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An Overview Of Post-Traumatic Stress Disorder: What Vocational Rehabilitation Specialists Need to Know. Jennifer Olson-Madden, PhD VISN 19 Eastern Colorado Healthcare System Mental Illness Research, Education and Clinical Center. Synopsis of Presentation.
Jennifer Olson-Madden, PhD
VISN 19 Eastern Colorado Healthcare System
Mental Illness Research, Education and Clinical Center
(Keane et al., 2006)
Only 1/3 of Iraq war veterans accessed mental health services first year of post-deployment (Hoge, Auchterloine & Milliken, 2006)
Recognition of PTSD or other trauma-related symptoms can:
Optimize clients’ overall healthcare and treatment through referral and triage
Aid in understanding and taking action around clients’ difficulties in the work settingRelevance for Vocational Rehabilitation Specialists
Information during this presentation is for educational purposes only – it is not a substitute for informed medical advice or training. You should not use this information to diagnose or treat a mental health problem without consulting a qualified professional/provider
An anxiety disorder resulting from exposure to an experience involving direct or indirect threat of serious harm or death; may be experienced alone (rape/assault) or in company of others
One re-experiencing symptom
Marked anxiety or increased arousal
Evidence of significant distress or impairment
Three dissociative symptoms: a subjective sense of numbing/detachment, reduced awareness of one’s surroundings, derealization, depersonalization, or dissociative amnesia
ASD is considered a predictor or PTSD, though not a necessary precondition
- To meet criteria for PTSD, symptom duration must be at least one month
- Often, the disorder is more severe and lasts longer when the stress is of human design (i.e., war-related trauma)
Social and Interpersonal
- Relationship issues
- Low self-esteem
- Alcohol and substance abuse
- Employment problems
- Trouble with the law
- Substance use
- Suicidal attempts
- Risky sexual behavior
- Reckless driving
Long-term, prolonged (months or years), repeated trauma or total physical or emotional control by another
- Long-term, severe domestic
or physical abuse
APA, 1994; 2000
Veterans with PTSD are also at risk for:
- Traumatic Brain Injury
Blast injuries are the leading cause of injury in the current conflict (DVBIC, 2005)
Being thrown, debris, burns
Research shows that among TBI patients who have a memory for the event, they were more likely to develop PTSD than those with no memory
Harvey & Bryant, 1998; 2000
Recreation and Self-care (i.e. sleep hygiene
Past distress and coping
Previous traumatic events
Deployment-related experiencesConsiderations for Comprehensive Assessment of OIF/OEF veterans
Cozza et. al., 2004
“In your life, have you had any experiences that were so frightening, horrible, or upsetting that in the past month you..”
* Endorsement of three items suggests that PTSD follow-up is warranted for a formal diagnosis
Prins, et.al., 2004
Keane, et.al., 2006
Veteran’s Affairs services: www.va.gov
National Centers for PTSD www.ncptsd.va.gov or www.ncptsd.org
VA Health Benefits Service Center 1.877.222.VETS or 1.800.827.1000
Vet Centers’ national number 1.800.905.4675
PTSD support groups can be located through VA, National Alliance for Mental Illness (NAMI), or About.com’s trauma resource page
Department of Health Services- in the blue government pages of the phone book
The Center for Mental Health Services Locator http://www.mentalhealh.samhsa.gov/databases/
Anxiety Disorders Association of America (ADAA)
Association for Advancement of Behavioral and Cognitive Therapies (database for CBT therapists)
National Institute on Alcohol Abuse and Alcoholism http://www.niaaa.nij.gov/faq/faq.htm
Substance Abuse Treatment Facility Locator http://findtreatment.samhsa.gov/
Stanford University Center for Excellence in the Diagnosis and Treatment of Sleep Disorders: www.med.stanford.edu/school/psychiatry/coe/
National Mental Health Hotline 1.800.969.NMHA (6642)
National Resource Center on Homelessness and Mental Illness 1.800.444.7415
National Suicide Prevention Lifeline 1.800.273.TALK (8255)
SAMHSA’s Center for Substance Abuse Treatment 1.800.662.HELP
Su Familia (Office of Minority Health Resources) 1.866.783.2645
Blast Injury: www.dvbic.org/blastinjury.html
Projects for Assistance in Transition from Homelessness (PATH) – 1.800.795.5486
Job Accommodation Network: www.jan.wvu.edu
Iraq War Clinician Guide, 2nd Edition; www.ncptsd.va.gov
American Psychiatric Association (1994). Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. American Psychiatric Association: Washington, D.C.
American Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revised. American Psychiatric Association: Washington, D.C.
Cozza, S.J., Benedek, D.M., Bradley, J.C., Grieger, T.A. (2004). Topics specific to the psychiatric treatment of military personnel. In Iraq War Clinician’s Guide (2nd Ed.). http://www.ncptsd.va.gov/war/guide/index.html
Defense and of Veteran Brain Injury Center. http://www.dvbic.org/blastinjury.html. Downloaded 09/15/2007.
Duke, L.M. & Vasterling, J.J. Epidemiological and methodological issues in neuropsychological research on PTSD. In Neuropsychology of PTSD: Biological, Cognitive and Clinical Perspectives. Vasterling & Brewin, Eds. The Guilford Press: 2005.
Harvey, A.G., & Bryant, R.A. (1998). Predictors of acute stress following mild traumatic brain injury. Brain Injury, 12, (2): 147-154.
Harvey, A.G. & Bryant, R.A. (2000). Two-year prospective evaluation of the relationship between acute stress disorder and posttraumatic stress disorder following traumatic brain injury. The American Journal of Psychiatry, 157, (4): 626-628.
Hoge, C.W., Castro, C.A., Messer, S.C., McGurk, D. (2004). Combat duty in Iraq and Afghanistan, mental health problems and barriers to care. The New England Journal of Medicine, 35, (1): 13-22.
Hoge, C.W., Auchterloine, J.L., Milliken, C.S. (2006). Mental health problems, use of mental health services, and attrition from military service after returning from deplloyment to Iraq or Afghanistan. Journal of the American Medical Association, 295, 1023-1032.
Insurance Information Institute. http://www.iii.org.
National Center for PTSD. http://www.ncptsd.va.gov
Prins, A., Ouimette, P., Kimerling, R., Camerond, R.P., Hugelshofer, D.S., Shaw-Hegwar, J., Thraikill, A., Gusman, F.D., Sheikh, J.I. (2004). The primary care PTSD screen (PC-PTSD): development and operating characteristics. Primary Care Psychiatry, 9 (1), January 2004, 9-14.