In a big reversal, the Army has issued a stern new set of guidelines to doctors tasked with diagnosing post-traumatic stress disorder (PTSD) among returning soldiers. Stop spending so much time trying to spot patients who are faking symptoms, the new guidelines instruct. Chances are, they’re actually ailing.
The 17-page document has yet to be made public but was described in some detail by the Seattle Times. In it, the Army Surgeon General’s Office specifically points out — and discredits — a handful of screening tests for PTSD that are widely used by military clinicians to diagnose a condition estimated to afflict at least 200,000 Iraq and Afghanistan veterans.
The Army Surgeon General finds great fault with a dense personality test popular with clinicians that ostensibly weeds out “malingerers,” as PTSD fakers are known.
But the results of what’s known as the Minnesota Multiphasic Personality Test are flawed, according to the report. PTSD sufferers often exhibit anxiety, insomnia, flashbacks and depression — all of which, some doctors believe, can be discounted under the test. The test devotes a large swath of questions to catching apparent exaggerations of symptom severity, seemingly inconsistent answers, or reported symptoms that don’t mesh with the typical signs associated with an illness.
“The report rejects the view that a patient’s response to hundreds of written test questions can determine if a soldier is faking symptoms,” the Seattle Times summarized. Where PTSD is concerned, that’s especially true. The condition is accompanied by symptoms that can differ markedly between patients: Some are hyperactive, others are lethargic; some exhibit frenetic rage while others are simply sullen and depressed.