Examining PTSD Symptoms and the Effectiveness of Group Therapy Among African American and Caucasian Veterans

Millions of Americans have served in the military, and improved survival rates in wars have increased the percentage of those who return home. Posttraumatic stress disorder (PTSD) is one of the most prevalent mental health diagnoses for veterans. Although few studies have examined the link, previous research as well as the minority stress model and transgenerational trauma theories, suggest that race may be associated with PTSD, particularly in military samples. The current study examined whether there were differences in PTSD symptomology (global and symptom cluster-specific) based on veterans’ race and whether group therapy effectively reduced symptoms of PTSD. Data were collected from male veterans who identified as non-Hispanic Caucasian or non-Hispanic African American (N = 450) and participated in a 10-week, combat-related, group therapy PTSD Recovery Program between 2010 and 2014. Participants completed the Posttraumatic Stress Disorder Checklist- Military version (PCL-M) measure at three time points (intake, pre-treatment, and post-treatment). Global PTSD symptoms and three of the four symptom clusters did not differ between African American and Caucasian participants at intake. However, the symptom cluster of re-experiencing was higher for African Americans compared to Caucasians at intake. Additionally, the Recovery Program led to a reduction in PCL-M scores. This symptom reduction occurred regardless of race, with neither racial group improving more than the other. Moreover, dropout rates for the Recovery Program were on par or better than those for other trauma-focused therapies. Although the overall racial and ethnic composition of groups was not related to most outcomes, the percentage of racial/ethnic minority members in groups was negatively associated with the number of sessions attended for Caucasians. Findings also indicated that the PCL-M demonstrated good psychometric properties in an African American sample. One implication from this study is that the current conceptualization and measurement of PTSD may be insufficient. It may be more helpful to examine specific PTSD symptom clusters, especially when assessing differences by race. The effectiveness of the PTSD Recovery Program supports alternative options to treating veterans with PTSD in the VA system. Last, it is important for therapists to consider the composition of groups when conducting group therapy