Validation of a multimethod assessment of posttraumatic stress disorders in Vietnam veterans.

Abstract

Veterans Administration Medical Center, Jackson, Mississippi andUniversity of Mississippi Medical CenterThere appears to be a high incidence of posttraumatic stress disorders (PTSD)in Vietnam veterans. Yet there is little information available on the reliability andvalidity of any approach to the assessment of these combat-related stress disorders.The present study was designed to determine if responses to the presentation ofmild combat stimuli would distinguish the following three carefully matchedgroups of veterans: (a) those with an exclusive diagnosis of PTSD, (b) inpatientson a psychiatry ward who clearly do not have PTSD, and (c) Vietnam veteranswith combat experience who are currently well adjusted. Behavioral, physiolog-ical, and self-report measures of anxiety obtained through this laboratory-basedassessment clearly distinguished the PTSD veterans from the remaining two crit-ical comparison groups. The utility of this tripartite assessment approach for thereliable identification of PTSD secondary to combat is discussed. Future researchdirections are presented.Posttraumatic stress disorders (PTSD) aredenned as the maladaptive emotional re-sponse that an individual may experience fol-lowing a discrete traumatic event. The dis-order is characterized by persistently high lev-els of anxiety, intrusive recollections of theevent through nightmares or flashbacks, ex-aggerated startle responses, severe sleep dis-turbances, avoidance of close interpersonalcontact, depression and guilt, constricted af-fect, and impairment of memory and con-centration abilities (cf. Diagnostic and Sta-tistical Manual of Mental Disorders—DSM-III; American Psychiatric Association, 1980).Traumatic events that can lead to a stressdisorder include vehicular accidents, naturaldisasters, rape, and combat. Many Vietnamveterans were exposed to severely traumaticevents during combat, and in addition ex-perienced considerable hostility and lack ofsupport upon return home. As a result, atleast 24% of Vietnam veterans surveyed re-