Conceptualizing a better understanding of diagnosing and treating posttraumatic stress disorder: a review of two case studies.

Clinical and epidemiological studies have supported the belief that human beings exposed to stressful life events are vulnerable to the symptomatology consistent with posttraumatic stress disorder (PTSD). However, early detection of symptoms consistent with PTSD oftentimes does not occur within the medicolegal arena. The importance of an early and accurate diagnosis is emphasized. Fortunately, the diagnosis of PTSD has become more clearly conceptualized in the DSM-IV criteria. Many of the characteristics consistent with this diagnosis are measured through the use of relatively recently developed and refined psychometric measures including the Posttraumatic Stress Diagnostic Scale, the Trauma Symptom Inventory, and the Personality Assessment Inventory-2. Additional measures including the Computerized Response Bias Test, the Word Memory Test, and the Validity Indicator Profile can detect exaggeration of symptoms without using specific tests for symptom validity. These measures, as well as biochemical determinations, are reviewed and presented along with the over-all structured clinical interviews and mental status examinations of two patients for a better understanding of the multimethod approach which establishes the reliability of the PTSD diagnosis.