 |
|
VA should revise its methods for evaluating and rating PTSD in veterans
May 09, 2007WASHINGTON -- To ensure more consistent and appropriate disability compensation for veterans, the U.S. Department of Veterans Affairs (VA) needs to revise how it evaluates former military personnel for service-connected post-traumatic stress disorder (PTSD) and determines the payment amounts they merit, says a new report from the Institute of Medicine and National Research Council. A surge in the number of disability claims for PTSD has revealed inconsistencies in compensation levels awarded across the country, raising questions about the effectiveness of the VA's current ways of assessing and rating this condition, and whether some veterans are getting payments that are too low, too high, or unmerited.
The agency should develop new evaluation methods and rating criteria specific to PTSD to replace current standards that yield a crude and overly general assessment of PTSD disability, said the committee that wrote the report. It urged the VA to base compensation decisions on how greatly PTSD affects all aspects of a veteran's daily life, not just his or her ability to be gainfully employed.
The agency also should ensure that all veterans applying for PTSD compensation receive a thorough, initial evaluation by an experienced clinical professional. These exams should be of sufficient duration to provide a detailed picture of each veteran's condition so that disability raters -- non-clinical personnel who determine whether a disability is connected to military service and the level of impairment it entails -- can make more consistent and better informed decisions about the level of compensation each veteran merits. More thorough evaluations also would enhance VA's ability to detect inappropriate claims, though the committee confirmed that PTSD symptoms can manifest many years after a traumatic event or may interfere with a veteran's ability to function only later in life.
"As the increasing number of claims to the VA shows, PTSD has become very significant public health problem, particularly for veterans of current and past conflicts," said committee chair Nancy Andreasen, Andrew H. Woods Chair of Psychiatry and director, Psychiatric Neuroimaging Research Center, Carver College of Medicine, University of Iowa, Iowa City. "Our review of the current methods for evaluating PTSD disability claims and determining compensation indicates that a comprehensive revision is needed."
Recent years have seen a spike in PTSD claims and a significant increase in disability payments for the condition. The number of cases jumped almost 80 percent between fiscal years 1999 and 2004, growing from 120,265 cases to 215,871. Payments for PTSD increased almost 150 percent over the same period, rising from $1.72 billion to $4.28 billion. The bulk of claims for PTSD compensation currently are coming from Vietnam War veterans who comprise the majority of living veterans, but claims also are being made by former service personnel of earlier conflicts as well as personnel who served in the first Gulf War and in the current conflicts in Iraq and Afghanistan. There likely will be many more claims from the latter group in the future, so how this issue is resolved now will eventually affect many active duty personnel.
A thorough, initial evaluation by an experienced professional is crucial to improving PTSD compensation decisions, the committee said. These exams determine whether former service members are experiencing PTSD and how severe it is. Currently, the time devoted to the evaluations varies widely as does the amount of detail examiners provide to the raters who determine the appropriate level of compensation. Moreover, many veterans denied compensation eventually receive it after applying for re-evaluation, sometimes multiple times. Ensuring that every veteran making a claim receives a comprehensive evaluation could make the process more efficient.
The report offers a starting point to help VA devise new ratings criteria specific to PTSD. The committee emphasized the need to rate PTSD disability based on a fuller range of an individual's capacity to function, not just on his or her ability to work. The focus on occupational impairment in the current rating scheme penalizes veterans who can and do work despite their symptoms, and may serve as a disincentive to work, the report says.
Many disability claims are being submitted by veterans who have been out of military service for several years, which has prompted questions about how long after a traumatic event PTSD can manifest and whether standardized tests could detect dissembling if someone tried to make a fraudulent claim. The committee found abundant evidence that PTSD can develop at any time after exposure to trauma. It also can manifest as a relapsing condition or flare up after being suppressed and undiagnosed. Aging, loss of mental acuity, the death of friends or spouses, and other factors can trigger or exacerbate symptoms as well. Standardized tests can be a useful part of an assessment, but they are no substitute for a thorough clinical assessment by a trained professional, the committee concluded.
Combat exposure is not the only potential trigger for PTSD among service members; sexual assault is another form of trauma. The available information suggests that female veterans are less likely to receive compensation for PTSD, which may in part be due to the difficulty of substantiating exposure to traumatic events unrelated to combat, including sexual harassment or assaults that occurred during service. VA should make a concerted effort to gather data and provide reference materials to help disability raters better address the management of PTSD claims related to sexual assault during military service, the report says.
The National Academies
"As the increasing number of claims to the VA shows, PTSD has become very significant public health problem, particularly for veterans of current and past conflicts," said committee chair Nancy Andreasen, Andrew H. Woods Chair of Psychiatry and director, Psychiatric Neuroimaging Research Center, Carver College of Medicine, University of Iowa, Iowa City. "Our review of the current methods for evaluating PTSD disability claims and determining compensation indicates that a comprehensive revision is needed."
