1. Posttraumatic Stress Disorder in Veterans Leticia Flores, PhD* E Justice Works Leadership Development Training October 23, 2014 23, 2014 Washington, DC * University of Tennessee

2. Goals for Talk PTSD as Diagnosis What does PTSD look, feel, sound like Relationship between PTSD and Substance Abuse (SA) Evaluating PTSD

3. PTSD Criteria (DSM-V, APA 2014) A. Exposure to actual or threatened death, serious injury or sexual violation (at least one)

4. 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

5. 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

6. PTSD Criteria Specify whether: Accompanied by recurrent, persistent dissociative symptoms Depersonalization Derealization Specify if: With delayed expression

7. Impairment and DSM-5 Old model- GAF New model- WHODAS You may want to make sure assessment includes this measure of impairment

8. 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

9. PTSD and SA Self-medication may often begin while on tour can start/increase once home

10. 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