As a nonclinician here is my question: Are PDs something a person might be predisposed to, such that a stressor, such as deployment--whether or not in combat because even those not in actual combat are in a constant tension of potential attack--could be a trigger to develop the underlying predisposition to something that had not as yet manifested itself? I'm thinking of the analogy to the diathesis-stress model for schizophrenia; or even for some folks who develop anxiety and/or depressive disorders, it seems that an environmental trigger can bring the disorder to bloom.
Annette Annette Kujawski Taylor, Ph. D. Professor, Psychological Sciences University of San Diego 5998 Alcala Park San Diego, CA 92110 tay...@sandiego.edu ________________________________________ From: Dr. Bob Wildblood [drb...@rcn.com] Sent: Monday, August 16, 2010 5:22 AM To: Teaching in the Psychological Sciences (TIPS) Subject: Re: [tips] Personality disorder or PTSD? 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 --- You are currently subscribed to tips as: tay...@sandiego.edu. To unsubscribe click here: http://fsulist.frostburg.edu/u?id=13534.4204dc3a11678c6b1d0be57cfe0a21b0&n=T&l=tips&o=4225 or send a blank email to leave-4225-13534.4204dc3a11678c6b1d0be57cfe0a2...@fsulist.frostburg.edu --- You are currently subscribed to tips as: arch...@jab.org. To unsubscribe click here: http://fsulist.frostburg.edu/u?id=13090.68da6e6e5325aa33287ff385b70df5d5&n=T&l=tips&o=4228 or send a blank email to leave-4228-13090.68da6e6e5325aa33287ff385b70df...@fsulist.frostburg.edu