Smith D W, Frueh B C, Sawchuk C N, Johnson M R
National Crime Victims Research and Treatment Center, Medical University of South Carolina, Charleston 29425, USA.
Depress Anxiety. 1999;10(3):119-24. doi: 10.1002/(sici)1520-6394(1999)10:3<119::aid-da5>3.0.co;2-k.
We examined the prevalence of pre- and post-combat traumatic events in the histories of 129 combat veterans referred to be evaluated for PTSD and examined the impact of these non-combat traumatic events on self-reported psychiatric symptoms. Participants were consecutive referrals to a Veterans Affairs outpatient post-traumatic stress disorder (PTSD) clinic who completed structured interviews, self-report measures (e.g., Minnesota Multiphasic Personality Inventory-2; MMPI-2), and a trauma history questionnaire as part of their routine clinical evaluations. Findings show that non-combat trauma was prevalent in this sample, with 65% (21% pre-combat) reporting physical assaults and 12% (11% pre-combat) reporting sexual assaults. Overall, history of sexual or physical assaults did not appear to be systematically related to reported symptom level. However, chi square analyses revealed a consistent over-representation of veterans who reported sexual trauma in the category suggestive of response exaggeration (i.e., MMPI-2 F-K validity index > or = 13). Finally, a hierarchical regression equation predicting F-K scores was computed, but accounted for only 15.9% of the variance in F-K. Presence of sexual assault history was the only predictor associated with a more pronounced response set suggestive of exaggeration or deception. These findings tentatively indicate that if history of sexual or physical assault has an impact on symptom reporting in combat veterans evaluated for PTSD, it is of modest magnitude.
我们调查了129名被转介来评估创伤后应激障碍(PTSD)的退伍军人病史中战斗前和战斗后创伤事件的发生率,并研究了这些非战斗创伤事件对自我报告的精神症状的影响。参与者是连续被转介到退伍军人事务部门诊创伤后应激障碍(PTSD)诊所的患者,他们在常规临床评估中完成了结构化访谈、自我报告量表(如明尼苏达多相人格问卷-2;MMPI-2)和创伤史问卷。研究结果表明,该样本中非战斗创伤很普遍,65%(战斗前为21%)报告遭受身体攻击,12%(战斗前为11%)报告遭受性侵犯。总体而言,性侵犯或身体攻击史似乎与报告的症状水平没有系统关联。然而,卡方分析显示,在提示反应夸大的类别中(即MMPI-2 F-K效度指数>或=13),报告有性创伤的退伍军人一直存在过度代表的情况。最后,计算了一个预测F-K分数的分层回归方程,但仅解释了F-K方差的15.9%。性侵犯史是与更明显的提示夸大或欺骗的反应倾向相关的唯一预测因素。这些发现初步表明,如果性侵犯或身体攻击史对接受PTSD评估的退伍军人的症状报告有影响,其程度也是适度的。