Background Of The Debate.
This website will collect and display endorsements from individuals and groups who consider a change in title from PTSD to PTSI an advantage for individuals who are so diagnosed. These endorsements will be reviewed for clarity and collegiality before posting. Anyone may write directly to the APA, DSM-5 committee. This site is meant to show the range of argument, evidence and concern to all who share the concern.
Thank you, Joyce Boaz, PTSI Website Administrator and Director, Gift From Within- A Non Profit Organization for Survivors of Trauma and Victimization.
Why Post Traumatic Stress Injury?
The name, PTSD, was created in 1980 as a new diagnosis. Diagnoses in psychiatry are developed as the medical and mental health communities advance their understanding through research, education, clinical experience, and historic events. The Vietnam war, the womens’ movement, genocide survivors, research on natural disasters all contributed to the PTSD concept.
Although many mental health professionals are licensed to give a diagnosis to a client or patient, only the American Psychiatric Association creates official diagnoses through its publication, the Diagnostic and Statistical Manual (DSM). This process began in the 1950s and has become more thorough and elaborate in the ensuing decades.
No one imagined 50 years ago how broadly and deeply the DSM would become institutionalized throughout healthcare, academia, government (including military organizations), NGOs, insurance, the law. This has enormously raised the stakes for all populations, military service members and military veterans surely among them.
The next DSM will be published in May, 2013. A committee is holding hearings, conducting studies, and publicizing its work in progress, inviting public comment through a website: http://www.dsm5.org/Pages/Default.aspx
Having the PTSD diagnosis has helped millions of people in various ways:
- It gave a name to something that was confusing, frightening and disabling.
- It allowed research into causes and remedies.
- It enabled insurance coverage and disability payment.
- It fostered self-help for those with the condition and collaboration among those who study and treat the condition.
- The name, PTSD, has helped all of us who care about trauma and its consequences.
But the name has also been a source of stigma. The “D” in PTSD, the word, “disorder,” discourages some from seeking care, from revealing their condition and from feeling a sense of honor, when their PTSD is just as honorable as any physical injury. When an injury is earned in battle, awards are given. There is no Purple Heart for PTSD. While the APA uses the term, “disorder,” for most diagnoses, there are many diagnoses without that word, Anorexia, Bulimia, Parasomnia, Social Phobia to name a few.
The former Vice Chief of Staff of the Army, an advocate for reducing the stigma of PTSD, argues strongly in favor of dropping that word, “disorder,” because, “disorder” perpetuates a bias and “has the connotation of being something that is a pre-existing problem that an individual has” before they came into the Army and “makes the person seem weak.”
In a letter to the President of the American Psychiatric Association, Frank Ochberg and Jonathan Shay endorsed General (ret) Chiarelli’s position, adding their own reasoning for a new name: Post Traumatic Stress Injury. Ochberg and Shay believe that the “injury model” and the injury name is correct from a medical and a public perception point of view.