Although the literature remains equivocal, the past few decades of research has yielded substantial evidence that individuals who develop posttraumatic stress disorder (PTSD) may experience functional impairment due to subtle weaknesses in multiple neurocognitive domains. However, a causal link between the development of PTSD and acquired cognitive deficits has not been definitively established, given the lack of prospective study utilizing objective testing both predating and following trauma exposure. Advances in genetic testing, use of biomarkers, and neuroimaging are providing new insight into the impact of trauma exposure and PTSD and cognitive performance. In the U.S. veteran population, PTSD and its sequelae require broad utilization of health care resources, leading to rising cost for patients, stakeholders, and payors. Individuals seeking treatment for PTSD frequently report comorbid short-term memory and attentional problems, often leading to neuropsychology referrals. The current study addressed a significant gap in empirical research, exploring how neuropsychological assessment was utilized to inform follow-up treatment in veterans with suspected PTSD and differential diagnostic consideration of a neurocognitive disorder. Individual electronic health records (EHRs) of 51 veterans who met screening criteria for PTSD based on the PTSD Checklist for DSM-5 (PCL-5) and completed neuropsychological testing at a large Department of Veterans Affairs (VA) medical facility were extracted. Data on frequency of recommendations, PTSD screening scores at time of testing and within 1 year following testing, and attention and processing speed performance were collected. Results demonstrated a significant correlation between PCL-5 score and implemented psychiatric recommendations (p = .01), suggesting appropriate referrals to mental health services were placed for veterans who endorsed higher levels of symptoms. Results did not reflect a significant dose-dependent relationship between attention task performance on RBANS and WAIS-IV Digit Span tasks and Trail-Making Test A and B and overall PTSD symptom severity, while findings were likely limited by small sample size. Future research is needed to expand our knowledge of clinical outcomes of neuropsychological testing, identifying how testing and related referrals can help improve interdisciplinary care and treatment outcomes for veterans and their families. Keywords: neuropsychology, cognitive, attention, outcomes, veterans, PTSD

"In Neuropsychological Practice with Veterans, Bush endeavors to compile a comprehensive account of how neuropsychological research, assessment, and treatment of veterans are impacted by military status. He succeeds brilliantly with this undertaking...[T]his is an essential text for those working with active duty service members and veterans, and is highly recommended to all those seeking new perspectives."--Journal of the International Neuropsychological Society "In Neuropsychological Practice with Veterans, Dr. Shane S. Bush provides a multifaceted overview of neuropsychological assessments and treatments associated with war veterans who have suffered from traumatic brain injury (TBI) during their service."--Somatic Psychotherapy Today Traumatic brain injury (TBI), afflicting approximately one third of injured veterans returning from duty in Iraq and Afghanistan, is considered the signature injury in these conflicts. In addition to TBI, symptoms of posttraumatic stress disorder (PTSD) and major depression often afflict these veterans and contribute to neurological symptoms. This is the first volume to provide a comprehensive overview of neuropsychologically grounded assessment, treatment, training, and trends for clinicians who work with this population. Encompassing the writings of clinicians and researchers experienced in working with the Veterans Administration (VA) population, the book is grounded in an understanding of the unique culture of the veteran with its specialized service delivery methods and procedures. In addition to its focus on veterans with TBI, the text also addresses the assessment and treatment of aging veterans of previous military conflicts and of combat and non-combat veterans with neurological and emotional problems related to aging, substance abuse, HIV/hepatitis, psychiatric disorders, and other problems. Key Features: Addresses the growing need for neuropsychological assessment and treatment of returning veterans as well as aging veterans of earlier conflicts Focuses on traumatic brain injury, posttraumatic stress disorder, and major depression Discusses assessment of malingering (faking); benefits, pension, return-to-work evaluations; polytrauma management; and training concerns Written by clinicians and researchers experienced in working with veterans Edited by a neuropsychology specialist who is well known in the VA community

This volume explores the unique psychiatric needs of active and former military personnel and offers clinical pearls for the optimal delivery of care for these individuals. Written by experts in military and veteran psychiatry, this book addresses the most common issues in military and veteran patients, including depression, traumatic brain injury, posttraumatic stress disorder, substance use disorder, homelessness, and suicidality. Chapters highlight the characteristics of veterans suffering from each disorder that requires special treatment, making it a valuable resource for both military and civilian clinicians. Veteran Psychiatry in the US is a valuable resource for all mental health clinicians working with or seeking to work with veterans, including psychiatrists, neurologists, primary care physicians, psychologists, counselors, social workers, nurses, residents, and all others.

