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Psychiatry Res. 2018 May;263:108-114. doi: 10.1016/j.psychres.2018.02.045. Epub 2018 Mar 30.

Going direct to the consumer: Examining treatment preferences for veterans with insomnia, PTSD, and depression.

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National Center for PTSD Women's Health Sciences Division, VA Boston Healthcare System, Boston, MA, USA; Boston University School of Medicine, Boston, MA, USA. Electronic address:
RAND Corporation, Santa Monica, CA, USA.
Monash Institute for Cognitive and Clinical Neuroscience, School of Psychological Sciences, Monash University, Australia.


Inclusion of consumer preferences to disseminate evidence-based psychosocial treatment (EBPT) is crucial to effectively bridge the science-to-practice quality chasm. We examined this treatment gap for insomnia, posttraumatic stress disorder (PTSD), depression, and comorbid symptoms in a sample of 622 young adult veterans through preference in symptom focus, treatment modality, and related gender differences among those screening positive for each problem. Data were collected from veteran drinkers recruited through targeted Facebook advertisements as part of a brief online alcohol intervention. Analyses demonstrated that veterans reported greater willingness to seek insomnia-focused treatment over PTSD- or depression-focused care. Notably, even when participants screened negative for insomnia, they preferred sleep-focused care to PTSD- or depression-focused care. Although one in five veterans with a positive screen would not consider care, veterans screening for both insomnia and PTSD who would consider care had a preference for in-person counseling, and those screening for both insomnia and depression had similar preferences for in-person and mobile app-based/computer self-help treatment. Marginal gender differences were found. Incorporating direct-to-consumer methods into research can help educate stakeholders about methods to expand EBPT access. Though traditional in-person counseling was often preferred, openness to app-based/computer interventions offers alternative methods to provide veterans with EBPTs.


Comorbidity; Depression; Insomnia; PTSD; Psychosocial treatment; Treatment preference; Veteran

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