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PTSD could become injury, not disorder

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POSTED: June 12, 2012 7:00 a.m.

Post-traumatic stress disorder could be in for a name change as some Army and Department of Veterans Affairs officials push to redefine its diagnosis as an injury, rather than a disorder.

In a Nov. 4, 2011, interview with PBS Newshour, Gen. Peter Chiarelli, who was then vice chief of staff but is now retired from the Army, said renaming PTSD could encourage more soldiers to seek help when they’ve exceeded their capacity to cope with a traumatic event.

Chiarelli’s call for a name change comes at a time when the American Psychiatric Association is updating its Diagnostic and Statistical Manual of Mental Disorders, which “classifies and defines the criteria for mental health conditions.”

Responding to questions about the possibility of such a name change, Fort Stewart’s Winn Army Community Hospital’s public affairs officer Michelle Gordon contacted the Army Medical Command’s Office of the Surgeon General.

“That is not up to the Army Medical Command,” said Maria Tolleson, media relations specialist for the Office of the Surgeon General Public Affairs, Directorate of Communications. “Right now, PTSD is a defined disorder in the Diagnostic and Statistical Manual of Mental Disorders. So the decision to re-define it will be made by the august body that makes up the American Psychiatric Association, which publishes the DSM.”

According to the PBS article, PTSD rates in the Army for combat infantry soldiers are 10 to 20 percent. Units involved in repeated, intense combat have PTSD rates of 25 percent to 30 percent.

Whether or not PTSD is redefined as PTSI, Tolleson said treatment for it will not change.

“PTSD by any other name is still PTSD,” she said. “So our treatment modalities would not change.”

The revised DSM is scheduled to be released in May 2013.

A May 14 National Public Radio report said the military and the VA want more veterans and service members to get appropriate treatment for PTSD, but language in the current definition, like “helplessness and fear,” doesn’t fit for the military, where soldiers are trained to “soldier through” pain and accomplish the mission.

Another key word, “malingering,” or faking an illness, could cost a soldier his or her benefits or lead to punishment. Official said changing this sort language and viewing PTSD as a long-term injury rather than a disorder could lift the stigma of a mental illness and encourage more soldiers to seek help if they’re “re-experiencing” a traumatic event, having distressing dreams or have become hypervigilant — an enhanced state of sensory sensitivity, usually accompanied with “jumpy” behavior.

A May 22 article in the Augusta Chronicle notes concern about coverage still exists, particularly with veterans applying for disability compensation from the VA. The article said dropping the word “disorder” from PTSD might reduce the stigma, but changing the term to injury could make it more difficult for veterans to qualify for permanent benefits because an injury implies something that heals.

 

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