In the public domain.

Interviews were conducted with a nationally representative sample of 1,200 male Vietnam veterans and the spouses or co-resident partners of 376 of these veterans. The veteran interview contained questions to determine the presence of posttraumatic stress disorder (PTSD) and items tapping family and marital adjustment, parenting problems, and violence. The spouse or partner (S/P) interview assessed the S/P's view of these items, as well as her view of her own mental health, drug, and alcohol problems and behavioral problems of school-aged children living at home. Compared with families of male veterans without current PTSD, families of male veterans with current PTSD showed markedly elevated levels of severe and diffuse problems in marital and family adjustment, in parenting skills, and in violent behavior. Clinical implications of these findings are discussed.

Structural equation modeling procedures were used to examine relationships among several war zone stressor dimensions, resilience-recovery factors, and post-traumatic stress disorder symptoms in a national sample of 1,632 Vietnam veterans (26% women and 74% men). A 9-factor measurement model was specified on a mixedgender subsample of the data and then replicated on separate subsamples of female and male veterans. For both genders, the structural models supported strong mediation effects for the intrapersonal resource characteristic of hardiness, postwar structural and functional social support, and additional negative life events in the postwar period. Support for moderator effects or buffering in terms of interactions between war zone stressor level and resilience-recovery factors was minimal.

Few guidelines exist for the psychological assessment of posttraumatic stress disorder (PTSD) in Vietnam combat veterans. The focus of the present study was to develop empirically based criteria for use of the Minnesota Multiphasic Personality Inventory (MMPI) to aid in the assessment and diagnosis of PTSD. Two hundred patients were assigned to either a PTSD group (n = 100) or to a non-PTSD control group (n = 100). Standard clinical profiles demonstrated that the PTSD group had overall higher mean elevations and an 8-2 configuration. A discriminant function analysis based on an empirically derived decision rule correctly classified 74% of the patients in each group. A special PTSD subscale was developed and cross-validated that improved diagnostic hit rates to 82% of the patients. The discriminant validity of the diagnosis of PTSD and the use of psychological tests in the assessment of Vietnam combat veterans are discussed.

In this rural sample, African American and white youth were equally likely to have psychiatric disorders, but African Americans were less likely to use specialty mental health services. School services provided care to the largest number of youths of both ethnic groups.