February 7, 2009

More on PTSD Rates in the War On Terror

Most existing studies define cases of PTSD and depression using criteria that have not been validated, that are not commonly used in population-based studies of civilians, and that are likely to exclude a significant number of servicemembers who have these conditions (italics added for emphasis, Rand, 2008, p. 94).
Read that last part again, “…likely to exclude a significant number of servicemembers who have these conditions (p. 94). Which will increase the percentage of veterans and soldiers who will or have developed severe mental illnesses.
Stringent screening criteria will miss not only actual cases of PTSD and depression but also subthreshold cases, individuals with symptoms of PTSD or depression who do not meet the established case definition yet (italics added) who experience significant impairment. Identifying subthreshold cases of PTSD and depression is important, since interventions and treatment aimed at these cases can reduce symptomatology and prevent progression to full diagnoses (p. 95).
Subthreshold cases of PTSD and depression left untreated will in all probability develop into full blown cognitive pathology and severe maladaptive symptomatology, warranting a diagnosis of a severe mental illness. Soldiers and veterans who do not receive treatment run a high risk of the mental wound to become entrenched into their psyche, further exacerbating their problems in living full productive lives.
Regardless of the sample, measurement tool, or time of assessment, combat duty and being wounded were consistently associated with positive screens for PTSD (p. 97).
Our servicemembers survive wounds that would have killed them in earlier wars. Coupled with the trauma of combat and killing, the trauma of surviving such devastation weighs heavily on the individuals mind.
…research conducted many years after previous conflicts, such as Vietnam…and the first Gulf War…have produced prevalence estimates equal to if not higher than those presented here, which may be due to the emergence of symptoms over time (i.e., a “delayed onset” PTSD) or increases in treatment seeking behaviors. We hypothesize that, regardless of its cause, the need for mental health services for servicemembers deployed to Afghanistan and Iraq will increase over time, given the prevalence of information available to date and prior experience with Vietnam. Policymakers may therefore consider the figures presented in these studies to underestimate the burden that PTSD, depression, and TBI will have on the agencies that will be called upon to care for these servicemembers now and in the near future (p. 105).
Heed the warnings, the research shows that as of right now PTSD rates are equal if not higher than previous wars and that the estimations “…underestimate the burden…” (p. 105). Given this information, I again, lay claim to the oncoming mental health epidemic that our soldiers, veterans and nation face.

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