شناسایی و مدیریت تمارض در افراد ارائه کننده برای درمان اختلال استرس پس از سانحه: روش ها، موانع و توصیه ها

Malingering of symptoms of posttraumatic stress disorder (PTSD) has become a growing concern, particularly in healthcare and other settings in which the diagnosis is associated with financial incentives such as disability benefits. Although there is a steadily increasing body of research on methods for detecting PTSD malingering, little has been written on the assessment and practical management of malingering in treatment settings. The present article addresses this important issue, including a review of the methods, obstacles, and possible solutions for assessing PTSD malingering, along with suggestions for managing cases in which malingering is strongly suspected.

Posttraumatic stress disorder (PTSD) arises after exposure to a traumatic stressor. That is, following exposure to a situation or event that is, or is perceived to be, threatening to the safety or physical integrity of oneself or others. PTSD symptoms include reexperiencing of the trauma (e.g., recurrent and intrusive thoughts, distressing dreams), avoidance and emotional numbing (e.g., avoidance of reminders of the traumatic event, restricted range of affect), and hyperarousal (e.g., exaggerated startle response) (American Psychiatric Association [APA], 2000). In other words, to diagnose PTSD these symptoms must persist for at least one month and must be associated with significant distress or impairment in functioning.