Using the World Health Organization Disability Assessment Schedule 2.0 to assess disability in veterans with posttraumatic stress disorder

• Published in: PloS one Vol. 14; no. 8; p. e0220806
• Main Authors: Bovin, Michelle J, Meyer, Eric C, Kimbrel, Nathan A, Kleiman, Sarah E, Green, Jonathan D, Morissette, Sandra B, Marx, Brian P
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 07.08.2019; Public Library of Science (PLoS)
• Subjects: Adult; Age; Age Factors; Biology and Life Sciences; Codification; Complications and side effects; Diagnosis; Diagnostic systems; Disability Evaluation; Female; Handbooks; Health care facilities; Humans; Male; Medical diagnosis; Medical examination; Medical research; Medicine; Medicine and Health Sciences; Mental disorders; Methods; Middle Aged; People and Places; Post traumatic stress disorder; Posttraumatic stress disorder; Psychological stress; Public health; Quantitative psychology; Schedules; Sex Factors; Social Sciences; Stress Disorders, Post-Traumatic - diagnosis; Veterans; Veterans hospitals; Womens health; World Health Organization; United States; North Carolina; United States > US; Texas; Massachusetts
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0220806

The introduction of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) was accompanied by the elimination of the Global Assessment of Functioning (GAF) scale, which was previously used to assess functioning. Although the World Health Organization Disability Assessment Schedule, Version 2.0 (WHODAS 2.0) was offered as a measure for further study, widespread adoption of the WHODAS 2.0 has yet to occur. The lack of a standardized instrument for assessing posttraumatic stress disorder (PTSD)-related disability has important implications for disability compensation. Accordingly, this study was designed to determine and codify the utility of the WHODAS 2.0 for assessing PTSD-related disability. Veterans from several VA medical centers (N = 1109) were included. We examined PTSD using several definitions and modalities and considered results by gender and age. Across definitions and modalities, veterans with PTSD reported significantly greater WHODAS 2.0 total (large effects; all ts > 6.00; all ps < .01; all Cohen's ds > 1.03) and subscale (medium-to-large effects; all ts > 2.29; all ps < .05; all Cohen's ds > .39) scores than those without PTSD. WHODAS 2.0 scores did not vary by gender; however, younger veterans reported less disability than older veterans (small effects; all Fs > 4.30; all ps < .05; all η2s < .05). We identified 32 as the optimally efficient cutoff score for discriminating veterans with and without PTSD-related disability, although this varied somewhat by age and gender. Findings support the utility of the WHODAS 2.0 in assessing PTSD-related disability.