (the CHUSE). Acta Psychiatr Scand. 1995;92:441–446.CrossRefGoogle ScholarPubMed
13.Resnick, SG, Bond, GR, Mueser, KT. Trauma and posttraumatic stress disorder in people with schizophrenia. Journal of Abnormal Psychology. 2003;112:415–423.CrossRefGoogle ScholarPubMed
14.Ross, CA, Anderson, G, Clark, P. Childhood abuse and the positive symptoms of schizophrenia. Hosp Community Psychiatry. 1994;45:489–491.Google ScholarPubMed
15.Mueser, KT, Rosenberg, SD, Goodman, LA, Trumbetta, SL. Trauma, PTSD, and the course of schizophrenia: an interactive model. Schizophr Res. 2002;53:123–143.CrossRefGoogle ScholarPubMed
16.Bond, GR, Becker, DR, Drake, RE, et al.Implementing supported employment as an evidence-based practice. Psychiatr Serv. 2001;52:313–322.CrossRefGoogle ScholarPubMed
17.Phillips, SD, Burns, BJ, Edgar, ER, et al.Moving assertive community treatment into standard practice. Psychiatr Serv. 2001;52:771–779.CrossRefGoogle ScholarPubMed
18.Pitschel-Walz, G, Leucht, S, Bäuml, J, Kissling, W, Engel, RR. The effect of family interventions on relapse and rehospitalization in schizophrenia—a meta-analysis. Schizophr Bull. 2001;27:73–92.CrossRefGoogle ScholarPubMed
19.Drake, RE, Mueser, KT, Brunette, MF, McHugo, GJ. A review of treatments for clients with severe mental illness and co-occurring substance use disorder. Psychiatr Rehabil J. 2004;27:360–374.CrossRefGoogle Scholar
20.Mueser, KT, Corrigan, PW, Hilton, D, et al.Illness management and recovery: a review of the research. Psychiatr Serv. 2002;53:1272–1284.CrossRefGoogle ScholarPubMed
21.Jordan, BK, Marmar, CR, Fairbank, JA, et al.Problems in families of male Vietnam veterans with posttraumatic stress disorder. J Consult Clin Psychol. 1992;60:916–920.CrossRefGoogle ScholarPubMed
22.Richardson, RD, Engel, CCJ, Hunt, SC, McKnight, K, McFall, MM. Are veterans seeking Veterans Affairs' primary care as healthy as those seeking Department of Defense primary care? A look at Gulf War veterans' symptoms and functional status. Psychosom Med. 2002;64:676–683.Google Scholar
23.Stein, MB, Walker, JR, Hazen, AL, Forde, DR. Full and partial posttraumatic stress disorder: findings from a community survey. Am J Psychiatry. 1997;154:1114–1119.Google ScholarPubMed
24.Diagnostic and Statistical Manual of Mental Disorders. 4th ed. Washington, DC: American Psychiatric Association; 1994.Google Scholar
25.Drake, RE, Becker, DR, Anthony, WA. A research induction group for clients entering a mental health research project. Hosp Community Psychiatry. 1994;45:487–489.Google Scholar
26.Becker, DR, Drake, RE. A Working Life for People with Severe Mental Illness. New York, NY: Oxford University Press; 2003.CrossRefGoogle Scholar
27.Bond, GR, Becker, DR, Drake, RE, Vogler, KM. A fidelity scale for the Individual Placement and Support model of supported employment. Rehabil Courts Bull. 1997;40:265–284.Google Scholar
28.Mueser, KT, Clark, RE, Haines, M, et al.The Hartford study of supported employment for severe mental illness. J Consult Clin Psychol 2004;72:479–490.CrossRefGoogle ScholarPubMed
29.Macias, C, Kinney, R, Rodican, C. Transitional employment: An evaluative description of Fountain House practice. Journal of Vocational Rehabilitation. 1995;5:151–158.CrossRefGoogle Scholar
30.First, MB, Spitzer, RL, Gibbon, M, Williams, JBW. Structured Clinical Interview for DSM-IV Axis-I Disorders. Patient, ed. New York, NY: Biometrics Research Department; 1996.Google Scholar
31.Green, BL. Trauma History Questionnaire. In: Stamm, BH, ed. Measurement of Stress, Self-Report Trauma, and Adaptation. Lutherville, Md: Sidran Press; 1996:366–368.Google Scholar
32.Mueser, KT, Salyers, MP, Rosenberg, SD, Ford, JD, Fox, L, Cardy, P. A psychometric evaluation of trauma and PTSD assessments in persons with severe mental illness. Psychol Assess. 2001;13:110–117.CrossRefGoogle ScholarPubMed
33.Kay, SR, Opler, LA, Fiszbein, A. The Positive and Negative Syndrome Scale (PANSS) for schizophrenia. Schizophr Bull. 1987;13:261–276.CrossRefGoogle ScholarPubMed
34.Rosenberg, M. Society and the Adolescent Self-Image. Princeton, NJ: Princeton University Press; 1965.CrossRefGoogle Scholar
35.Ware, JE, Kosinski, M, Keller, SD. SF-36 Physical and Mental Health Summary Scales: A User's Manual. Boston, Mass: Health Assessment Lab; 1994.Google Scholar
36.Lehman, A, Kernan, E, Postrado, L. Toolkit for Evaluating Quality of Life for Persons with Severe Mental Illness. Baltimore, MD: The Evaluation Center at Human Services Research Institute; 1995.Google Scholar
