Posttraumatic Stress Disorder Diagnosis and Assessment (2006) / Chapter Skim
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Appendix A: Specific Questions Posed by the Department of Veterans Affairs to the Institute of Medicine
Appendix A: Specific Questions Posed by the Department of Veterans Affairs to the Institute of Medicine
Pages 41-46
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From page 41... ...
PTSD symptoms might be mild to severe, and functioning might be influenced by other factors, such as comorbid conditions or social support. Severe symptoms might be disabling even in the absence of a full diagnosis.
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From page 42... ...
Traumatic events during wartime, for example, might include serving in dangerous military roles, such as driving a truck at risk for encountering roadside bombs, patrolling the streets, and searching homes for enemy combatants, suicide attacks, sexual assaults or severe sexual harassment, physical assault, duties involving graves registration, accidents causing serious injuries or death, friendly fire, serving in medical units, killing or
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From page 43... ...
Health professionals with experience in diagnosing psychiatric disorders should rely on a confidential interview to elicit and document the patient's recollection of events, the impact on the patient, and to determine whether symptoms are present. Health professionals should ask relevant questions to determine whether the patient's report is consonant with the DSM-IV traumatic-stressor criteria (criterion A)
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From page 44... ...
. The interview should elicit the patient's symptoms, assess the history of potentially traumatic events, determine whether the patient meets the
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From page 45... ...
Health professionals should be aware that veterans, especially those who have served in war theaters, are at risk for the development of PTSD, but might present with physical or psychiatric complaints that are symptomatic of substance use disorder or other psychiatric conditions. Health professionals should ask all veterans about possible exposure to potentially traumatic events.
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From page 46... ...
Potential biomarkers currently under study include increased concentrations of corticotropin-releasing factor in the cerebrospinal fluid; low cortisol concentrations in the blood; measures of hyperarousal; delayed habituation to loud noises; panic attacks and flashbacks when noradrenergic systems are activated; alterations of brain structures, such as hyperactivation of the amygdala and hypoactivation of the prefrontal cortex when the person remembers trauma; and sleep disturbances, including nightmares of traumatic events. Reduced volume of the hippocampus might also be correlated with the development of PTSD.
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