Psychotic-like experiences, symptom expression, and cognitive performance in combat veterans with posttraumatic stress disorder.
Apparent psychotic symptoms are often associated with posttraumatic stress disorder (PTSD), but these symptoms are poorly understood. In a sample of 30 male Vietnam combat veterans with severe and chronic PTSD, we conducted detailed assessments of psychotic symptom endorsement, insight, symptom severity, neurocognitive function, and feigning. Two thirds of the subjects endorsed a psychotic item but did not believe that the experiences were real. Those endorsing psychotic items were higher in PTSD severity, general psychopathology, and dissociation but not depression, functional health, cognitive function, or feigned effort. Severity of psychotic symptoms correlated with dissociation, combat exposure, and attention but not PTSD, depression, or functional health. Those endorsing psychotic items scored higher on a screen but not on a detailed structured interview for malingering. Endorsement of psychotic experiences by combat veterans with PTSD do not seem to reflect psychotic symptoms or outright malingering.
*VA Palo Alto Health Care System, Palo Alto, CA; †Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA; and ‡VA National Center for Posttraumatic Stress Disorder, Menlo Park, CA.
Steven E
SE
Lindley
Eve B
EB
Carlson
Kimberly R
KR
Hill
D002908:Chronic Disease; D003130:Combat Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D015897:Comorbidity; D006801:Humans; D008297:Male; D008875:Middle Aged; D011618:Psychotic Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology; D012720:Severity of Illness Index; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology; D014481:United States; D014728:Veterans / Q000523:psychology*; D047829:Vietnam Conflict