Latino Veterans with PTSD: A Systematic Review
The primary goal of this systematic review was to analyze the existing literature on Latino veterans with PTSD and critically evaluate attention to cultural issues. The objectives were to: describe the characteristics of research articles on Latino veterans with PTSD, identify the extent to which cultural factors were included, synthesize primary results of included articles, and discuss gaps in the literature and needs for future research.
Methods: This systematic review adhered to the strategies outlined in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses, designed to improve quality and transparency of systematic reviews. An EBSCO search engine, covering multiple databases was used in conjunction with a separate search of the Published International Literature on Traumatic Stress database and manual review of reference lists to identify a total of 207 unique potential sources.
All articles were screened for the following inclusion criteria: quantitative or qualitative study reporting results related to Latino U.S. veterans with PTSD, peer-reviewed, available in English, and published since 1980. Data from on study design, sample size, percent Latino, percent women, data source/setting, veteran service era, PTSD measure, key findings, and cultural considerations the eligible articles was extracted for analysis. The articles were sorted based on key findings into two categories (assessment or treatment related), synthesized, and critiqued.
Results: Twenty-nine articles focused on assessment and treatment topics from prevalence to treatment outcomes were identified. All articles were quantitative, with mostly VA samples ranging from 18 to 732,085 veterans (4.2 - 100% Latino). The majority of the studies used Vietnam era veteran samples and did not include Latinas. Only 13 of the studies mentioned culture as part of the context for Latino veterans, and only seven included cultural factors as part of the design of the study.
Related to assessment, mixed results tend to support that Latino veterans are more at risk for PTSD than non-Latino White veterans. Lower pre-combat age, lower education, lower Armed Forces Qualification Test (AFQT) scores and higher exposure to combat may explain these differences. Related to treatment, Latino veterans may be more likely to receive psychotropic medication, be treated in inpatient PTSD programs, be in treatment groups longer, and be more satisfied with their treatment than non-Latino White veterans. There is limited evidence that Latino Veterans do as well as non-Latino White veterans in treatment for PTSD.
Conclusion and Implications: Findings highlight lack research focused on understanding cultural factors related to assessment and treatment of Latino veterans with PTSD. Culturally informed research on Latino veterans from current wars, Latina veterans, and Latino veteran treatment outcomes are necessary for provide culturally appropriate care to this growing veteran subgroup.