ptsd Controversy Builds About The Prevalence Of Ptsd In Vietnam Veterans

[allan]

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Controversy Builds About the Prevalence of PTSD in Vietnam Veterans

Plus My Comments

Article sent to me by our Veterans Advocate Paul Sutton.

_http://www.2ndbattalion94thartillery.com/Chas/PTSDContinues.htm_'>http://www.2ndbattalion94thartillery.com/Chas/PTSDContinues.htm_

(http://www.2ndbattalion94thartillery.com/Chas/PTSDContinues.htm)

My meeting with Congressman Filner will be on September 28 in DC.

Kelley

Controversy Builds About the Prevalence of PTSD in Vietnam Veterans

Below is an article sent to me by our Veterans Advocate Paul Sutton.

As most of you know there is a raging battle since Vietnam of what constitutes Post Traumatic Stress Disorder (PTSD), is it curable, or is it only treatable with minimizing some of the effects of PTSD, is it even recognizable in its infancy, is it a life long disorder, how long does it take to diagnose, how many visits, and what is the proper methodology; and on and on.

In addition, there seems to be a battle between the medical doctors and the psychologist and psychiatry in general regarding this issue.

I cannot stress enough the lack of taking into consideration the neuropsychological and neuropsychiatric effects of the herbicides used in Vietnam. That is the first rule of DSM-IV.

Yet, it seems it has been totally ignored because of the Veterans cost and possible incrimination of the toxic chemicals themselves.

NEUROLOGICAL AND NEUROPSYCHIATRIC EFFECTS

Many times, I have posted findings of Ranch Hand found neuropsychological disorders, Army Chemical Corps findings of increased mental disorders, IARC findings of personality changes when exposed to the dioxin, TCDD, Dow Chemical statements made in 1965 of neuropsychological disorders associated, Harvard medical studies, EPA has reported mental faculties disorders which I would think could be found as PTSD symptoms or at least confused as part of the diagnosis. If one looks at the reports of mental disorders found significant, not diagnosed as PTSD but found as separate issues such as mood disorders, schizophrenia, anxiety, panic attacks, depression; Ranch Hand alone found statically significant excess in - psychological disorders of depression, somatization, and severity of psychological distress. Antisocial and paranoid scores were significantly higher along with psychotic delusion. I would also add in the chemical company workers themselves sent into clean up toxic spills, forest workers, rail road workers and the increase in suicides is also part of this complicated equation.

Even the CDC noted:

"In the 1988 Psychosocial Characteristics part of the Vietnam Experience Study (VES), <172> the CDC

found that among Vietnam veterans, certain psychological problems were significantly more prevalent, including depression (4.5% vs. 2.3%; odds ratio = 2.0; 95% C.I. = 1.3 - 1.8) and generalized anxiety (4.9% vs. 3.2%;

odds ratio = 2.0; 95% C.I. = 1.1 - 2.1). About 15% of Vietnam, veterans experienced combat-related posttraumatic stress disorder at some time during their military service. Depression and anxiety were not restricted to the group of veterans having posttraumatic stress disorder. "

If you took three or four of these disorders as a sum rather than individual disorders in a report could you not diagnose as PTSD; or did you miss PTSD. I think the answer is obvious and very confusing as what part is trauma and what part is a neurotoxic chemical. So yes, it is no wonder doctors have a hard time defining what is PTSD in Vietnam Veterans. Moreover, certainly this why in some cases decades after the trauma our Vietnam Veterans are diagnosed with PTSD as the toxic chemical effects manifest.

Nevertheless, assuming there were no toxic chemicals; can we put a time line on as VA has done in the past with the toxic chemical damages? The answer is no.

Many Veterans turned to drugs, many to alcohol or both and some turned into working themselves to death to avoid the confrontations.

As they get older, they can no longer work as they once did and finally they have to admit there is an issue and have been in their life since their return from war. They have to admit that in many cases, they were wrong and it was not the world and their family that was wrong in every case.

Most of these men will not have made many friends since returning from Vietnam. They may have workers at work they have to get along with or in some cases not and they lose their job. They have a few acquaintances but that is about it; as a strong indicator.

Now I did not make this up. This is a result of talking to two VA mental health doctors for at least 16 weeks twice a week that run a very good program on recovery.

The one thing that really disturbed me was the one doctor said in 16 years no one from VA benefits had called him to discuss a case. How VA can deny any case without talking to the treating VA doctor is about out of my capability to rationalize. Obviously, they can and do more often than not.

I think from my experience with these doctors the first thing is to get to the Veteran that there is a potential problem early on in his or her life and what to look for not only by the Veteran but family members as well - then certainly they will have better quality of life. He or she is then given the tools to recognize the symptoms and then seek treatment in both counseling as well as medication, if needed. In most cases the medication and counseling go hand and hand. The Vet feeling somewhat better because of intensive counseling then goes off the medication without the doctors consultation. The two steps forward are now taken four steps back.

