(PS4-88) Examining Trends Among Military Personnel with Sexual and Gender Minoritized Identities Receiving Augmented PTSD treatment with Stellate Ganglion Block

Abstract Text: Posttraumatic stress disorder (PTSD) is the most frequently diagnosed mental health condition among veterans and military personnel, with prevalence significantly higher among women than men. Studies also suggest military personnel with gender and sexual minoritized (SGM) identities hold greater risk for PTSD and report long-term mental health challenges including suicidal thoughts and behaviors (STB). Adjunctive treatments to psychotherapy such as massed Cognitive Processing Therapy (mCPT) can result in sustained symptom improvements; research shows that a stellate ganglion block (SGB) significantly reduces common hyperarousal symptoms. Given limited research into treatment experiences and outcomes for SGM military personnel, and high prevalence of PTSD and STBs within this group, we sought to examine these trends among SGM military personnel receiving mCPT treatment with adjunctive SGB.

The study involved a single-blind randomized clinical trial with a waitlist control. US military personnel and veterans receiving virtual mCPT were randomly assigned to receive the SGB procedure during the first week or three months after mCPT. Participants completed the Life Events Checklist for the DSM-5 (LEC-5), PTSD Checklist for DSM-5 (PCL-5), Patient Health Questionnaire (PHQ-9) and the Self-Injurious Thoughts and Behaviors Inventory-Revised (SITBI-R) multiple times during the study period.

Data collection remains ongoing. Participants were 71 US military personnel and veterans (Mage=41.4, SD=9.1) who mostly identified as non-Hispanic (90%), White (85%), and male (75.7%). Seventeen participants identified as female, and six (8.5%) participants held another sexual or gender minoritized identity. Of SGM participants, (i.e., female or LGB), the average PCL-5 score was 55.3 (95% CI [49.3-61.2]) versus their heterosexual/cisgender/male counterparts (47.2; 95% CI [42.4-52.0]). Among those with SGM identities, 15 (88.2%) endorsed experiencing items 8 and 9 around sexual violence or another unwanted sexual experience on the LEC-5. Finally, of SGM participants, the average PHQ-9 score was 18.1 (95% CI [16.0-20.2]) versus their counterparts 16.0 (95% CI [14.6-17.4]), with 88.2% (15) SGM participants reporting lifetime suicidal ideation using the SITBI-R. We intend to include results from our repeated measures analysis of PTSD and depressive symptoms upon completion of the study in April.

Our findings reinforce previous literature showing a higher prevalence of PTSD and related symptoms among SGM individuals and reveal that this remains true among SGM military personnel. mCPT with augmented SGB presents as noninferior for SGB participants. Future research should prioritize understanding treatment outcomes and recommendations among SGM military personnel.