Tuesday, May 12, 2009
How much of a PTSD problem is there?
I just saw a brief segment on CNN dealing with the shooting of five service members by another in a clinic in Iraq. (See Sgt. charged with killing 4 soldiers, 1 sailor by Michelle Tan Army Times 05/12/09.)
One of the talking heads on the CNN segment was saying that one third of soldiers returning from Iraq are diagnosed with post-traumatic stress disorder (PTSD).
Now, I think it's a real scandal that the Army seems to be reluctant to recognize the extent of this problem. Getting the right treatment for soldiers suffering from combat-related disorders is important for all kinds of reasons, one of which this mass murder case dramatizes.
David Dobbs in the April 2009 Scientific American, Soldiers' Stress: What Doctors Get Wrong about PTSD, argues - apart from the issues about access to proper treatment - that some of the estimates of the incidence of PTSD are seriously exaggerated. The articles three summary bullet-points:
Dobbs summarizes the studies on PTSD as follows:
The biggest longitudinal study of soldiers returning from Iraq, led by VA researcher Charles Milliken and published in 2007, seemed to confirm that we should expect a high incidence of PTSD. It surveyed combat troops immediately on return from deployment and again about six months later and found around 20 percent symptomatically "at risk" of PTSD. But of those reporting symptoms in the first survey, half had improved by the second survey, and many who first claimed few or no symptoms later reported serious symptoms. How many of the early "symptoms" were just normal adjustment? How many of the later symptoms were the imposition of a trauma narrative onto other problems?Even the Millikin study, which Dobbs argues that the other data suggest is exaggerated in its 20% estimate, doesn't justify the "one third" number the CNN talking head was using this morning.
See also: Richard McNally, Progress and Controversy in the Study of Posttraumatic Stress Disorder Annual Review of Psychology 2003 (article first published 08/06/02). Dobbs calls McNally "perhaps the most forceful of the critics" of the prevalence of the PTSD diagnosis.
Tags: iraq war, ptsd, richard mcnally
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No subject for immortal verse
That we who lived by honest dreams
Defend the bad against the worse."
-- Cecil Day-Lewis from Where Are The War Poets?
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