Symptom Overreporting in Combat Veterans Evaluated for PTSD: Differentiation on the Basis of Compensation Seeking Status

• Published in: Journal of personality assessment 1997-04, Vol.68 (2), p.369-384
• Main Authors: Frueh, B. Christopher, Gold, Paul B., de Arellano, Michael A.
• Format: Article
• Language: English
• Subjects: Adult and adolescent clinical studies; American people; Anxiety disorders. Neuroses; Bias; Biological and medical sciences; Case-Control Studies; Claims; Combat Disorders - diagnosis; Combat Disorders - psychology; Disability allowances; Factors; Humans; Insurance, Disability; Malingering - psychology; Mass Screening - methods; Mass Screening - standards; Medical sciences; Middle Aged; MMPI; Post-traumatic stress disorder; Posttraumatic stress disorder; Psychiatric Status Rating Scales; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Reporting; Sensitivity and Specificity; Veterans; Vietnam War
• ISSN: 0022-3891; 1532-7752
• DOI: 10.1207/s15327752jpa6802_8

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 pan 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.