News Commentary: Army Fails to Support Troops

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Personality Disorder Diagnosis
Instrumental in Denial of Benefits

Between 2005 and 2007, the Army discharged about 1,000 soldiers a year with a diagnosis of personality disorder, effectively barring them from receiving veteran health care and combat-related disability payments.  Unlike Post-traumatic Stress Disorder (PTSD), caused by encounters with life-threatening events, a personality disorder has its roots in early life, rendering it a pre-existing condition and therefore not the Army’s responsibility.

After a 2007 article appeared in The Nation noting those figures, the Army announced a new policy that required higher level review of all cases.  Soon after that, diagnoses  of personality disorder dropped to 75 percent of their previous level while those of  PTSD skyrocketed, reaching 14,000 by 2008.  Despite this coincidence, the Army steadfastly denies that it had inappropriately discharged all those service members.

In a recent New York Times report on the issue, a personality disorder was described as “a deeply ingrained maladaptive pattern of behavior” whose symptoms could be mistaken for those of the “anger, irritability, anxiety and depression” associated with PTSD.

There are ten categories of personality disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM), only two of which contain any of those symptoms:  Antisocial Personality Disorder (“irritability and aggressiveness”) and Borderline Personality Disorder (“dysphoria, irritability or anxiety,” “inappropriate, intense anger or difficulty controlling anger”).  Both of these labels carry major stigma, the first because it describes a person without conscience and the second by virtue of its pejorative connotations in the mental health field.

Studies have found up to three quarters of people with Borderline Personality Disorder (BPD) have histories of childhood sexual and physical abuse.  Not surprising then that its symptoms mirror those of PTSD.  Assaults on children during the critical years of brain development affect their ability as adults to manage emotions and relate to others.

In selecting the personality disorder diagnosis, the Army managed its bottom line at the expense of the women and men who suffer mental anguish from their war experiences.  Apparently this practice has not abated; Army psychiatrists have discovered another diagnosis that blames the victim, Adjustment Disorder, characterized by “marked distress that is in excess of what would be expected given the nature of the [psychosocial] stressor.”  Congress is looking into that one.

One has to wonder at the shabby treatment service members continue to receive at the hands of the institutions designated to serve them.  Saving money by denying benefits to those who need and deserve them constitutes unconscionable behavior, not unexpected from narcissistic or antisocial personality types but from the United States military?