Treatment for posttraumatic stress disorder in military and veteran populations: final assessment.

In response to the attacks of September 11, 2001, the United States entered into military conflicts in Iraq and Afghanistan. While prior wars and conflicts have been characterized by such injuries as infectious diseases and catastrophic gunshot wounds, the signature injuries suffered by U.S. military personnel involved in these conflicts are blast wounds and the psychiatric consequences of exposure to combat, particularly posttraumatic stress disorder (PTSD). PTSD is triggered by a specific traumatic event, which can include combat. The cluster of symptoms that characterize it include persistent re-experiencing of the event; emotional numbing or avoidance of thoughts, feelings, conversations, or places associated with the trauma; and hyper-arousal, such as exaggerated startle responses or difficulty concentrating. An estimated 13 to 20 percent of the 2.6 million U.S. service members who have fought in Iraq or Afghanistan since 2001 may have PTSD. As the United States reduces its military involvement in the Middle East, the Departments of Defense (DoD) and Veterans Affairs (VA) anticipate that increasing numbers of returning veterans will need PTSD services. Congress, concerned by the number of service members and veterans at risk for, or already diagnosed with, PTSD asked the DoD, in consultation with the VA, to sponsor an Institute of Medicine (IOM) study to assess both departments' PTSD treatment programs and services. This report, Treatment for Posttrau-matic Stress Disorder in Military and Veteran Populations: Initial Assessment, is the first of two mandated in the National Defense Authorization Act for Fiscal Year 2010. [the Iraq and Afghanistan] conflicts are blast wounds and the psychiatric consequences of exposure to combat, particularly posttrau-matic stress disorder.