Beth Benoit wrote:
> It seems to me that this kind of debate is at the
> heart of psychology: Is it a personality disorder
> or is it the result of stress?
Again, just from my experience of a number of years in private practice,
several of which I worked with veterans who had been given a psychiatric
diagnosis and were eligible for treatment for these disorders, and also having
served in the military and gone through their psychological evaluation upon
reporting to boot camp, I would have to say first that it would be nearly
impossible to diagnosis an individual with a personality disorder ("...an
enduring patter of inner experience and behavior that deviates markedly from
the expectations of the individual's culture, is pervasive and inflexible, has
an onset in adolescence or early adulthood, is stable over time, and leads to
distress and impairment." DSM-IV-TR) in the amount of time that they do the
evaluations, since PDs are not often easily diagnosed in the first visit to a
psychologist.
This would suggest that that diagnosis on discharge would be nearly impossible
to be considered legitimate. PTSD, on the other hand can often be done
relatively quickly after a person has been subjected to an actual or perceived
life-threatening experience.
The statement in the article, "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." Again, according to
DSM-IV-TR, and adjustment disorder "is a psychological response to an
identifiable stressor or stressors that results in the development of
clinically significant emotional or emotional symptoms." This diagnosis,
although it should be differentiated from a true PTSD, seems to be a more
legitimate diagnosis for many troops returning from a battle situation, and
neither diagnosis should be considered to be a "pre-existing" condition. It's
much easier to deal with someone who has lost a limb or who has suffered
traumatic brain injury, than someone who has suffered severe psychological
trauma from the horror of war.
Historically, the government has always had difficulty resolving the problem of
the promises it makes to those who they are trying to enlist and the reality of
the way they deal with returning veterans. Our history in regard to this issue
goes back to WWI. This will continue to be a problem so long as we don't
figure in the cost of treating those individuals who will need care after
serving in the military who have been damaged or disabled, and include these
costs in military appropriation bills.
.
Robert W. Wildblood, PhD
Adjunct Psychology Faculty
Germanna Community College
drb...@rcn.com
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