U.S. District Judge Anna Diggs Taylor in Detroit became the first judge to strike down the National Security Agency’s program, which she says violates the rights to free speech and privacy, as well as the separation of powers enshrined in the Constitution.” (Tracy Press)
The study, authored by Bruce Dohrenwend from Columbia University and associates, and published in Science, cross-referenced veterans’ combat records against claims of disability, based on data the Veterans’ Administration had collected to search for fraudulent claims. There has long been a sense that the reported prevalence of PTSD in Vietnam veterans was implausibly high. Some studies place the rate above 30% despite the fact that only an extimated 15% of Vietnam-era veterans saw frontline combat. The new study estimates the overall prevalence rate at around 19% instead. It agrees with earlier studies estimating that half of diagnosed PTSD sufferers remain disabled by their symptoms.
However, for several reasons we should not leap to the conclusion that the overdiagnosis was the fault of exaggerated or fraudulent claims, although I am sure that veterans’ anger at their abandonment by American society upon their return certainly fueled an attitude in some of exploiting the disability system. It is ridiculous to say that war traumatizes only those who saw grunt combat. This first of ‘modern wars’ did not have conventional front lines or easy ways of distinguishing enemy combatants from civilians (as in Iraq). As the study authors point out in rejecting the idea that veterans have consistently exaggerated their claims, there was broad traumatic exposure to ambushes and shellings as well as treating casualties. Also, this was the first war with a high degree of efficient depersonalized remote-control killing by carpet bombing, which traumatizes participants and observers in a different but often no less profound way. As in the Iraqi action, a widespread sense of cynical disaffection and betrayal by their country came with the realization that the war was based on disingenuous intentions and lies and that the soldiers were cannon fodder for immoral and misguided old men.
But there are other reasons that previous estimates about the prevalence of PTSD have been inflated. First of all, as readers of FmH have heard me opine before, the label is often applied in a fast and loose manner rather than diagnosed by rigorous criteria. There really is a disease state that arises from exposure to overwhelming trauma threatening one’s survival or bodily integrity or that of those around you, with lasting psychological and physiological damage and substantial resulting impairment of functioning, sometimes for the rest of the sufferer’s life. But it takes an experience outside the pale of what can reasonably be expected in human experience, and outside of the stress parameters our nervous systems evolved to cope with. It does not happen after any ol’ upsetting experience. So I place the fault for the overdiagnosis of PTSD as much on the shoulders of naive and unsystematic practitioners as I do with exaggerating complainants (whether we are talking about combat trauma or alleged sexual abuse victims, the other segment of the society with epidemic PTSD diagnosis rates). Dohrenwend’s group applied tight criteria in making the diagnosis, which I favor. Furthermore, the study also, quite rightly, excluded trauma disability claims in veterans which originated with events prior or subsequent to their military service, e.g. devastating auto accidents etc.
Of course there are implications from this study for the estimated rates of combat trauma with which Iraq veterans will come home, and planning for mental health services for them. Despite my pet peeve about ‘formal’ PTSD being overdiagnosed in modern American mental health practice, the numbers of those returning from the Middle East who will be psychically devastated and their ability to function in civilian society impaired will be more extensive, not less, than the services the Veterans’ Administration has planned to provide. The debate over the legitimacy and extent of the PTSD diagnosis should not mislead us into thinking that only those with ‘official’ PTSD need services. Let us hope the sophists do not use this study to justify withholding any chances of recovery and resumption of civilian functioning to tens of thousands of decommissioned soldiers returning from the Middle Eastern actions.
