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Army Has Difficult Time Diagnosing PTSD


It appears the Army might have a difficult time diagnosing PTSD. The Army has revealed that an estimated 1,000 soldiers were discharged from their duties the year 2005 and 2007 because they diagnosed these brave men and women with a personality disorders rather than PTSD which can be treated.

Army acknowledges problems in diagnosing PTSD

Under demand not only from Congress, but from the public, the Army acknowledged the problem and began to “drastically” cut the number of soldiers given the diagnosis of personality disorders. Advocates for veterans are quite concerned about the stigma and the treatment for a disorder that does not exist for these fearless soldiers that make them ineligible for military health care and other benefits.

"We really have an obligation to go back and make sure troops weren't misdiagnosed," said Dr. Barbara Van Dahlen, a clinical psychologist whose nonprofit "Give an Hour" connects troops with volunteer mental health professionals.

The US Army denies that any soldier was misdiagnosed before 2008, when it drastically cut the number of discharges due to personality disorders and diagnoses of post-traumatic stress disorders began to soar.

The Army regards PTSD as a treatable mental disability caused by the acute stresses of war, the military designation of a personality disorder can have devastating consequences for soldiers. Defined as a "deeply ingrained maladaptive pattern of behavior," a personality disorder is considered a "pre-existing condition" that relieves the military of its duty to pay for the person's health care or combat-related disability pay.

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Sadly, the Army discharged over 1,000 soldiers a year between 2005 and 2007 for having a personality disorder. Interesting, after an article in The Nation magazine exposed the practice, the Defense Department changed its policy and began requiring a top-level review of each case to ensure post-traumatic stress or a brain injury wasn't the underlying cause.

Once the policy changed and the cases got better attention, the annual number of personality disorder cases dropped by 75 percent. Only 260 soldiers were discharged on those grounds in 2009. Coincidentally, At the same time, the number of PTSD cases has skyrocketed and by 2008, more than 14,000 soldiers had been diagnosed with PTSD.

Army officials deny that soldiers were discharged unfairly, saying they reviewed the paperwork of all deployed soldiers dismissed with a personality disorder between 2001 and 2006.

"There's no reason to believe personality discharges would go down so quickly" unless the Army had misdiagnosed hundreds of soldiers each year in the first place, said Bart Stichman, co-director of the National Veterans Legal Services Program.

Stichman's organization is working through a backlog of 130 individual cases of wounded service members who feel they were wrongly denied benefits. Just like in the civilian world where many insurance companies deny coverage for illnesses that develop before a policy is issued, the government can deny a service member veteran health care benefits and combat-related disability pay for pre-existing ailments.

Many soldiers as well as the public are very pleased to know that a congressional inquiry is under way to determine whether the Army is relying on a different designation referred to as an "adjustment disorder to dismiss soldiers and avoid giving them benefits.



The Army and the VA also have problems diagnosing traumatic brain injury (TBI). Both have put an emphasis on imaging to show physical damage despite the fact that according to many brain injury experts that in 75% of cases of TBI no obvious physical damage is apparent. Also, this is not limited to just mild cases as very severe symptoms may be apparent. Furthermore, while some improve over time others do not or even get worse. Often TBI is misdiagnosed or the true severity is underestimated. To make matters worse, these people are often not capable of navigating the maze of paperwork to get the help they need. They are often ignored or patronized by those who are supposed to help because they don't believe they are really hurt. Unfortunately, severe TBI without imaging evidence is all too real and common.