Heterogeneity of posttraumatic stress disorder symptoms in Croatian war veterans: retrospective study

To determine the relationship between the intensity of combat-related posttraumatic stress disorder (PTSD) and the intensity of predominating symptoms.

The study included 151 veterans from 1992-1995 war in Croatia (aged 38.3+/-7.3 years) with PTSD. The veterans were psychologically tested with the Mississippi Scale for Combat-related PTSD (M-PTSD), Questionnaire on Traumatic Combat and War Experiences (USTBI-M), and Minnesota Multiphasic Personality Inventory-version 201 (MMPI-201).

The discriminative analysis of the data revealed that the group with lower PTSD intensity had the highest scores on MMPI scales D (depression, T-score 98.3+/-5.6), Hs (hypochondriasis, 90.1+/-5.1), and Hy (hysteria, 89.5+/-4.9), whereas the group with higher PTSD intensity, besides these three scales (D=95.7+/-5.3; Hs=87.6+/-4.3; Hy=85.6+/-4.7), also had clinically significantly elevated Pt (psychastenia, 80.6+/-5.6), Sc (schizophrenia, 79.6+/-4.8), and Pa (paranoia, 85.6+/-5.4) scales, with the highest Pa scale.

It was possible to differentiate study participants with different PTSD intensity on the basis of their MMPI profile. More intense PTSD was associated with externalized symptoms, such as aggression, acting-out, hostility, and mistrust, whereas less intensive PTSD was associated with mostly depressive symptoms. Our study showed that different intensity of PTSD has different symptom patterns.