This disorder seems to require constant diligence of observation in 'actions as well as reactions' both physical as well as mental and the tools given the veteran to identify and change those outcomes.

Below is the article and this continuing saga of PTSD.

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Controversy Swirls Around PTSD in Vietnam Vets

Military.com | Law & Health Week | August 31, 2007

Controversy Builds About the Prevalence of PTSD in Vietnam Veterans

Newswise — Controversy continues to swirl concerning the findings of a landmark study that estimated the percentage of Vietnam veterans suffering from posttraumatic stress disorder (PTSD).

Traumatic stress experts have renewed a clash over the results of the 1988 National Vietnam Veterans Readjustment Study (NVVRS), which originally estimated that 30.9 percent of veterans endure the effects of PTSD during their lifetime, and that 15.2 percent still suffered from PTSD more then ten years after the war. The actual prevalence of PTSD in veterans is vigorously debated among the field’s leading researchers, with long-lasting public policy implications for veterans of all U.S. wars, including the current conflict in Iraq.

New opinions by several parties involved are reported in the August issue of the Journal of Traumatic Stress, published by the International Society of Traumatic Stress Studies (ISTSS).

Bruce P. Dohrenwend, PhD, of Columbia University, et al. conducted a recent reanalysis of the NVVRS, which found an 18.7 percent prevalence rate of lifetime war-related PTSD and 9.2 percent of current PTSD at the time of the study. The authors say that the finding of lower rates is the result only of differences in the definition of the disorder and does not represent a significantly lower total number of soldiers impacted.

The key finding of their study, according to Dohrenwend et al., was that the NVVRS confirms a “strong dose/response relationship between severity of exposure to war-zone stressors and PTSD.” The more soldiers are exposed to the horrors of war, the more likely they are to suffer from posttraumatic stress.

Richard J. McNally, PhD, of Harvard University, argues that the original NVVRS and the more recent Dohrenwend reanalysis overestimated the prevalence of PTSD in veterans by using faulty criteria for diagnosing the disorder. According to McNally, 5.4 percent of Vietnam veterans showed clinically significant functional impairment at the time of the NVVRS study.

“Eliminating cases who exhibit no functional impairment is an important way to address a chief concern of the NVVRS’s critics,” said McNally. “Not all emotional changes wrought by serving in a war zone are symptoms of disease or disorder.”

A number of experts disagree with McNally’s interpretation of the data, including the original authors of the NVVRS study. William E. Schlenger, PhD, of Duke University Medical Center, et al., claim McNally misrepresents the findings of Dohrenwend et al.’s analysis.

“[McNally’s] erroneous statements and misrepresentations seem clearly to be not random,” said Schlenger et al. “Instead, they appear to have been crafted to support a specific bias that has significant policy implications, i.e. that PTSD prevalence among Vietnam veterans is a minor problem, and the real problem is veterans faking combat exposure and PTSD symptoms to qualify for service-connected disability.”

According to Dean Kilpatrick, PhD, of the National Crime Victims Research and Treatment Center Medical University, “In my view, the reexamination by Dohrenwend and colleagues is a major contribution to this public policy debate…It confirms that most veterans of the Vietnam War were resilient, but that an important subset continued to have PTSD over a decade after the war was over.”

Despite disagreements on numbers and methods, the experts concur that the government has a responsibility to adequately treat veterans with PTSD. “Regardless of [frequency], the central issue is whether resources are sufficient to meet current demand,” said McNally. “The key question is, 'If a veteran seeks mental health care, will that be able to obtain prompt access to state-of-the-art, evidence-based [care]?’ If not, then we must increase resources."

The International Society for Traumatic Stress Studies is an international multidisciplinary, professional membership organization that promotes advancement and exchange of knowledge about severe stress and trauma.

Copyright 2007 Military.com. All opinions expressed in this article are the author's and do not necessarily reflect those of Military.com.

From the August issue of the Journal of Traumatic Stress, published by the International Society of Traumatic Stress Studies (ISTSS) via Military.com.

Note the disagreement with these study results by the one of the original authors of the NVVRS study, William E. Schlenger.

Edited September 8, 2007 by allan

[Jay Johnson]

Good article. It's sad that there's "debate" over this topic, because none of the sides have any real conclusive evidence one way or another and what concrete evidence we do have shows an organic change in the brains of PTSD veterans. As my wife's *civilian* psychologist recently said, "you have an organic disorder and I'm here to help you COPE with it, not cure it". Any psych who says he/she can *cure* PTSD is speaking out of the wrong end of his/her anatomy:-)