Providing mental health care to veterans requires empathy and specialized knowledge. Our workshop focuses on treatment issues facing clinicians working with veterans. Combat deployments affect the physical and mental health of veterans. Common mental health conditions encountered in veterans include PTSD (both combat and military sexual trauma-related), depression, suicide, substance abuse, traumatic brain injury, chronic musculoskeletal pain, medically unexplained symptoms (e.g., fatigue, somatic, and cognitive complaints such as memory, attention, and concentration difficulties), and sleep disturbances. Veterans are at higher risk of suicide than the general population. Individuals with PTSD have a higher risk of developing medical illnesses such as cardiovascular disease. The conceptual model of allostasis and allostatic load may serve as a mechanism through which stress, and more specifically PTSD, might precipitate medical illness. Allostasis is the adaptive process of maintaining homeostasis by expending and directing energy towards challenges, while allostatic load represents the cumulative cost to an organism of enduring repetitive cycles of adaptation. Our workshop will introduce screening tools important for the workup of veterans with mental health symptoms, including the PCL-5 PTSD screen and the Columbia Suicide Severity Rating Scale. Participants will practice using these tools and will learn strategies to manage veterans with positive screens via interactive case examples. Our session will review evidence-based psychotherapeutic modalities and psychopharmacological treatments of PTSD. We will also discuss the use of physical exercise for managing allostatic load and brain recovery.

**This content was captured for the 2020 APA On Demand product and may reference information from various sources and terminology from previous editions of the DSM.

Learning Objectives

• Understand that combat veterans suffer a wide variety of war-related neuropsychiatric consequences (e.g., posttraumatic stress disorder (PTSD) and traumatic brain injury (TBI).
• Define the Polytrauma Clinical Triad, Military Sexual Trauma, Moral Injury, and Posttraumatic Growth.
• Identify that individuals with PTSD are at increased risk for medical conditions, particularly cardiovascular disease.

Target Audience

Psychiatrists, Residents/Fellows

Estimated Time to Complete

Estimated Duration: 75 minutes
Begin Date: November 1, 2021
End Date: November 1, 2024

How to Earn Credit

Participants who wish to earn AMA PRA Category 1 Credit ™ or a certificate of participation may do so by completing all sections of the course including the evaluation. After evaluating the program, course participants will be provided with an opportunity to claim hours of participation and print an official CME certificate (physicians) or certificate of participation (non-physicians) showing the completion date and hours earned. 

Continuing Education Credit

The American Psychiatric Association (APA) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. 

The APA designates this enduring CME activity for a maximum of 1.5 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Faculty and Planner Disclosures

Program Presenters

• James Rustad, M.D. Assistant Professor of Psychiatry, Dartmouth School of Medicine. Reports no financial relationships with commercial interests.
• Douglas Noordsy, M.D. Clinical Professor and Director of Lifestyle Psychiatry, Stanford University School of Medicine. Reports no financial relationships with commercial interests.
• Samuel Kohrman, M.D. Psychiatry Fellow, Massachusets General Hospital. Reports no financial relationships with commercial interests.
• Ivan Chik, M.P.H., M.D. Psychiatry Specialist, Dartmouth Medical Center. Reports no financial relationships with commercial interests
• Dr. Geraldine McWilliams, MD., Instructor in Psychiatry, Dartmouth School of Medicine. Reports no financial relationships with commercial interests

Program Planners

• Tristan Gorrindo, M.D., Former Director of Education, American Psychiatric Association. Reports no financial relationships with commercial interests.
• Katie Putnam, Membership Development Specialist, American Psychiatric Association. Reports no financial relationships with commercial interests.
• Ally Brown, Associate Director, Online Learning, American Psychiatric Association. Reports no financial relationships with commercial interests.

Accessibility for Participants with Disabilities

The American Psychiatric Association is committed to ensuring accessibility of its website to people with disabilities. If you have trouble accessing any of APA’s online resources, please contact us at 202-559-3900 for assistance.

Technical Requirements

This internet-based CME activity is best experienced using any of the following:

• The latest and 2nd latest public versions of Google Chrome, Mozilla Firefox, or Safari
• Internet Explorer 11+

This Web site requires that JavaScript and session cookies be enabled. Certain activities may require additional software to view multimedia, presentation, or printable versions of the content. These activities will be marked as such and will provide links to the required software. That software may be: Adobe Acrobat Reader, Microsoft PowerPoint, and Windows Media Player.

Optimal System Configuration:

• Browser: Google Chrome (latest and 2nd latest version), Safari (latest and 2nd latest version), Internet Explorer 11.0+, Firefox (latest and 2nd latest version), or Microsoft Edge (latest and 2nd latest version)
• Operating System: Windows versions 8.1+, Mac OS X 10.5 (Leopard) +, Android (latest and 2nd latest version), or iOS/iPad OS (latest and 2nd latest version)
• Internet Connection: 1 Mbps or higher

Minimum Requirements:

• Windows PC: Windows 8.1 or higher; 1 GB (for 32-bit)/2 GB (for 64-bit) or higher RAM; Microsoft DirectX 9 graphics device with WDDM driver; audio playback with speakers for programs with video content
• Macintosh: Mac OS X 10.5 or higher with latest updates installed; Intel, PowerPC G5, or PowerPC G4 (867MHz or faster) processor; 512 MB or higher RAM; audio playback with speakers for programs with video content

For assistance: Contact educme@psych.org for questions about this activity | Contact learningcenter@psych.org for technical assistance