PTSD symptoms among male Vietnam veterans: Prevalence and associations with diagnostic status.

Abstract

The present study examined reported rates of specific posttraumatic stress disorder (PTSD) symptoms in a veteran sample and the extent to which specific symptoms predicted PTSD diagnostic status. A sample of 1325 unmedicated male Vietnam veterans were interviewed using the Structured Clinical Interview for the Diagnostic and Statistical Manual, 3rd edition revised (DSM–III–R) by doctoral-level clinicians. Of the total sample, 798 met diagnostic criteria for current PTSD, 189 met criteria for a lifetime diagnosis of PTSD, and 338 did not meet criteria for either current or lifetime PTSD. Overall, participants endorsed a median of 9, and a mean of 8.4 (SD 5.4) out of 17 possible PTSD symptoms. The most frequently endorsed symptoms among participants meeting criteria for current PTSD were hypervigilance and detachment from others, followed by intrusive recollections and sleep difficulties. The symptoms with the greatest diagnostic sensitivity in this sample were hypervigilance and detachment from others and those with the greatest diagnostic specificity were flashbacks and nightmares. Intrusive recollections and interpersonal detachment were the overall best predictors of current PTSD diagnostic status. Psychiatric comorbidity was associated with increased overall symptom endorsement rather than the presence of a different pattern of symptom distribution. The finding that hyperarousal and detachment symptoms are more strongly associated with PTSD diagnosis is consistent with reports from other studies conducted with veterans and other trauma-exposed samples. However, certain symptoms were found to occur at higher rates than have been reported in different populations with PTSD.