Page 52 - January Febuary 2016 Issue
P. 52
PTSD Among Military Personnel: A Review
world wars. Keiser’s (1968) book The The Structured Clinical Interview for DSM-
Traumatic Neurosis describes speciic III-R (SCID; Spitzer, Williams, Gibbon & First,
problems following trauma supporting the 1990) has been the interview most frequently
existence of PTSD prior to the Vietnam War. used to date to evaluate the presence or absence
The studies done among survivors of World of PTSD. The SCID provides a comprehensive
War II death & prisoner of war (PoW) camps, evaluation of Axis I and Axis II diagnoses.
and the Vietnam War accelerated the growth The PTSD module is concise and relatively
of studies related to PTSD among military easy to administer and score, while addressing
personnel. the major diagnostic features of the disorder.
Kulka et al. (1990) found a kappa of .93 when
In 1968, the Diagnostic and Statistical a second clinician listened to audiotapes of the
Manual of Mental Disorders (2nd ed., target interview and then made independent
DSM-II; American Psychiatric Association, diagnoses. McFall et al. (1990) reported 100
1968, p.49) mentioned about the effects percent diagnostic reliability between two
of traumatic stress as ‘fear associated with clinicians who completed independent SCIDs
military combat and manifested by trembling, on ten subjects. Keane, Kolb and Thomas
running, and hiding’. In 1969, the Manual (1988) observed a kappa of .68 for PTSD
of the International Statistical Classiication SCID diagnoses derived from two independent
of Diseases, Injuries, and Causes of Death clinicians who individually interviewed the
(8th ed.; ICD-8; World Health Organization, same patients (N = 37). Kulka et al. (1990)
1969, p.158) referred to condition as also found the SCID diagnosis to be strongly
‘combat fatigue’. Common patterns in the correlated with other indices of PTSD (i.e., the
psychological sequel of women who had Mississippi Scale, the Impact of Event Scale, the
been sexually assaulted, termed as rape PK-Scale of the MMPI). These results suggest
trauma syndrome, and combat related trauma that the PTSD module of the SCID is a measure
contributed to a set of cluster of symptoms with respectable reliability and validity. The
that represented PTSD. limitation of this instrument is that it yields only
dichotomous information about each symptom
Posttraumatic stress disorder (PTSD) was and therefore severity of disorder and changes in
introduced in ICD in its 9th edition, in 1978, symptom level cannot be easily detected.
and in DSM in its 3rd edition, in 1980. In
1994, the acute short-term effects of exposure The Diagnostic Interview Scale (DIS-NIMH)
to a traumatic event were introduced in is a highly structured interview that correlated
DSM-IV as acute stress disorder (ASD). highly with other known measures of PTSD
(Watson et al., 1991) but when used in a
Measures of PTSD community sample, where the base rate of
PTSD was low, the DIS performed poorly, with
I. Structured Clinical Interviews estimates of .23 for sensitivity and .28 for kappa
(Kulka et al. 1991).
52
world wars. Keiser’s (1968) book The The Structured Clinical Interview for DSM-
Traumatic Neurosis describes speciic III-R (SCID; Spitzer, Williams, Gibbon & First,
problems following trauma supporting the 1990) has been the interview most frequently
existence of PTSD prior to the Vietnam War. used to date to evaluate the presence or absence
The studies done among survivors of World of PTSD. The SCID provides a comprehensive
War II death & prisoner of war (PoW) camps, evaluation of Axis I and Axis II diagnoses.
and the Vietnam War accelerated the growth The PTSD module is concise and relatively
of studies related to PTSD among military easy to administer and score, while addressing
personnel. the major diagnostic features of the disorder.
Kulka et al. (1990) found a kappa of .93 when
In 1968, the Diagnostic and Statistical a second clinician listened to audiotapes of the
Manual of Mental Disorders (2nd ed., target interview and then made independent
DSM-II; American Psychiatric Association, diagnoses. McFall et al. (1990) reported 100
1968, p.49) mentioned about the effects percent diagnostic reliability between two
of traumatic stress as ‘fear associated with clinicians who completed independent SCIDs
military combat and manifested by trembling, on ten subjects. Keane, Kolb and Thomas
running, and hiding’. In 1969, the Manual (1988) observed a kappa of .68 for PTSD
of the International Statistical Classiication SCID diagnoses derived from two independent
of Diseases, Injuries, and Causes of Death clinicians who individually interviewed the
(8th ed.; ICD-8; World Health Organization, same patients (N = 37). Kulka et al. (1990)
1969, p.158) referred to condition as also found the SCID diagnosis to be strongly
‘combat fatigue’. Common patterns in the correlated with other indices of PTSD (i.e., the
psychological sequel of women who had Mississippi Scale, the Impact of Event Scale, the
been sexually assaulted, termed as rape PK-Scale of the MMPI). These results suggest
trauma syndrome, and combat related trauma that the PTSD module of the SCID is a measure
contributed to a set of cluster of symptoms with respectable reliability and validity. The
that represented PTSD. limitation of this instrument is that it yields only
dichotomous information about each symptom
Posttraumatic stress disorder (PTSD) was and therefore severity of disorder and changes in
introduced in ICD in its 9th edition, in 1978, symptom level cannot be easily detected.
and in DSM in its 3rd edition, in 1980. In
1994, the acute short-term effects of exposure The Diagnostic Interview Scale (DIS-NIMH)
to a traumatic event were introduced in is a highly structured interview that correlated
DSM-IV as acute stress disorder (ASD). highly with other known measures of PTSD
(Watson et al., 1991) but when used in a
Measures of PTSD community sample, where the base rate of
PTSD was low, the DIS performed poorly, with
I. Structured Clinical Interviews estimates of .23 for sensitivity and .28 for kappa
(Kulka et al. 1991).
52
