Assessment of social functioning in combat veterans with PTSD

Maladaptive patterns of social functioning have been widely noted as core f eatures associated with the clinical syndrome of combat-related posttraumat ic stress disorder (PTSD), including interpersonal violence, social anxiety and avoidance, marital/family discord, and occupational impairment. Unfort unately, clinical instruments for evaluating the complex domains of social functioning are lacking, and no measures have been developed specifically f or combat-related PTSD. Therefore, the development of reliable and valid pr ocedures for assessing the social functioning of this group is sorely neede d. A number of strategies currently exist, including symptom severity, symp tom chronicity, and monetary gain incentive; however, assessment of this po pulation represents several unique challenges. Until measures of social fun ctioning are developed and validated specifically for combat-related PTSD, comprehensive assessment should consist of a multimethod approach, includin g (a) self-report measures; (b) structured interviews and clinician ratings ; (c) patient ratings (e.g., daily diaries); (d) behavioral performance ass essments of social skill strengths and deficits; and (e) other behavioral a ssessments, including functional analysis, psychophysiological measurements , and objective indicators of functioning. The development of an endstate f unctioning index, anchored to a normal population, would advance our abilit y to gage the social functioning of veterans following treatment. (C) 2000 Elsevier Science Ltd. All rights reserved.