Posttraumatic stress disorder (PTSD) is one of the signature injuries of the U.S. conflicts in Afghanistan and Iraq, but it affects veterans of all eras. It is estimated that 7-20% of service members and veterans who served in Operation Enduring Freedom and Operation Iraqi Freedom may have the disorder. PTSD is characterized by a combination of mental health symptoms - re-experiencing of a traumatic event, avoidance of trauma-associated stimuli, adverse alterations in thoughts and mood, and hyperarousal - that last at least 1 month and impair functioning. PTSD can be lifelong and pervade all aspects of a service member's or veteran's life, including mental and physical health, family and social relationships, and employment. It is often concurrent with other health problems, such as depression, traumatic brain injury, chronic pain, substance abuse disorder, and intimate partner violence. The Department of Defense (DoD) and the Department of Veterans Affairs (VA) provide a spectrum of programs and services to screen for, diagnose, treat for, and rehabilitate service members and veterans who have or are at risk for PTSD. The 2010 National Defense Authorization Act asked the Institute of Medicine to assess those PTSD programs and services in two phases. The Phase 1 study, Treatment for Posttraumatic Stress Disorder in Military and Veteran Populations: Initial Assessment, focused on data gathering. Treatment for Posttraumatic Stress Disorder in Military and Veteran Populations Final Assessment is the report of the second phase of the study. This report analyzes the data received in Phase 1 specifically to determine the rates of success for each program or method. Treatment for Posttraumatic Stress Disorder in Military and Veteran Populations Final Assessment considers what a successful PTSD management system is and whether and how such a system is being implemented by DoD and VA. This includes an assessment of what care is given and to whom, how effectiveness is measured, what types of mental health care providers are available, what influences whether a service member or veteran seeks care, and what are the costs associated with that care. This report focuses on the opportunities and challenges that DoD and VA face in developing, implementing, and evaluating services and programs in the context of achieving a high-performing system to care for service members and veterans who have PTSD. The report also identifies where gaps or new emphases might be addressed to improve prevention of, screening for, diagnosis of, and treatment and rehabilitation for the disorder. The findings and recommendations of Treatment for Posttraumatic Stress Disorder in Military and Veteran Populations: Final Assessment will encourage DoD and VA to increase their efforts in moving toward a high-performing, comprehensive, integrated PTSD management strategy that addresses the needs of current and future service members, veterans, and their families.

"...this foundational volume on military neuropsychology should be on the bookshelf of every mental health clinician that may come in contact with military service members." --International Journal of Emergency Mental Health "...an important text dedicated to this subspecialty in the larger field of neuropsychology...The book integrates in a coherent manner the different aspects of military neuropsychological practice and provides a clear clinical road map for neuropsychologists and other psychologists working with military personnel in various settings."--PsycCRITIQUES This text covers the unique features of neuropsychological evaluations in the military. The author presents a thorough examination of the assessment needs of various military populations, with a special emphasis on traumatic brain injury, and the neurocognitive aspects of stress-related problems, such as posttraumatic stress disorder (PTSD) and decision-making under stress. The chapters of the book are designed to integrate theory and application, and include case study examples as well as a comprehensive review of the latest research. Key Features: Discusses the development of neuropsychology and its advances in the military Presents methods of dealing with military issues, such as head injuries, HIV, PTSD, learning disorders, and more Explains the importance of baseline testing, stress research, and multiple brain injury rehabilitation techniques

This book takes a case-based approach to addressing the challenges psychiatrists and other clinicians face when working with American combat veterans after their return from a war zone. Written by experts, the book concentrates on a wide variety of concerns associated with posttraumatic stress disorder (PTSD), including different treatments of PTSD. The text also looks at PTSD comorbidities, such as depression and traumatic brain injury (TBI) and other conditions masquerading as PTSD. Finally, the authors touch on other subjects concerning returning veterans, including pain, disability, facing the end of a career, sleep problems , suicidal thoughts, violence, , and mefloquine “toxidrome”. Each case study includes a case presentation, diagnosis and assessment, treatment and management, outcome and case resolution, and clinical pearls and pitfalls. Post-Traumatic Stress Disorder and Related Diseases in Combat Veterans is a valuable resource for civilian and military mental health practitioners, and primary care physicians on how to treat patients returning from active war zones.

Traumatic brain injury (TBI) remains a significant source of death and permanent disability, contributing to nearly one-third of all injury related deaths in the United States and exacting a profound personal and economic toll. Despite the increased resources that have recently been brought to bear to improve our understanding of TBI, the developme