Apparent symptom overreporting in combat veterans evaluated for ptsd

Frueh, B. Christopher; Hamner, Mark B.; Cahill, Shawn P.; Gold, Paul B.; Hamlin, Kasey

doi:10.1016/s0272-7358(99)00015-x

Cited by 209 publications

(147 citation statements)

References 188 publications

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“…Another possibility would be that servicemen might have exaggerated reports of health in the questionnaire. 20 This possibility cannot be discounted in our study, but it is suggestive that the percentage of servicemen needing medical help according to the MOs is similar to the percentage of 'screen-positives'. Thus if some of the servicemen exaggerated symptoms, others may have underreported their symptoms.…”

Section: Discussionmentioning

confidence: 61%

Screening for physical and psychological illness in the British Armed Forces: III: The value of a questionnaire to assist a Medical Officer to decide who needs help

et al. 2004

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Objectives:To estimate the positive and negative predictive values (PPVT and NPVT), sensitivity and specificity of a full and abridged screening questionnaire of physical and psychological health, using primary care doctors' (medical officers [MOs]) assessments as to whether the servicemen needed medical help as a gold standard. Methods:From a tri-service random sample of those who completed a questionnaire, all 'screenpositive' and an equal random sample of 'screen-negative' were selected to attend their medical centre. MOs were aware that the screening was aimed at detecting psychological illness, but were blind as to the 'screen-positivity' of any serviceman. The MO completed a questionnaire that asked whether the patient needed medical help and whether s/he was previously aware of this need.Results: 314 subjects were available for analysis. The PPVT was 47% (95% confidence interval [CI] 36-59%) for the full questionnaire and 48% (95% CI 36-60%) for the abridged questionnaire. Of those 'screen-positive' subjects whom the MO rated as needing help, one third had problems already known to the MO, regardless of the length of the questionnaire. The sensitivity and specificity of the full and abridge questionnaires were 43% and 74%, and 36% and 83% respectively. The PPVT did not vary greatly between health dimensions nor did selection of servicemen with very high scores. Conclusions:The use of MOs as a gold standard is important because of their central role in initiating the management of any condition uncovered by a screening programme. Using MOs as a gold standard, the validity of the screening questionnaires for physical and psychological health in the military was mediocre.

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Section: Discussionmentioning

confidence: 61%

Screening for physical and psychological illness in the British Armed Forces: III: The value of a questionnaire to assist a Medical Officer to decide who needs help

et al. 2004

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“…It has been shown that veterans may exaggerate or fabricate symptoms of PTSD and depression to present a case for disability payments [Burkett and Whitley, 1998;Frueh et al, 2000]. If this be the case, severity of PTSD would be more equivalent across the combat and noncombat groups, accounting even less for the apparent differences in cognitive performance between these groups.…”

Section: Discussionmentioning

confidence: 99%

Learning and memory impairment in PTSD: relationship to depression

et al. 2008

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Memory function was studied in combat veterans with posttraumatic stress disorder (PTSD), combat veterans without PTSD, and noncombat veterans. The Vocabulary and Digit Span subtests of the WAIS and Logical Memory (LMS) and Verbal Paired Associates (VPAS) subtests of the Wechsler Memory Scale III were administered. Combat veterans with PTSD showed impaired memory on the LMS and VPAS compared to combat veterans without PTSD or noncombat veterans. Veterans with PTSD also showed lower WAIS Vocabulary subtest scores--but not digit span subtest scores--than combat veterans without PTSD or noncombat veterans. Medication status, co-morbid diagnosis, and age all failed to account for these memory differences, but when self-assessed depression--as measured by the Zung Self-Rating Depression Scale--or anxiety--as measured by the Spielberger State-Trait Anxiety Scale--was statistically removed, group differences on these memory measures were no longer significant. However, using a stepwise regression procedure, in which both anxiety and depression were employed to predict the LMS and VPAS scores, only the Zung scale reliably predicated performance. The present results, showing that PTSD is associated with general learning and memory impairments, is an important finding, but the specific effects of depression as a mediator of these deficits should be further studied.

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“…Next, given the concern that a subgroup of veterans may exaggerate or feign PTSD to obtain disability compensation (Frueh, Hamner, Cahill, Gold, & Hamlin, 2000; P.J. Resnick, 1997), we examined between-cluster differences on several MMPI-2 measures of overreported psychopathology.…”

Section: Clinical Presentations In Ptsdmentioning

confidence: 99%

Clinical presentations in combat veterans diagnosed with posttraumatic stress disorder

et al. 2003

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This article investigated subtypes of symptom patterns among male combat veterans diagnosed with posttraumatic stress disorder (PTSD) through a cluster analysis of their Minnesota Multiphasic Personality Inventory-2 (MMPI-2; Butcher, Graham, Ben-Porath, Tellegen, Dahlstrom, & Kaemmer, 2001) clinical and validity scales. Participants were 126 veterans seeking outpatient treatment for combat-related PTSD at a Veterans Affairs Medical Center. Two well-fitting MMPI-2 cluster solutions (a four-cluster solution and a three-cluster solution) were evaluated with several statistical methods. A four-cluster solution was determined to best fit the data. Follow-up analyses demonstrated between-cluster differences on MMPI-2 "fake bad" scales and content scales, the Beck Depression Inventory (BDI; Beck, Ward, Mendelson, Mock, & Erbaugh, 1961), Dissociative Experiences Scale (DES; Bernstein & Putnam, 1986), Mississippi Combat PTSD scale (M-PTSD; Keane, Caddall, & Taylor, 1988), and Clinician-Administered PTSD Scale (CAPS-1; Blake et al., 1990). Clusters also were different in disability-seeking status, employment status, and income. Implications for research and clinical practice using the MMPI-2 with combat veterans presenting with PTSD are briefly addressed.

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Apparent symptom overreporting in combat veterans evaluated for ptsd

Cited by 209 publications

References 188 publications

Screening for physical and psychological illness in the British Armed Forces: III: The value of a questionnaire to assist a Medical Officer to decide who needs help

Screening for physical and psychological illness in the British Armed Forces: III: The value of a questionnaire to assist a Medical Officer to decide who needs help

Learning and memory impairment in PTSD: relationship to depression

Clinical presentations in combat veterans diagnosed with posttraumatic stress disorder

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