A qualitative study of veterans' mixed emotional reactions to receiving a PTSD diagnosis

Many veterans do not engage in needed mental health care. To address this problem, we need to understand these patients' experiences from the very start of their care, which includes the assessment and diagnosis process and the communication of that diagnosis to the patient. The patient's reaction to this process can set the tone for the patient's relationship with the mental health system and his or her therapist, yet therapists often receive little training in how to most effectively provide a diagnosis to patients. Prior research has examined emotional reactions to receiving a psychotic spectrum diagnosis, which sometimes included both positive and negative reactions, but to the authors' knowledge, no work has examined reactions to receiving a posttraumatic stress disorder (PTSD) diagnosis. This qualitative study expands upon that work by examining common reactions to receipt of a PTSD diagnosis among low treatment-engaging veterans, changes in that reaction over the first few weeks postdiagnosis, and differences among reactions across veterans who initiate versus refuse evidence-based psychotherapy. Among 50 participants, self-reported reactions were categorized as positive, neutral, and negative. Positive reactions included validation, hope, and proactivity; neutral reactions included confusion, uncertainty, and acceptance; and negative reactions included shock, denial, and fear of stigma. We discuss recommendations for therapists in providing diagnoses in a patient-centered, cognitive-behavioral therapy-consistent way, to maximize the chances of engaging patients into mental health care. (PsycINFO Database Record (c) 2019 APA, all rights reserved).