Personality Disorder

[carlie]

I can't find the information I'm looking for to bring about a suggestion to another vet

and hope to get some help on this.

My question is: Does a Personality Disorder fall under the category of Anxiety Disorders ?

Thanks so much,

carlie

Edited January 31, 2007 by carlie

[Josephine]

I can't find the information I'm looking for to bring about a suggestion to another vet

and hope to get some help on this.

My question is: Does a Personality Disorder fall under the category of Anxiety Disorders ?

Thanks so much,

carlie

Personality disorders are considered “congenial or developmental” abnormalities. A personality disorder is characterized by pathological trends in personality structure and manifested by a lifelong pattern of behavior, rather than by symptoms characteristic of an acquired psychiatric disease. Because of its inherent or intrinsic nature, it is not considered a disease for which service connection can be granted.

In order to receive a Personality disorder by the VA.

The veteran must receive a psychological examination in compliance with C.F.R &4.126.

Carlie,

Having been diagnosed with anxiety with depresssion for 42 years and now I am told that I have a personality disorder, without testing, I will say, no, they are not the same.

The Va will pay for anxiety, but no Personality Disorder. Anxiety can be one of the symptoms of PTSD.

This is my understanding, and hope that it helps.

Josephine

Edited January 31, 2007 by Josephine

[carlie]

Damn Josephine,

You're the vet I was trying to find this information for. HA -- you'r post is what I was doing a little research on.

I'm going to point out something in one of your last postings. It's another prime example of the VA contradicting itself,

or at least that's the way I see it.

"During another examination in April 2006, a Staff Psychiatrist reviewed your entire file and stated that several inconsistencies were noted. He stated your symptoms were primarily consistent with a “personality disorder” and that it did not appear that you developed a chronic psychiatric disability while on active duty. "

"As to the diagnosed anxiety disorder, the evidence does not establish this condition developed or was permanently aggravated while you were on active duty. "

So my question on this is ?

Did the VA staff psychiatrist list you with the personality disorder --- yet the VA says diagnosed Anxiety disorder ?

This would be a contradiction if I've understood it right.

Good luck,

Hope this helps a vet,

carlie

[Berta]

They are two distinctly different types of disorders.

The DSM IV (which VA uses)(Diagnostic Statistical Manual) defines both of these conditions :

http://allpsych.com/disorders/personality/index.html

I learned a lot about PDs when I did some volunteer work for my former vet rep-

He had a PD vet who he spent more time on than probably any other claim he ever had --a personal friend of his-(he also made an error and told the vet he got TDIU award when the vet actually got a pension award-and was trying to cover his rear end on that one so the vet would not make a stink.

He even tried to manipulate the regs to reopen this claim-that does no work-

I spent hours with the vet and with his SMRs and current med records-

His PD diagnosis- in my unmedical opinion-after spending all this time with the vet- was absolutely correct.

The fact is- a personality disorder can be an inaccurate diagnosis and it can be changed.

But this takes a strong professional medical opinion- (I advise a Psychiatric opinion over Psychologist on this)

with a complete rationale of a new diagnosis based on the results of the MMPI and the additional battery of tests that can alter the diagnosis of PD.

Still the newer diagnosis must fit into one or more of the categories of mental illness that the VA will service connect.

Then that leaves the nexus of a stressor or accident, rape, death of buddy etc---that also must be proven.

The VBM has a lot of information on PD diagnosis and some advise as to how to get the diagnosis corrected-

On page 141 they state that a PD can develop along with bonafide service connectable PTSD-

but still- it takes bonafide medical evidence to diagnosis that.

Also if the military service of the vet reveals nothing that could be negative and be symptomatic of PD-this too is something the VA has to consider.

But- Carlie- if I were you-

I would follow the advise of NVLSP (VBM) and suggest that the veteran get a full psychiatric medical opinion -along with the full gamut of psychological testing-

MMPI, Weschler, Hand, Shipley-etc-

The VA gave Rod 7 in all-

to associate the level of his PTSD from his CVA residuals-

wha was interesting (these tests took 2 whole days) and a VA psychiatrist and another professional shrink was called in-

was that they revealed PTSD as catastrophic and also detailed the residuals of his Section 1151 brain trauma separately from the PTSD-both disabilities were awarded 100% disabled as separate independent conditions-

the shrink spent time with both of us on the results-

funny thing this all proved his claim for higher PTSD rating- the SSA had given him 2 separate awards-also -for two disabling conditions at 100%-

and the VA NEVER used the results-in his lifetime-

My long point here is-

this vet will need medical evidence to combat the PD diagnosis.