37.Liang, KY, Zeger, SL. Longitudinal data analysis using generalized linear models. Biometrika. 1986;73:13–22.CrossRefGoogle Scholar
38.Liang, KY, Zeger, SL. Regression analysis for correlated data. Annu Rev Public Health. 1993;14:43–68.CrossRefGoogle ScholarPubMed
39.Harris, M, Fallot, RD. Envisioning a trauma-informed service system: a vital paradigm shift. New Dir Ment Health Serv 2001;89:3–22.CrossRefGoogle Scholar
40.Rosenberg, SD, Mueser, KT, Friedman, MJ, et al.Developing effective treatments for posttraumatic disorders among people with severe mental illness. Psychiatr Serv. 2001;52:1453–1461.CrossRefGoogle ScholarPubMed
41.Harris, M. Trauma Recovery and Empowerment: A Clinician's Guide for Working With Women in Groups. New York, NY: The Free Press; 1998.Google Scholar
42.Mueser, KT, Rosenberg, SD, Jankowski, MK, Hamhlen, J, Descamps, M. A cognitivebehavioral treatment program for posttraumatic stress disorder in severe mental illness. American Journal of Psychiatric Rehabilitation. 2004;7:107–146.CrossRefGoogle Scholar
43.Rosenberg, SD, Mueser, KT, Jankowski, MK, Salyers, MP, Acker, K. Cognitive-behavioral treatment of posttraumatic stress disorder in severe mental illness: Results of a pilot study. American Journal of Psychiatric Rehabilitation. 2004;7:171–186.CrossRefGoogle Scholar
44.Foa, EB, Keane, TM, Friedman, MJ. Guidelines for the treatment of PTSD. J Trauma Stress. 2000;13:539–555.CrossRefGoogle Scholar
45.Mueser, KT, Salyers, MP, Mueser, PR. A prospective analysis of work in schizophrenia. Schizophr Bull. 2001;27:281–296.CrossRefGoogle ScholarPubMed
46.Read, J, Argyle, N. Hallucinations, delusions, and thought disorder among adult psychiatric inpatients with a history of child abuse. Psychiatric Services. 1999;50:1467–1472.CrossRefGoogle ScholarPubMed
47.Surrey, J, Swett, C Jr, Michaels, A, Levin, S. Reported history of physical and sexual abuse and severity of symptomatology in women psychiatric outpatients. Am J Orthopsychiatry. 1990;60:412–417.CrossRefGoogle ScholarPubMed
48.Butler, RW, Mueser, KT, Sprock, J, Braff, DL. Positive symptoms of psychosis in post-traumatic stress disorder. Biol Psychiatry. 1996;39:839–844.CrossRefGoogle Scholar
49.Hamner, MB, Frueh, BC, Ulmer, HG, Arana, GW. Psychotic features and illness severity in combat veterans with chronic posttraumatic stress disorder. Biol Psychiatry. 1999;45:846–852.CrossRefGoogle ScholarPubMed
50.Sautter, FJ, Brailey, K, Uddo, MM, Hamilton, MF, Beard, MG, Borges, AH. PTSD and comorbid psychotic disorder: comparison of veterans diagnosed with PTSD or psychotic disorder. J Trauma Stress. 1999;12:73–88.CrossRefGoogle ScholarPubMed
51.Bustamante, V, Mellman, TA, David, D, Fins, AI. Cognitive functioning and the early development of PTSD. J Trauma Stress. 2001;14:791–797.CrossRefGoogle ScholarPubMed
52.Golier, JA, Yehuda, R, Lupien, SJ, Harvey, PD, Grossman, R, Elkin, A. Memory performance in Holocaust survivors with posttraumatic stress disorder. Am J Psychiatry. 2002;159:1682–1688.CrossRefGoogle ScholarPubMed
53.Clum, GA, Nishith, P, Resick, PA. Trauma-related sleep disturbance and self-reported physical health symptoms in treatment-seeking female rape victims. J Nerv Ment Dis. 2001;189:618–622.CrossRefGoogle ScholarPubMed
54.Hidalgo, RB, Davidson, JRT. Posttraumatic stress disorder: epidemiology and healthrelated considerations. J Clin Psychiatry. 2000;61(suppl 7):5–13.Google ScholarPubMed
55.Zlotnick, C, Bruce, S, Weisberg, RB, Shea, MT, Machan, J, Keller, M. Social and health functioning in female primary care patients with post-traumatic stress disorder with and without comorbid substance abuse. Compr Psychiatry. 2003;44:177–183.CrossRefGoogle ScholarPubMed
56.Kuhn, E, Blanchard, EB, Hickling, EJ. Posttraumatic stress disorder and psychosocial functioning within two samples of MVA survivors. Behav Res Ther. 2003;41:1105–1112.CrossRefGoogle ScholarPubMed
57.Roberts, WR, Penk, WE, Gearing, ML, Robinowitz, R, Dolan, MP, Patterson, ET. Interpersonal problems of Vietnam combat veterans with symptoms of posttraumatic stress disorder. J Abnorm Psychol. 1982;91:444–450.CrossRefGoogle ScholarPubMed
58.Becker, DR, Drake, RE, Bond, GR, Xie, H, Dain, BJ, Harrison, K. Job terminations among persons with severe mental illness participating in supported employment. Community Ment Health J. 1998;34:71–82.CrossRefGoogle ScholarPubMed