Assessment Of Veterans Research Articles

Predicting secondary posttraumatic stress symptoms among spouses of veterans: Veteran's distress or spouse's perception of that distress?

There is a relatively wide consensus that veterans' posttraumatic stress symptoms (PTSS) may lead to the development of secondary traumatization (ST) among their spouses. However, there is limited knowledge about the way the ST develops over time, as well as its predictors. The current longitudinal study examined ST trajectories among spouses of Israeli war veterans with PTSS, as well as the contribution of veterans' PTSS and wives' assessment of veterans' PTSS to these trajectories. Data were collected from both spouses at 3 time points, 30, 35-37, and 42 years after the 1973 Yom Kippur War (2003, 2008-2010, and 2015, respectively). Using multiple-group Latent Class Growth Analysis (LCGA), we identified 4 distinct ST trajectories. The majority of wives (68%) were in the resilient group, 12% were in the recovery group, approximately 10% were in the chronic PTSS group and another 10% were in the delayed-onset group. Multinomial regressions revealed that veterans' PTSS predicted the 4 different trajectories among their wives. In addition, wives in the recovery and chronic groups who perceived their veteran husbands' PTSS to be higher also reported higher ST. This study highlights the complexity of the development of ST trajectories over time. Findings supports the idea of PTSS contagion, and reveals the contributing role of both objective and perceived levels of veterans' PTSS in ST. Therefore, implementing interventions aimed at alleviating both individual and couple-level distress may be warranted. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Workplace Perceptions of Veterans and Nonveterans in the Department of Veterans Affairs

Much has been written about veterans and their reintegration into civilian society, but little or no information is available about veterans’ workplace perceptions and how these might differ from those of nonveterans. The authors compared veterans’ and nonveterans’ attitudes about work (including job satisfaction aspects, perceptions of coworker interactions, supervisory support, and others) in the U.S. Department of Veterans Affairs (VA) based on responses to the organizational census, VA All Employee Survey (AES; N = 179,271). Based on differences in crude (unadjusted, but controlling for location) item odds ratios (range 0.65–1.08), compared to nonveterans, veterans scored modestly lower on most AES items. The authors show how controlling for demographics changes the relative size and, in some cases, the direction of the differences. This current study is 1 of only 2, to our knowledge, large-scale assessments of veterans’ workplace perceptions and the only 1 which controlled the results for demographic characteristics.

Understanding and meeting information needs for patients with posttraumatic stress disorder.

BackgroundPosttraumatic Stress Disorder (PTSD) is a commonly occurring mental illness. There are multiple treatments for PTSD that have similar effectiveness, but these treatments differ substantially in other ways. It is desirable to have well-informed patients involved in treatment choices. A patient decision aid (PtDA) is one method to achieve this goal. This manuscript describes the rationale and development of a patient decision aid (PtDA) designed for patients with PTSD.MethodsWe conducted an informational needs assessment of veterans (n = 19) to obtain their baseline information needs prior to the development of the PtDA. We also conducted a literature review of effective PTSD treatments, and we calculated respective effective sizes. A PtDA prototype was developed according to the guidelines from the International Patient Decision Aid Standards. These standards guided our development of both content and format for the PtDA. In accordance with the standards, we gathered feedback from patients (n = 20) and providers (n = 7) to further refine the PtDA. The information obtained from patients and the literature review was used to develop a decision aid for patients with PTSD.ResultsPatients with PTSD reported a strong preference to receive information about treatment options. They expressed interest in also learning about PTSD symptoms. The patients preferred information presented in a booklet format. From our literature review several treatments emerged as effective for PTSD: Cognitive Therapy, Exposure Therapy, Eye Movement Desensitization Therapy, Selective Serotonin Reuptake Inhibitors, venlafaxine, and risperidone. ConclusionIt appears that the criteria set forth to develop decision aids can effectively be applied to PTSD. The resultant PTSD patient decision aid is a booklet that describes the causes, symptoms, and treatments for PTSD. Future work will examine the effects of use of the PTSD decision aid in clinical practice.Trial registrationClinicaltrials.gov identifier NCT00908440. Registered May 20, 2009.Electronic supplementary materialThe online version of this article (doi:10.1186/s12888-016-0724-x) contains supplementary material, which is available to authorized users.

