Developing and validating rapid assessment instruments

Specifically, PTSD is associated with impairments in occupational and academic functioning [2–6], marital and family functioning [5,7–8], parenting [9–10], and friendships and socializing [11].

Additional studies have shown associations between PTSD and objective indicators of quality of life (QOL) such as homelessness and unemployment [12–13].

The Clinical Practice Guideline (CPG) provides evidence-based recommendations for diagnosing and treating a spectrum of stress-related disorders.

Included in the CPG were recommendations for assessing posttraumatic stress disorder (PTSD) and other stress disorder-related functional impairment.

clinical practice guideline, Department of Defense, Department of Veterans Affairs, education, family, functional impairment, intimate relationships, occupational functioning, posttraumatic stress disorder, social functioning.

Abbreviations: ASD = acute stress disorder; CAPS = Clinician-Administered PTSD Scale; COSR = combat and operational stress reaction; CPG = clinical practice guideline; DOD = Department of Defense; DSM-IV-TR = Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision; GAF = Global Assessment of Functioning; IOM = Institute of Medicine; IPF = Inventory of Psychosocial Functioning; LIFE = Longitudinal Interval Follow-Up Evaluation; M = mean impairment score; OIF/OEF = Operation Iraqi Freedom/Operation Enduring Freedom; PTSD = posttraumatic stress disorder; QOL = quality of life; SD = standard deviation; VA = Department of Veterans Affairs; WHO = World Health Organization; WHODAS-II = WHO Disability Assessment Schedule II. Marx, Ph D; VA National Center for Posttraumatic Stress Disorder at VA Boston Healthcare System, 150 S Huntington Ave, 116B-4, Boston, MA 02130; 857-364-6071; fax: 857-364-4501; Email: Research has consistently shown posttraumatic stress disorder (PTSD) to be associated with impairments in functioning across a number of psychosocial domains [1].

In 2010, the Department of Veterans Affairs (VA) and the Department of Defense (DOD) jointly published the revised [16].


We briefly review some of the empirical literature on the association between PTSD and functional impairment and some of the more frequently used methods and measures for assessing functional impairment and introduce a new measure currently being developed by our group.

We suggest that information obtained via patient self-report and/or clinician rating be supplemented whenever possible with collateral data from friends, family members, coworkers, or supervisors to provide a complete picture of current and premorbid functional status.

Finally, we explore several important issues that we encourage clinicians to keep in mind when assessing functional impairment among Veterans and Active Duty servicemembers.

Such impairments are common among populations at high risk for PTSD, such as military personnel deployed to combat [3,5–6,8–14].

Research suggests that these impairments are currently affecting many Veterans of the wars in Iraq and Afghanistan (Operations Iraqi Freedom and Enduring Freedom) and are therefore important to identify and treat [15].

The VA/DOD CPG recommends a comprehensive assessment of all relevant domains of functioning.


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