There are many costs to individuals with PTSD in addition to psychological and emotional distress. Impairment in functioning is an important component of PTSD. It affects not only the individual, but also relationship dynamics and the larger context of society. Due to the nature of the diagnosis (e.g., the impact on isolation, avoidance, mood instability), individuals with PTSD often experience functional impairment in the following domains: Interpersonal, social, developmental, educational, occupational, and physical (Allison-Aipa, Ritter, Sikes, & Ball, 2010; American Psychiatric Association, 2013; Thomas et al., 2010). In a study of male combat veterans with PTSD, 31.9% reported four or more chronic physical health related symptoms (Zatzick
