Treatment for Posttraumatic Stress Disorder in Military and Veteran Populations Final Assessment (2014) / Chapter Skim
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2 Diagnosis, Course, and Prevalence of PTSD
2 Diagnosis, Course, and Prevalence of PTSD
Pages 29-46
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military and veteran populations. DIAGNOSTIC CRITERIA FOR PTSD In May 2013, the American Psychiatric Association released revised PTSD criteria in DSM-5 (see Table 2-1)
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Intense psychological distress at if the traumatic event(s) were recurring.
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Efforts to avoid thoughts, or physical sensations) that arouse feelings, or conversations recollections of the traumatic event(s)
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In addition, the person must experience clinically significant distress or functional impairment. The DSM-IV-TR A2 criterion that the person's response to a traumatic event involved intense fear, helplessness, or horror, has been removed.
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Numerous factors influence treatment outcomes, and no single treatment, even ones that have substantial evidence bases, has been demonstrated to be effective for everyone who has PTSD. It has been suggested that about 33% of people in the general population who have PTSD are resistant to treatment; the non-response rates for cognitive behavioral therapy may be as high as 50% and for selective serotonin reuptake inhibitors about 20–40% (Green, 2013)
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It bears noting that PTSD is not the only health problem that service members and veterans may have; many of them have no PTSD, whether they were exposed to a traumatic event or not, but they may have other mental and physical health conditions not only as a result of their military service but from aging, lifestyle, and family history. Diagnosis and treat
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military and veteran populations, data on the overall prevalence of the disorder and other mental health disorders in the general U.S. population are discussed below.
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(2007) report that United Kingdom forces who deployed for 13 months or more in a 3-year time frame "were more likely to fulfill the criteria for posttraumatic stress disorder." The frequency and duration of exposure to traumatic events during deployment has been associated with an increased risk for the development of PTSD (Tanielian and Jaycox, 2008; see the phase 1 report for a more detailed discussion of deployment-related risk factors for PTSD)
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Some service members may leave active duty but remain eligible for care in the MHS as retirees or as dependents. For example, if a male soldier is in the Army National Guard but his wife is on active duty, he is included both while he is activated as a National Guard member and after he is deactivated.
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9,252 (3.2) Component Active Duty 2004 455,256 5,496 (1.2)
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The prevalence of PTSD was 8% in those without any injuries, 13% in those with a penetrating injury, 29% with blunt trauma, and 33% with combination injuries. Data from the Armed Forces Health Surveillance Center shows that from January 1, 2000, to December 31, 2012, there were 11,033 hospitalizations of active-duty service members (all service branches)
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In VA, the most common co-occurring mental health disorders among all veterans (male, female, OEF and OIF, and non-OEF or OIF) in 2013 were dysthymia, anxiety disorder, major depressive disorder, alcohol or drug use disorders, and bipolar disorders.
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. Data from DoD and VA show marked increases in PTSD among military service and veteran populations.
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2004. The differential association of intimate partner physical, sexual, psychological, and stalking violence and posttraumatic stress symptoms in a nationally representative sample of women.
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2009. A prospective study of posttraumatic stress disorder symptoms and coronary heart disease in women.
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2008. Posttraumatic stress disorder and employment in veterans participating in Veterans Health Administration compensated work therapy.
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1997. Posttraumatic stress disorder and functioning and quality of life outcomes in a nationally representative sample of male Vietnam veterans.
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