Hospital-based Clinical Forensic Program in Violence Risk Assessment: Utilization and Management Considerations

Introduction Risk assessment of future disruptive and violent acts is of great importance to public protection and care in the medical setting. The VA Puget Sound created a Disruptive Behavior Evaluation Clinic, which utilizes clinical forensic risk evaluations in its assessments of veterans with disruptive Patient Record Flags or at elevated risk for violent behavior. Objectives This poster will review the results of a utilization study of the Disruptive Behavior Evaluation Clinic after its first two years in operation. Aim To better understand the utilization of the clnic for future targeted interventions and allocation of resources to reduce risk of violent or disruptive behavior at the facility. Methods Medical charts of all evaluees assessed in the Disruptive Behavior Evaluation Clinic were reviewed to assess the evaluee characteristics, mental health and substance abuse histories, recommendations from the forensic evaluator, whether recommendations were followed, and disposition of persons evaluated in the facility's Disruptive Behavior Evaluation Clinic. Results Results indicate that the most common diagnoses for persons evaluated in the clinic to date were alcohol or substance use disorders, personality disorder, and primary psychotic disorders. Demographics, referral source, and disposition outcomes were tabulated. As a result of the forensic risk assessment reports generated by the clnic several evaluees subsequently qualified for housing services. Conclusion The information on utilization is helpful to better assess the characteristics of veterans most prone to violence at one VA facility. It helps the facility allocate risk reduction resources to targeted clinics or programs.

Model for Assessing Disruptive Behavior in the Medical Setting: Pilot Study of Provider Satisfaction

Background: Risk assessment of future disruptive and violent acts is of great importance to public protection and care in the medical setting. The VA Puget Sound, Seattle, is utilizing clinical forensic risk evaluations in its assessments of veterans with disruptive Patient Record Flags or at elevated risk for violent behavior. Aim: To assess and compare provider knowledge, experience, and satisfaction with the clinical forensic risk assessment through the facility's Disruptive Behavior Evaluation Clinic. Method: A pilot internet-based survey was constructed to evaluate provider characteristics, experience, and satisfaction with a new Disruptive Behavior Evaluation Clinic. Members of the hospital's Disruptive Behavior Committee and mental health service lines were asked about their familiarity and confidence in the consultative service. Results: Forty-four providers responded. Of these, 23 providers were familiar with the Disruptive Behavior Evaluation Clinic and its clinical forensic risk assessments. All members of the facility's Disruptive Behavior Committee were familiar with the risk assessments. Members of the Disruptive Behavior Committee as well as clinical providers from the mental health service lines ranked highly the utility of the detailed risk assessments and risk management recommendations. Conclusions: The provider satisfaction survey provided evidence for the overall satisfaction with the use of clinical forensic risk assessments in VA facilities for assessment and management of persons with Patient Record Flags and other indicators of elevated risk of disruptive or violent behavior at one VA hospital.

Psychological health of Australian veterans of the 1991 Gulf War: an assessment using the SF-12, GHQ-12 and PCL-S

Elevated rates of psychological morbidity and symptomatology have been widely reported in 1991 Gulf War veterans. The present study used brief self-report instruments to compare the psychological health of Australian Gulf War veterans with that of a randomly sampled military comparison group. The 12-item Short Form Health Survey (SF-12), 12-item General Health Questionnaire (GHQ-12), Posttraumatic Stress Disorder Checklist--Specific (PCL-S) and Military Service Experience (MSE) questionnaire were administered to 1424 male Australian Gulf War veterans and 1548 male Australian Defence Force members who were operational at the time of the Gulf War conflict, but were not deployed there. The Gulf War veterans exhibited poorer psychological health, as measured by the above three instruments, than the comparison group members. For Gulf War veterans, the number of stressful experiences, as measured by the MSE questionnaire, was correlated with scores on the three instruments. SF-12 mental health component summary scores and PCL-S caseness, but not GHQ-12 caseness, differed significantly between Gulf War veterans and comparison group members who had been on at least one active deployment. More than a decade after the 1991 Gulf War, Australian Gulf War veterans are exhibiting higher levels of current (past month) psychological ill-health, as measured using the GHQ-12 and PCL-S, as well as lower mental health status, as measured by the SF-12, than the comparison group. Although not a replacement for formal psychiatric diagnosis, instruments such as those above may aid in the assessment of veterans' psychological health.

Addiction psychiatric assessment of veterans with chronic hepatitis C

Addiction psychiatric assessment of veterans with chronic hepatitis C

Symptom Overreporting in Combat Veterans Evaluated for PTSD: Differentiation on the Basis of Compensation Seeking Status

We examined the role of compensation-seeking status on response patterns to self-report inventories of acute psychopathology and psychological distress in a group of 165 combat veterans evaluated for posttraumatic stress disorder (PTSD) at a Department of Veteran Affairs (VA) Medical Center. Veterans completed the Minnesota Multiphasic Personality Inventory-Revised, Beck Depression Inventory, Mississippi Scale for Combat-Related PTSD, a fixed-response format version of the Dissociative Experiences Scale, and Impact of Events Scale as pan of a standard assessment battery. Results showed that compensation-seeking veterans endorsed dramatically higher levels of psychopathology across measures and produced sharply elevated fake-bad validity indices as compared to non-compensation-seeking veterans. Differences between the two groups on most scales and indices exceeded effect sizes of 1.0, even when effects of income, global assessment of functioning, and clinician-rated severity of PTSD were controlled for. It is suggested that the availability of VA disability compensation for combat-related PTSD impedes accurate initial assessment of veterans presenting for treatment and may impair estimation of long-term therapeutic outcome in this population.