Symptom overreporting in combat veterans evaluated for PTSD: differentiation on the basis of compensation seeking status.
We examined the role of compensation-seeking status on response patterns to self-report inventories of acute psychopathology and psychological distress in a group of 165 combat veterans evaluated for posttraumatic stress disorder (PTSD) at a Department of Veteran Affairs (VA) Medical Center. Veterans completed the Minnesota Multiphasic Personality Inventory-Revised, Beck Depression Inventory, Mississippi Scale for Combat-Related PTSD, a fixed-response format version of the Dissociative Experiences Scale, and Impact of Events Scale as part of a standard assessment battery. Results showed that compensation-seeking veterans endorsed dramatically higher levels of psychopathology across measures and produced sharply elevated "fake-bad" validity indices as compared to non-compensation-seeking veterans. Differences between the two groups on most scales and indices exceeded effect sizes of 1.0, even when effects of income, global assessment of functioning, and clinician-rated severity of PTSD were controlled for. It is suggested that the availability of VA disability compensation for combat-related PTSD impedes accurate initial assessment of veterans presenting for treatment and may impair estimation of long-term therapeutic outcome in this population.
Frueh
B C
BC
Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Veterans Affairs Medical Center, Charleston, USA.
Gold
P B
PB
de Arellano
M A
MA
D015982:Bias; D016022:Case-Control Studies; D003130:Combat Disorders / Q000175:diagnosis* / Q000523:psychology*; D006801:Humans; D018868:Insurance, Disability; D008950:MMPI; D008306:Malingering / Q000523:psychology*; D008403:Mass Screening / Q000379:methods / Q000592:standards*; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D012680:Sensitivity and Specificity; D014728:Veterans