Mental Health Services Research

, Volume 7, Issue 2, pp 89-101

First online:

Employment Outcomes and PTSD Symptom Severity

  • Mark W. SmithAffiliated withCooperative Studies Program and Health Services Research & Development Service, VA Palo Alto Health Care SystemVA Palo Alto Health Care System Email author 
  • , Paula P. SchnurrAffiliated withNational Center for PTSD, VA Medical and Regional Office CenterDepartment of Psychiatry, Dartmouth Medical School
  • , Robert A. RosenheckAffiliated withNortheast Program Evaluation Center, VA Connecticut Health Care SystemDepartment of Psychiatry, Yale Medical School

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A diagnosis of chronic war-related posttraumatic stress disorder (PTSD) has been linked consistently to poor employment outcomes. This study investigates the relation further, analyzing how symptom severity correlates with work status, occupation type, and earnings. Study participants were male Vietnam veterans with severe or very severe PTSD who received treatment in the Department of Veterans Affairs system (N = 325). Veterans with more severe symptoms were more likely to work part-time or not at all. Among workers, more severe symptoms were weakly associated with having a sales or clerical position. Conditional on employment and occupation category, there was no significant relation between PTSD symptom level and earnings. Alternative PTSD symptom measures produced similar results. Our findings suggest that even modest reductions in PTSD symptoms may lead to employment gains, even if the overall symptom level remains severe.


posttraumatic stress disorders employment income Veterans Veterans hospitals mental health services