Measuring outcome in posttraumatic stress disorder.

This article summarizes the features of posttraumatic stress disorder (PTSD) that may affect treatment outcome and discusses the areas in which treatment outcome can be productively evaluated. PTSD is a complex psychiatric condition that tends to run a chronic course. Measurement of treatment outcome in PTSD is confounded by multiple factors, including a high prevalence of comorbid disorders, reactivation of the syndrome by ongoing environmental stressors, spontaneous recovery of the early disorder, and a fluctuating course of the chronic disorder. Four principal domains of treatment outcome may be evaluated in PTSD: core symptom severity, comorbid conditions (particularly depression), adverse practices (e.g., violence or alcohol consumption), and social/vocational disability. To gain an accurate assessment of these domains, a comprehensive assessment battery is needed. The relevant instruments and their yield in studies of PTSD are reviewed.