Knoll James, Resnick Phillip J
Dartmouth Medical School, One Prince Street, Concord, NH 01061, USA.
Psychiatr Clin North Am. 2006 Sep;29(3):629-47. doi: 10.1016/j.psc.2006.04.001.
The detection of malingered PTSD is made particularly challenging by the subjective nature of PTSD criteria and requires a thorough, systematic approach. The psychiatrist must gather and analyze evidence from the evaluation, clinical records, psychologic testing, third parties, and other sources. Although some individuals may malinger PTSD to avoid criminal sanctions, the most common motivation for malingering PTSD is financial gain. Clinical nuances may help distinguish genuine from malingered PTSD. The psychiatrist should be aware of the differences observed between civilian and combat-related PTSD. Although special effort is required, the psychiatrist bears considerable responsibility to assist society in differentiating true PTSD from malingering.Undetected malingering is not limited simply to fraudulent monetary awards, but can involve misuse of limited mental health resources, leading to negative consequences for the mental health system. As Burkett aptly notes, malingered combat PTSD cases "take time, energy, and financial resources away from treating true combat veterans with PTSD. And real combat vets who truly need help end up in group therapy with phonies, get disgusted, and quit treatment".
创伤后应激障碍（PTSD）伪装的检测因PTSD标准的主观性而极具挑战性，需要采用全面、系统的方法。精神科医生必须从评估、临床记录、心理测试、第三方及其他来源收集并分析证据。虽然有些人可能伪装PTSD以逃避刑事制裁，但伪装PTSD最常见的动机是经济利益。临床细微差别可能有助于区分真正的PTSD和伪装的PTSD。精神科医生应了解平民PTSD与战斗相关PTSD之间的差异。尽管需要付出特别努力，但精神科医生在协助社会区分真正的PTSD和伪装方面负有重大责任。未被发现的伪装不仅限于欺诈性金钱奖励，还可能涉及有限心理健康资源的滥用，给心理健康系统带来负面后果。正如伯克特恰如其分地指出的那样，伪装的战斗PTSD病例“占用了治疗真正患有PTSD的战斗退伍军人的时间、精力和财政资源。而真正需要帮助的真正战斗退伍军人最终却与伪装者一起参加团体治疗，感到厌恶并放弃治疗”。