This is as far as you can go- to make this suggest to the vet and to highlight anything at all in the SMRs and treatment records that could help a private doctor to properly assess this vet.

The vet I worked with said at first he would get an IMO and then gave every excuse he could think of-not to get one-

A year later the vet rep- as I was helping another vet in his office- handed me the PD vets folder again- he had gotten another denial-and I handed it right backto him--I had exhausted every avenue of advocacy I could offer. The vet still needed a current solid independent medical opinion.

I think maybe this is why the vet rep screwed up my AO claim.I dont have a magic wand.

( I logged in and still had problems posting this- had to copy it twice-I can only take time to reply to only a few topics -this copying and relogging in takes too long-

[huskerfanfl]

Josephine is correct with her citation regarding personaility disorder. It is not a type of anxiety disorder or depression.

It is possible for someone to have a personality disorder and also be diagnosed with anxiety and/or depression. The way I read the statement that Josephine included was that they are saying that her symptoms indicate a personality disorder as the primary disorder.

The other statement indicates that she may have an anxiety disorder, but it did not occur or get aggravated during service. In short, they did not believe a connection exists.

[Josephine]

Josephine is correct with her citation regarding personaility disorder. It is not a type of anxiety disorder or depression.

It is possible for someone to have a personality disorder and also be diagnosed with anxiety and/or depression. The way I read the statement that Josephine included was that they are saying that her symptoms indicate a personality disorder as the primary disorder.

The other statement indicates that she may have an anxiety disorder, but it did not occur or get aggravated during service. In short, they did not believe a connection exists.

C&P Exam: Cxxxxxxxxx Staff Psychologist VAMC October 18, 2004

Diagnosis: Anxiety Disorder not otherwise Specific with Depression

Of course, it is recognized that such experiences are not proven, though this veteran’s friend does corroborate them. In addition, the veteran had two psychiatric referrals within a short period of time in March 1964. Given this fact, it makes it more likely than not that she had some kind of psychiatric difficulty while in the service, and she was judged to be unsuitable for service. It is unclear why, despite the veteran’s report of telling of her stressors, that they were not documented. The veteran also has indicated no childhood psychiatric difficulties again making the beginning of her troubles dating to service more likely.

C&P Exam: Dr. Lxxxxxxxxxx Staff Psychiatrist VAMC April 12, 2005

Dr. Lxxxxxx C&P April 12, 2005:

AXIS 1: Anxiety disorder not otherwise specific.

AXIS II: personality disorder, not otherwise specific, with borderline, histrionic, and dependent traits

AXIS 111:

(1) Rheumatic heart disease

(2) Transient ischemic attacks

(3) Hypertension

(4) Hypothyroidism

(5) Inner ear problems

(6) Diabetes

(7) Headaches

(8) Degenerative disk disease of L-4-5 and L5-Sl

AXIS IV: None

AXIS V: Current global Assessment of Functioning equals 40

AXIS IV: None

There are several inconsistencies in Mrs. Txxxxxx allegations. She stated both that she did not have emotional problems prior to the service and that she was “always excitable and nervous”. (Dr. Lxxxxxxxxxxxxis referring to an office visit with a Neurologist; Dr. xxxxxx when the veteran stated, she had been nervous all of her life, being 34 years since discharge from the navy, this is the only life that Mrs. Txxxxxxxx remembered.) Mrs. Txxxxxxx symptoms are primarily consistent with a personality disorder. Furthermore, it does not appear that Mrs. Txxxxx developed a chronic psychiatric disability while on active duty.

She was separated from the navy because of “unsuitability” related to her dissatisfaction with the service and several incidents, which she considered indicative of abuse. There is no record of ongoing anxiety or nervousness that was documented during her active duty. In fact, her entrance and exit physicals make no mention whatsoever of any psychiatric symptoms. It is the finding of this board that the veteran’s anxiety disorder was not caused by or worsened by her time in the service.

If I did not enter service with the personality disorder and did not have the anxiety before service and Dr. C. was giving me librium and cafergot.

Where did it come from? If the veteran has been treated for anxiety since the day she left service and in service with the medications - what is the etilogy of it. That is all the BVA wants to know?

What was the reason for the early discharge?

Josephine

[huskerfanfl]

Berta,

You make some very good points. If PD is not the correct diganosis it can be changed, and I think with the way the VA operates that means change as in not be a factor in your exam as either Axis I or II. What people need to keep in mind is that like physical disabilites that can cause anxiety and depression, it is possible for mental disorders to do the same, so if personality disorder is diagnosed, then the anxiety and depression can be diagnosed as secondary to the personality disorder.