Journal of Consulting and Clinical Psychology 1983, Vol. 51, No. 4, 488-494 Copyright 1983 by the American Psychological Association, Inc. Validation of a Multimethod Assessment of Posttraumatic Stress Disorders in Vietnam Veterans Paul F. Malloy, John A. Fairbank, and Terence M. Keane Veterans Administration Medical Center, Jackson, Mississippi and University of Mississippi Medical Center There appears to be a high incidence of posttraumatic stress disorders (PTSD) in Vietnam veterans. Yet there is little information available on the reliability and validity of any approach to the assessment of these combat-related stress disorders. The present study was designed to determine if responses to the presentation of mild combat stimuli would distinguish the following three carefully matched groups of veterans: (a) those with an exclusive diagnosis of PTSD, (b) inpatients on a psychiatry ward who clearly do not have PTSD, and (c) Vietnam veterans with combat experience who are currently well adjusted. Behavioral, physiolog- ical, and self-report measures of anxiety obtained through this laboratory-based assessment clearly distinguished the PTSD veterans from the remaining two crit- ical comparison groups. The utility of this tripartite assessment approach for the reliable identification of PTSD secondary to combat is discussed. Future research directions are presented. Posttraumatic stress disorders (PTSD) are denned as the maladaptive emotional re- sponse that an individual may experience fol- lowing a discrete traumatic event. The dis- order is characterized by persistently high lev- els of anxiety, intrusive recollections of the event through nightmares or flashbacks, ex- aggerated startle responses, severe sleep dis- turbances, avoidance of close interpersonal contact, depression and guilt, constricted af- fect, and impairment of memory and con- centration abilities (cf. Diagnostic and Sta- tistical Manual of Mental Disorders—DSM- III; American Psychiatric Association, 1980). Traumatic events that can lead to a stress disorder include vehicular accidents, natural disasters, rape, and combat. Many Vietnam veterans were exposed to severely traumatic events during combat, and in addition ex- perienced considerable hostility and lack of support upon return home. As a result, at least 24% of Vietnam veterans surveyed re- This research was supported by a Veterans Adminis- tration Merit review award to Terence M. Keane. The authors would like to thank Barbara Martin and Juesta Caddell for their assistance in the study. Requests for reprints should be sent to Paul F. Malloy or T. M. Keane, Vietnam Stress Management Program (116B), Veterans Administration Medical Center, Jack- son, Mississippi 39216. ported significant problems in their reinte- gration and adjustment to civilian life, and an undetermined number of these have de- veloped PTSD secondary to the traumas of combat (Egendorf, Kadushin, Laufer, Roth- bart, & Sloan, 1981). Unfortunately, very little empirical data exist on methods for the systematic assess- ment and treatment of PTSD in combat vet- erans, especially in Vietnam combat veter- ans. Instead, the literature is replete with studies that simply document the existence of problems in Vietnam veterans, enumerate possible treatment techniques, report non- data-based case reports, or present theoreti- cal conceptualizations of the disorders (cf. Fairbank, Langley, Jarvie, & Keane, 1981). An initial attempt to provide empirical in- formation on Vietnam veterans (Penk et al., 1981) compared groups of combat and non- combat veterans who were seeking treatment for substance abuse on standardized mea- sures of psychological adjustment. They found that combat veterans reported significantly more problems following discharge from the military than did noncombatants, yet they could not be distinguished reliably on the basis of their Minnesota Multiphasic Person- ality Inventory (MMPI) profiles. The absence of a difference between the groups on the MMPI was perhaps due to the heterogeneity 488