Frueh B C, Gold P B, de Arellano M A
Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Veterans Affairs Medical Center, Charleston, USA.
J Pers Assess. 1997 Apr;68(2):369-84. 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 part 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.
我们在一家退伍军人事务部（VA）医疗中心，对165名接受创伤后应激障碍（PTSD）评估的参战退伍军人进行了研究，考察了寻求赔偿状态对急性精神病理学和心理困扰自评量表反应模式的影响。退伍军人完成了明尼苏达多相人格调查表-修订版、贝克抑郁量表、与战斗相关的PTSD密西西比量表、解离体验量表的固定反应格式版本以及事件影响量表，作为标准评估套餐的一部分。结果显示，与不寻求赔偿的退伍军人相比，寻求赔偿的退伍军人在各项测量中认可的精神病理学水平显著更高，并且产生了大幅升高的“伪装不良”效度指标。即使控制了收入、整体功能评估和临床医生评定的PTSD严重程度的影响，两组在大多数量表和指标上的差异仍超过了1.0的效应量。研究表明，VA为与战斗相关的PTSD提供残疾赔偿，会妨碍对前来接受治疗的退伍军人进行准确的初始评估，并可能损害对该人群长期治疗结果的估计。
