The consistency of combat exposure reporting and course of PTSD in Vietnam War veterans

Authors

  • K. C. Koenen,

    1. Departments of Society, Human Development, and Health and Epidemiology, Harvard School of Public Health, Boston, MA and Department of Psychiatry, Boston University School of Medicine, Boston, MA
    Search for more papers by this author
  • S. D. Stellman,

    1. Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY
    Search for more papers by this author
  • B. P. Dohrenwend,

    1. Department of Psychiatry, Columbia University and New York State Psychiatric Institute and Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY
    Search for more papers by this author
  • J. F. Sommer Jr.,

    1. American Legion, Washington. D.C.
    Search for more papers by this author
  • J. M. Stellman

    Corresponding author
    1. Department of Health Policy and Management, Mailman School of Public Health, Columbia University, New York, NY
    • Department of Health Policy and Management, Mailman School of Public Health, Columbia University, New York, NY 10032
    Search for more papers by this author

Abstract

Self-reports of traumatic events are often used in clinical and epidemiologic studies. Nevertheless, research suggests combat exposure reports may be biased by posttraumatic stress disorder (PTSD) symptom severity, leading to an inflated dose-response relation between combat exposure and PTSD. The authors examined the consistency in combat exposure reports and their relation to PTSD symptoms in Vietnam Veteran American Legionnaires who responded to two mailed surveys (1984, 1998; N = 1,462). Combat exposure reports were highly reliable (test–retest correlation = 0.87). However, changes in exposure reporting were related to changes in PTSD symptoms, specifically reexperiencing symptoms. The effect size of the dose-response relation attributable to changes in reporting was smaller for continuous than categorical measures. Findings are discussed in relation to recent controversies over veterans' combat exposure reports.

Ancillary