The psychological consequences of combat exposure: The importance of appraisals and post-traumatic stress disorder symptomatology in the occurence of delusional-like ideas

Objective. The aim of the current study is to explore the association between combat experience and the occurrence of delusional-like beliefs. It is hypothesized that negative post-trauma appraisals and positive beliefs about paranoia will be associated with vulnerability to delusional ideas and that veterans who meet criteria for post-traumatic stress disorder (PTSD) will be more likely to hold delusional-like ideas. Design. A small-scale survey design was employed in order to ensure that detailed information was gathered concerning battle exposure. Methods. Forty-one British war veterans completed questionnaires relating to combat experience, delusional ideation, beliefs about paranoia, appraisals of combat trauma and PTSD symptomatology. Results. Negative post-trauma cognitions and positive and negative beliefs about paranoia were associated with increased predisposition to delusional beliefs; however, the severity of combat experience was not. It was also found that veterans who met criteria for PTSD were more likely to hold delusional-like ideas compared with those who did not. Furthermore, the PTSD group held more negative post-trauma cognitions and more positive beliefs about paranoia. Conclusions. These findings suggest that PTSD symptoms may confer vulnerability to delusional beliefs and that this may be mediated by negative appraisals about the self, the world and dysfunctional beliefs about paranoia. However, it is possible that psychotic-like phenomena confer vulnerability to PTSD. The implications of these findings are discussed. © 2007 The British Psychological Society.