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we observe a case in which a Soldier scores above the References
cutoff, the probability that he has PTSD is only 0.55. 1. Hing M, Cabrera J, Barstow C, et al. Special Operations
This means that a substantial percentage of survey re- Forces and incidence of post-traumatic stress disorder
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their PTSD group probably did not actually have the 2. Weathers FW, Litz BT, Herman DS. The PTSD Checklist:
condition of interest. This conclusion is supported by a reliability, validity, and diagnostic utility. Paper presented
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et al. study respondents against the mean PCL scores of matic Stress Studies, October 1993, San Antonio, TX.
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It is further supported by analysis with the Test Valida- ployment-related stress and trauma in Dutch soldiers re-
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Primary Care Posttraumatic Stress Disorder Screen and
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10
Ramchand et al. ) among studies that are otherwise 8. Frederick R, Bowden S. The test validation summary. As-
well done and held in high regard (see, e.g., Smith et sessment. 2009;16:215–236.
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11
to erroneous PTSD BR estimates that can encumber our mary to explore constructs in symptom validity tests. J
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tinued narrative of PTSD” that “kindle[s] self-fulfilling PTSD, depression, and TBI among returning servicemem-
prophecies and actually contribute[s] to an increase in bers. In Tanielian T, Jaycox L, editors. Invisible wounds
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aware of the greater implications of our work. As such, spective population based U.S. military cohort study. Br
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Keywords: posttraumatic stress disorder, surveys
Disclaimers
Opinions expressed here do not necessarily reflect those
of any organization with which the authors are affili-
ated. We are grateful to Paul Dean, PhD (COL, U.S. Dr. Neller is in independent practice in Southern Pines, North
Army), Jeff McNeil, PhD (LTC, U.S. Army), Dan Sea- Carolina.
grave, PsyD, ABPP, and Rick Frederick, PhD, ABPP
(CPT, U.S. Navy, Ret) for their helpful comments. A MAJ Butcher is affiliated with the United States Army Spe-
more detailed analysis of the Hing et al. study is avail- cial Operations Command at Fort Bragg, North Carolina.
able on request: daniel.neller.ctr@ahqb.soc.mil.

Disclosures
The authors have nothing to disclose.

92 Journal of Special Operations Medicine Volume 14, Edition 1/Spring 2014