Recent years have seen a spike in PTSD claims and a significant increase in disability payments for the condition. The number of cases jumped almost 80 percent between fiscal years 1999 and 2004, growing from 120,265 cases to 215,871. Payments for PTSD increased almost 150 percent over the same period, rising from $1.72 billion to $4.28 billion. The bulk of claims for PTSD compensation currently are coming from Vietnam War veterans who comprise the majority of living veterans, but claims also are being made by former service personnel of earlier conflicts as well as personnel who served in the first Gulf War and in the current conflicts in Iraq and Afghanistan. There likely will be many more claims from the latter group in the future, so how this issue is resolved now will eventually affect many active duty personnel.
A thorough, initial evaluation by an experienced professional is crucial to improving PTSD compensation decisions, the committee said. These exams determine whether former service members are experiencing PTSD and how severe it is. Currently, the time devoted to the evaluations varies widely as does the amount of detail examiners provide to the raters who determine the appropriate level of compensation. Moreover, many veterans denied compensation eventually receive it after applying for re-evaluation, sometimes multiple times. Ensuring that every veteran making a claim receives a comprehensive evaluation could make the process more efficient.
The report offers a starting point to help VA devise new ratings criteria specific to PTSD. The committee emphasized the need to rate PTSD disability based on a fuller range of an individual's capacity to function, not just on his or her ability to work. The focus on occupational impairment in the current rating scheme penalizes veterans who can and do work despite their symptoms, and may serve as a disincentive to work, the report says.
Many disability claims are being submitted by veterans who have been out of military service for several years, which has prompted questions about how long after a traumatic event PTSD can manifest and whether standardized tests could detect dissembling if someone tried to make a fraudulent claim. The committee found abundant evidence that PTSD can develop at any time after exposure to trauma. It also can manifest as a relapsing condition or flare up after being suppressed and undiagnosed. Aging, loss of mental acuity, the death of friends or spouses, and other factors can trigger or exacerbate symptoms as well. Standardized tests can be a useful part of an assessment, but they are no substitute for a thorough clinical assessment by a trained professional, the committee concluded.
Combat exposure is not the only potential trigger for PTSD among service members; sexual assault is another form of trauma. The available information suggests that female veterans are less likely to receive compensation for PTSD, which may in part be due to the difficulty of substantiating exposure to traumatic events unrelated to combat, including sexual harassment or assaults that occurred during service. VA should make a concerted effort to gather data and provide reference materials to help disability raters better address the management of PTSD claims related to sexual assault during military service, the report says.
The National Academies
Post-traumatic Stress Disorder Current Events and Post-traumatic Stress Disorder News RSSNew UAB Study Sheds Light on Brain's Response to Distress, Unexpected Events
In a new study, psychologists at the University of Alabama at Birmingham (UAB) are able to see in detail for the first time how various regions of the human brain respond when people experience an unexpected or traumatic event.
Psychiatric impact of torture could be amplified by head injury
Depression and other emotional symptoms in survivors of torture and other traumatic experiences may be exacerbated by the effects of head injuries, according to a study from the Harvard Program in Refugee Trauma (HPRT), based in the Massachusetts General Hospital (MGH) Department of Psychiatry.
Use of cannabinoids (marijuana) could help post-traumatic stress disorder patients
Use of cannabinoids (marijuana) could assist in the treatment of post-traumatic stress disorder patients. This is exposed in a new study carried out at the Learning and Memory Lab in the University of Haifa's Department of Psychology.
MU Researchers Use Computational Models to Study Fear
The brain is a complex system made of billions of neurons and thousands of connections that relate to every human feeling, including one of the strongest emotions, fear.
Researchers unravel mystery behind long-lasting memories
A new study by researchers at Wake Forest University School of Medicine may reveal how long-lasting memories form in the brain.
PTSD associated with higher Alzheimer's/dementia risk; moderate alcohol consumption may lower it
Though discoveries about Alzheimer's disease risk factors are often in the news, adults do not know about the relationship between Alzheimer's disease risk and heart health, nor that physical activity can be protective against dementia.
Neuroscience research could benefit US Army, yet challenge traditional approaches
Advances in neuroscience research could benefit the Army, particularly in areas of soldier training and education. However, an emerging trend of using individual variability in neural processes such as cognition, stress response, and decision making to improve group performance is likely to challenge conventional approaches to training and educating soldiers.
Witnessing violence affects kids' health
School-aged children who witness violence in urban communities show symptoms of post-traumatic stress. They also suffer physiological effects with a disruption to their normal cortisol production pattern during the day, which may have long-term negative effects on their health.
Controlling our brain's perception of emotional events
Research performed by Nicole Lauzon and Dr. Steven Laviolette of the Schulich School of Medicine & Dentistry at The University of Western Ontario has found key processes in the brain that control the emotional significance of our experiences and how we form memories of them.
Researchers reveal how the brain processes important information
Researchers at UT Southwestern Medical Center have shed light on how the neurotransmitter dopamine helps brain cells process important information.
