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The British Journal of Psychiatry (2005) 186: 467-472
© 2005 The Royal College of Psychiatrists

Documented combat exposure of US veterans seeking treatment for combat-related post-traumatic stress disorder{dagger}

B. CHRISTOPHER FRUEH, PhD

Medical University of South Carolina and Ralph H. Johnson Veterans Affairs Medical Center, Charleston, South Carolina

JON D. ELHAI, PhD

Disaster Mental Health Institute, University of South Dakota, Vermillion, South Dakota

ANOUK L. GRUBAUGH, PhD, JEANNINE MONNIER, PhD, TODD B. KASHDAN, MS and JULIE A. SAUVAGEOT, MSW

Medical University of South Carolina

MARK B. HAMNER, MD

Medical University of South Carolina and Ralph H. Johnson Veterans Affairs Medical Center, Charleston, South Carolina

B. G. BURKETT, MBA

Plano, Texas

GEORGE W. ARANA, MD

Medical University of South Carolina and Ralph H. Johnson Veterans Affairs Medical Center, Charleston, South Carolina, USA

Correspondence: Dr B. Christopher Frueh, VA Medical Center (116), 109 Bee Street, Charleston, South Carolina 29401, USA. Tel: +1 843 789 7967; fax: +1 843 805 5782; e-mail: fruehbc{at}musc.edu

Declaration of interest None. Funding detailed in Acknowledgements.

{dagger} See invited commentary, pp. 473-475, this issue

Background There are concerns regarding the validity of combat exposure reports of veterans seeking treatment for combat-related post-traumatic stress disorder (PTSD) within US Veterans Affairs Medical Centers.

Aims To verify combat exposure history for a relevant sample through objective historical data.

Method Archival records were reviewed from the US National Military Personnel Records Center for 100 consecutive veterans reporting Vietnam combat in a Veterans Affairs PTSD clinic. Cross-sectional clinical assessment and 12-month service use data were also examined.

Results Although 93% had documentation of Vietnam war-zone service, only 41% of the total sample had objective evidence of combat exposure documented in their military record. There was virtually no difference between the Vietnam ‘combat’ and ‘no combat’ groups on relevant clinical variables.

Conclusions A significant number of treatment-seeking Veterans Affairs patients may misrepresent their combat involvement in Vietnam. There are implications for the integrity of the PTSD database and the Veterans Affairs healthcare system.




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