{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T06:59:13Z","timestamp":1773298753145,"version":"3.50.1"},"reference-count":23,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2024,3,10]],"date-time":"2024-03-10T00:00:00Z","timestamp":1710028800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Traumatic Stress"],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Studies have raised concerns about possible inequities in the U.S. Department of Veterans Affairs (VA)\u2019s awards of disability for posttraumatic stress disorder (PTSD) to women. However, the diagnoses and opinions made by disability examiners have not been studied. A sample of 270 initial PTSD examination reports and corresponding VA decisions were studied. Compared to men, women veterans were as likely to be diagnosed with a service\u2010related mental disorder, \u03c7<jats:sup>2<\/jats:sup>(1, <jats:italic>N<\/jats:italic> = 270) = 2.31, <jats:italic>p<\/jats:italic> =\u00a0.129, odds ratio (<jats:italic>OR<\/jats:italic>) = 1.79, 95% CI [0.84, 3.80], and be granted service\u2010connection, \u03c7<jats:sup>2<\/jats:sup>(1, <jats:italic>N<\/jats:italic> = 270) = 0.49, <jats:italic>p<\/jats:italic> =\u00a0.483, <jats:italic>OR<\/jats:italic> = 1.28, 95% CI [0.65, 2.51]. Women veterans were considered to have more psychiatric symptoms, <jats:italic>Z<\/jats:italic> = \u22122.05, <jats:italic>p<\/jats:italic> =\u00a0.041, <jats:italic>r<\/jats:italic> =\u00a0.16, and more psychiatric impairment, <jats:italic>Z<\/jats:italic> = \u22122.48, <jats:italic>p<\/jats:italic> =\u00a0.013, <jats:italic>r<\/jats:italic> =\u00a0.20, but the percentage of disability awarded by the VA did not differ, \u03c7<jats:sup>2<\/jats:sup>(1, <jats:italic>N<\/jats:italic> = 270) = 0.49, <jats:italic>p<\/jats:italic> =\u00a0.483; <jats:italic>OR<\/jats:italic> = 1.28, 95% CI [0.65, 2.51]. Secondary analyses implicate the role of military sexual trauma and premilitary trauma in explaining sex differences in symptoms and impairment. The findings indicate that neither opinions by examiners nor corresponding decisions by the VA regarding service connection reflect a negative bias toward women veterans. Results indicate that unbiased examinations lead to equitable VA claims decisions for women veterans. Future studies of the VA PTSD disability program nationally, including examination procedures and VA policies and implementation, will promote equity for women veterans in the PTSD claims process.<\/jats:p>","DOI":"10.1002\/jts.23034","type":"journal-article","created":{"date-parts":[[2024,3,11]],"date-time":"2024-03-11T03:44:37Z","timestamp":1710128677000},"page":"586-593","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Examining bias in the award of Veterans Affairs (VA) disability benefits for posttraumatic stress disorder in women veterans: Analysis of evaluation reports and VA decisions"],"prefix":"10.1002","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3476-4143","authenticated-orcid":false,"given":"Mayumi O.","family":"Gianoli","sequence":"first","affiliation":[{"name":"VA Connecticut Healthcare System  West Haven Connecticut USA"},{"name":"Department of Psychiatry Yale School of Medicine  New Haven Connecticut USA"},{"name":"Department of Psychiatry University of Connecticut School of Medicine Farmington Connecticut USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7251-0320","authenticated-orcid":false,"given":"Andrew W.","family":"Meisler","sequence":"additional","affiliation":[{"name":"VA Connecticut Healthcare System  West Haven Connecticut USA"},{"name":"Department of Psychiatry Yale School of Medicine  New Haven Connecticut USA"},{"name":"Department of Psychiatry University of Connecticut School of Medicine Farmington Connecticut USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rebecca","family":"Gordon","sequence":"additional","affiliation":[{"name":"VA Connecticut Healthcare System  West Haven Connecticut USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,3,10]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.books.9780890425596"},{"key":"e_1_2_6_3_1","unstructured":"Committee on Veterans\u2019 Affairs. (2017 July 25).PTSD claims: Assessing whether VBA is effectively serving veterans. Hearing before the Subcommittee on Disability Assistance and Memorial Affairs[Hearing].https:\/\/docs.house.gov\/meetings\/VR\/VR09\/20170725\/106322\/HHRG\u2010115\u2010VR09\u2010Transcript\u201020170725.pdf"},{"key":"e_1_2_6_4_1","volume-title":"Structured Clinical Interview for DSM\u20105 Disorders, Clinician Version (SCID\u20105\u2010CV)","author":"First M. B.","year":"2016"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.13m08374"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11606\u2010022\u201007580\u20108"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/jts.20163"},{"key":"e_1_2_6_8_1","unstructured":"Hunt C.(1996).Women veteran issues Part 1: Developing PTSD sexual assault claims[VBA satellite training teleconference]. Compensation and Pension Training Operations."},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.7249\/RRA1848\u20101"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.whi.2011.07.010"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005650\u2010200308000\u201000008"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/milmed\/usz052"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/milmed\/usz208"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.whi.2021.07.004"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1037\/1942\u20109681.S.1.37"},{"key":"e_1_2_6_16_1","unstructured":"U.S. Department of Veterans Affairs Office of the Inspector General. (2018).Denied posttraumatic stress disorder claims related to military sexual trauma[Report 17\u201005248\u2010241].https:\/\/www.va.gov\/oig\/pubs\/VAOIG\u201017\u201005248\u2010241.pdf"},{"key":"e_1_2_6_17_1","unstructured":"U.S. Government Accountability Office. (2020).Female active\u2010duty personnel: Guidance and plans needed for recruitment and retention efforts. Report to congressional committees[Report GAO\u201020\u201061].https:\/\/www.gao.gov\/products\/gao\u201020\u201061"},{"key":"e_1_2_6_18_1","unstructured":"Veterans Benefits Administration. (2021).Compensation 2021.https:\/\/www.benefits.va.gov\/REPORTS\/abr\/docs\/2021_compensation.pdf"},{"key":"e_1_2_6_19_1","unstructured":"Weathers F. W. Blake D. D. Schnurr P. P. Kaloupek D. G. Marx B. P. &Keane T. M.(2013).The Clinician\u2010Administered PTSD Scale for DSM\u20105 (CAPS\u20105).https:\/\/www.ptsd.va.gov\/professional\/assessment\/adult\u2010int\/caps.asp"},{"key":"e_1_2_6_20_1","unstructured":"Weathers F. W. Litz B. 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P.(2013).The PTSD Checklist for DSM\u20105 (PCL\u20105).https:\/\/www.ptsd.va.gov\/professional\/assessment\/adult\u2010sr\/ptsd\u2010checklist.asp"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1177\/1524838016683459"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwab102"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1177\/088626098013001003"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1177\/1524838007307295"}],"container-title":["Journal of Traumatic Stress"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jts.23034","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,1]],"date-time":"2024-08-01T06:43:53Z","timestamp":1722494633000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jts.23034"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,3,10]]},"references-count":23,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2024,8]]}},"alternative-id":["10.1002\/jts.23034"],"URL":"https:\/\/doi.org\/10.1002\/jts.23034","archive":["Portico"],"relation":{},"ISSN":["0894-9867","1573-6598"],"issn-type":[{"value":"0894-9867","type":"print"},{"value":"1573-6598","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,3,10]]},"assertion":[{"value":"2023-09-30","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-02-15","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-03-10","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}