More Post-traumatic Stress Disorder Current Events and Post-traumatic Stress Disorder News Articles
 |
Conquering Post-Traumatic Stress Disorder: The Newest Techniques for Overcoming Symptoms, Regaining Hope, and Getting Your Life Back by Victoria Lemle Beckner (Author), John B. Arden (Author) More than 13 million Americans experience Post Traumatic Stress Disorder, and one out of 13 adults will develop it in their lifetime. Recent worldwide crises and events including the Iraq war; the September 11th attacks; numerous Columbine-like events; the Catholic Church child molestation scandal; and the Katrina tragedy in New Orleans, continue to present thousands more PTSD cases each year in all age groups. This book helps victims make sense of the events that led to their illness and teaches them how to create a new reality with specific advice and action plans that put them on the road to recovery and long-term healing. |
 |
Post-Traumatic Stress Disorder For Dummies (For Dummies (Psychology & Self Help)) by Mark Goulston (Author) As Dr. Mark Goulston tells his patients who suffer from post-traumatic stress disorder (PTSD), "The fact that you’re still afraid doesn’t mean you’re in any danger. It just takes the will and the way for your heart and soul to accept what the logical part of your mind already knows." In Post-Traumatic Stress Disorder For Dummies, Dr. Goulston helps you find the will and shows you the way. A traumatic event can turn your world upside down, but there is a path out of PTSD. This reassuring guide presents the latest on effective treatments that help you combat fear, stop stress in its tracks, and bring joy back into your life. You'll learn how to: Identify PTSD symptoms and get a diagnosis Understand PTSD and the nature of trauma Develop a PTSD treatment... |
 |
War and the Soul: Healing Our Nation's Veterans from Post-Traumatic Stress Disorder by Edward Tick (Author) This book teaches how truly to heal war trauma in veterans, their families, and our communities. Drawing on history, mythology, and soldiers' stories from World War I to Iraq, it affirms the deep damage war does to the psyche and addresses how to reclaim the soul from war's hell. |
 |
The PTSD Workbook: Simple, Effective Techniques for Overcoming Traumatic Stress Symptoms by Mary Beth Williams (Author), Soili Poijula (Author) Post-traumatic stress disorder is an extremely debilitating condition that can occur after exposure to a terrifying event or ordeal. In The PTSD Workbook, readers determine the type of trauma they experienced, identify their physical, mental, and emotional symptoms, and learn effective techniques and interventions to overcome them. They start with the exercise best suited to relieve their worst symptom then progress to less troubling symptoms, picking up key information about PTSD along the way. |
 |
ABC News Nightline Invisible Casualties: Three Part Series |
 |
The Post Traumatic Stress Disorder Relationship: How to Support Your Partner and Keep Your Relationship Healthy by Diane England (Author) War, physical and sexual abuse, and natural disasters. All crises have one thing in common: Victims often suffer from post-traumatic stress disorder (PTSD) and their loved ones suffer right along with them. In this book, couples will learn how to have a healthy relationship, in spite of a stressful and debilitating disorder. They’ll learn how to:Deal with emotions regarding their partner’s PTSD Talk about the traumatic event(s)Communicate about the effects of PTSD to their childrenHandle sexual relations when a PTSD partner has suffered a traumatic sexual eventHelp their partner cope with everyday life issues When someone has gone through a traumatic event in his or her life, he or she needs a partner more than ever. This is the complete guide to keeping the relationship strong and... |
 |
Coping With Post-Traumatic Stress Disorder: A Guide for Families by Cheryl A. Roberts (Author) Post-Traumatic Stress Disorder is a medically recognized disorder that develops as a result of a traumatic event; as a result of PTSD, an individual may suffer nightmares and flashbacks and become hypervigilant, angry, or emotionally numb. This work describes PTSD: causes, symptoms, effects, and coping strategies. While there is no "cure," individuals and their loved ones can find healthy ways to cope, and it is important to recognize the strengths that arise in both individuals and families as a result of living with the disorder. This handbook describes how the characteristics of PTSD manifest in daily life and details its effects on the emotional, mental, and physical aspects of an individual’s life, including disorders and physical disabilities that may occur jointly or as... |
 |
Post-traumatic and Acute Stress Disorders: The Latest Assessment and Treatment Strategies by Matthew J. Friedman (Author) Approximately half of all men and women will be exposed to a traumatic event, such as: assault, terrorism, military combat, car accident, domestic violence, or natural disaster. Of those exposed, eight percent of Americans and 20-30 percent of people elsewhere will develop trauma-related symptoms that impair day-to-day functioning. Who is at risk, and what is the likelihood of recovery? How does PTSD differ from other acute stress disorders? Get answers from the expert, plus: Targeted case studies Assessment and treatment guidelines for children and adolescents as well as adults Information on over 38 assessment tools 8 cognitive behavioral therapies and eye movement desensitization Comparative table of PTSD medication dosages, indications, and contraindications ... |
 |
Healing from Post-Traumatic Stress by Monique Lang (Author) An effective, life-affirming guide to help you get through your traumatic experience Written by an experienced psychotherapist who has helped hundreds of trauma victims in her private practice, workshops, and lectures, this unique, progressive approach to healing is designed to help you cope with the aftermath of a stressful event. An informative guide with a user-friendly format, this workbook invites you to participate in the process of your recovery, using simple anxiety-reducing exercises, revealing questions, yoga and meditation tools, art therapy, writing, and other therapeutic techniques. |
| © 2009 BrightSurf.com |