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Posttraumatic Stress
Disorder in Veterans
Leticia Flores, PhD*
E Justice Works Leadership Development Training
October 23, 2014 23, 2014
Washington, DC
* University of Tennessee
Goals for Talk
• PTSD as Diagnosis
• What does PTSD look, feel, sound like
• Relationship between PTSD and Substance Abuse (SA)
• Evaluating PTSD
PTSD Criteria
(DSM-V, APA 2014)
• A. Exposure to actual or threatened death,
serious injury or sexual violation (at least one)
PTSD Criteria
• B. Presence afterward of intrusive symptoms related
to traumatic event
• C. Avoidant behaviors
• D. Negative alterations in cognitions and mood
• E. Marked alterations in arousal and reactivity
associated with the traumatic event, beginning or
worsening after the event
PTSD Criteria
• F. Disturbance lasts for more than one month
• G. Disturbance causes significant distress and social,
occupational, and other impairment *
• H. Disturbance is not attributable to medication,
alcohol, or other medical conditions
PTSD Criteria
• Specify whether:
• Accompanied by recurrent, persistent dissociative
• Depersonalization
• Derealization
• Specify if:
• With delayed expression
Impairment and DSM-5
• Old model- GAF
• New model- WHODAS
• You may want to make sure assessment includes this
measure of impairment
So, What does PTSD Look
Like in Real Life?
• A- exposure
• B- intrusive symptoms
• C- avoidance
• D- negative cognitions/mood
• E- alterations in arousal/reactivity
• F- Duration > 1 month
• G- Clinically significant distress/impairment
• H- Disturbance not attributed to other conditions
• Self-medication
• may often begin while on tour
• can start/increase once home
Testing for PTSD
• Assessment focuses on
Trauma symptomology
Past/co-occurring mental health issues
Degree of impairment (WHODAS)
Motivation/secondary gain issues
Secondary sources to verify event (via records,
collaborating colleagues)
• Last two enhance credibility of report