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Institute of Medicine (IOM) report titled: Posttraumatic Stress Disorder: Diagnosis and Assessment.
VA's Best Practice Manual for
Posttraumatic Stress Disorder (PTSD) Compensation and Pension Examinations, available for viewing or download here.
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In response to growing national concern about the number of veterans who might be at risk for posttraumatic stress disorder (PTSD) as a result of their military service, the Department
of Veterans Affairs (VA) asked the Institute of Medicine (IOM) to conduct a study on the
diagnosis and assessment of, and treatment and compensation for PTSD. An existing IOM
committee, the Committee on Gulf War and Health: Physiologic, Psychologic and Psychosocial Effects of Deployment-Related Stress, was asked to conduct the diagnosis, assessment, and treatment aspects of the study because its expertise was well-suited to the task. The committee was specifically tasked to review the scientific and medical literature related to the diagnosis and assessment of PTSD, and to review PTSD treatments (including psychotherapy and pharmacotherapy) and their efficacy. In addition, the committee was given a series of specific questions from VA regarding diagnosis, assessment, treatment, and compensation. The questions pertaining to diagnosis and assessment and the committees responses are provided in Appendix
A. This report is a brief elaboration of the committees responses to VAs questions, not a detailed discussion of the procedures and tools that might be used in the diagnosis and assessment of PTSD.
The committee decided to approach its task by separating diagnosis and assessment from treatment and preparing two reports. This first report focuses on diagnosis and assessment of
PTSD. Given VAs request for the report to be completed within 6 months, the committee elected to rely primarily on reviews and other well-documented sources. A second report of this
committee will focus on treatment for PTSD
CONTENTS
EXECUTIVE SUMMARY.........................................
Characteristics of Posttraumatic Stress Disorder.....................1
Current Diagnostic Criteria.............................2
Clinical Diagnosis and Assessment.................2
Assessment Instruments.........................3
1 INTRODUCTION................................................5
Characteristics of Posttraumatic Stress Disorder............5
Committees Task and Approach..................................6
Organization of the Report............................................7
References.....................................................................7
2 DIAGNOSIS AND ASSESSMENT..................................9
Current Diagnostic Criteria.............................................9
Clinical Diagnosis .........................................................11
Assessment..............................................................13
Biomarkers of Posttraumatic Stress Disorder.............15
Conclusion ...................................................................15
References.....................................................................15
3 ASSESSMENT INSTRUMENTS......................................19
Diagnostic Interviews ......................................................19
Self-Reports of Traumatic Events.............................................21
Nondiagnostic Assessment and Screening Instruments...........21
Conclusion .......................................................................23
References........................................................................23
APPENDIXES
A SPECIFIC QUESTIONS POSED BY THE DEPARTMENT OF
VETERANS AFFAIRS TO THE INSTITUTE OF MEDICINE 27
Reference.......................................................................30
B ESTABLISHING POSTTRAUMATIC STRESS DISORDER
AS A PSYCHIATRIC
DISORDER................................................................31
Core Clinical Features................................................32
Differentiating Posttraumatic Stress Disorder from Other Disorders 33
Conducting Laboratory Studies of Posttraumatic Stress Disorder..34
Demonstrating Temporal Stability of Posttraumtic Stress Disorder 34
Determining Whether Posttraumatic Stress Disorder Aggregates
in Families...................35
Conclusion ...............................................36
References...........................................................36
Copyright © National Academy of Sciences. All rights reserved.
Posttraumatic Stress Disorder: Diagnosis and Assessment
http://www.nap.edu/catalog/11674.html
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C RISK AND PROTECTIVE FACTORS...........................39
Risk Factors................................................................39
Protective Factors.............................................................43
Conclusion .................................................................43
References..............................................................44
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