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OBJECTIVE This study examines the differential impact of military, civilian adult, and childhood sexual assault on the likelihood of developing posttraumatic stress disorder (PTSD). It also examines the relationship of military sexual assault (MSA) to service utilization and health care costs among women who access services through Veterans Affairs (VA). (More)
BACKGROUND Very few systematic human studies focus on changing the underlying traumatic memory after posttraumatic stress disorder (PTSD) has been established. Evidence from animal and human studies indicates that cortisol can be used to address traumatic memories. This translational pilot study is based on our previous rodent research in which extinction(More)
BACKGROUND Little is known about the health outcomes of clinician-supervised, performance-based, abstinence-contingent therapeutic work programs on homeless persons with addiction disorders. This study examined the effect of the Department of Veterans Affairs compensated work therapy program (CWT) on nonvocational outcomes. With mandatory urine screenings(More)
OBJECTIVE Budgetary constraints often limit practicing psychiatrists from conducting more thorough diagnostic evaluations. This study examined physicians' diagnosing and prescribing practices in the context of feedback from nurse-administered, structured clinical interviews of psychiatric patients in publicly funded outpatient mental health settings. (More)
The present study explored the potential for change in personality in women in recovery. Dimensions of the Temperament and Character Model and the five-factor model of personality were examined at baseline and at follow-up after treatment for addiction. Within both models of personality, the factors which have been found to be the best predictors of the(More)
A large body of literature exists describing the challenges associated with implementing rand-omized controlled clinical trials (RCTs) [1]. However, when clinical trials are conducted within Department of Veterans Affairs (VA) Medical Center (VAMC) settings, several additional and unique factors contribute to the difficulty of conducting RCTs. The(More)
This article traces the history of classification systems for mental illness and then reviews the history of the American diagnostic system for mental disorders. The steps leading up to each publication of the Diagnostic and Statistical Manual (DSM) are described including leaders, timelines, pre-publication meetings, and field trials. Important changes in(More)
The widely used posttraumatic stress disorder (PTSD) Checklist (PCL) has established reliability and validity, but it does not differentiate posttraumatic symptom frequency from intensity as elements of posttraumatic symptom severity. Thus, the PCL in its existing form may not provide a comprehensive appraisal of posttraumatic symptomatology. Because of(More)