Does the "D" in PTSD cause individuals suffering from it to shy away from treatment? That's what some people think, and in the midst of the American Psychiatric Association's revision of its well-known, yet often controversial book, The Diagnostic and Statistical Manual of Mental Disorders (DSM), the debate is heating up. 

In an article for the Washington Post, Greg Jaffe writes, "It has been called shell shock, battle fatigue, soldier’s heart and, most recently, post-traumatic stress disorder, or PTSD. Now, military officers and psychiatrists are embroiled in a heated debate over whether to change the name of a condition as old as combat." The proposed change: post-traumatic stress injury.

Jaffe reports that military officers and some psychiatrists believe that replacing "disorder" with "injury" will reduce the stigma associated with the diagnosis, thereby resulting in more trauma victims seeking treatment. The argument goes that while "disorder" connotes a permanent mental condition, "injury" suggests that the problem is time-limited and can be healed with treatment.

While this name change request, which originated with the US Army, may sound simple and straightforward, history shows us that changes in diagnoses can be anything but. One of the major concerns voiced is that altering a diagnostic label may have far-reaching financial implications for health insurers and disability claims. Specifically, some insurers and government agencies may not be willing to reimburse mental health providers for a condition that isn't considered a disease or disorder.

Jaffe says that those supporting the name change point out that PTSD is the only "mental illness" that must be caused by an outside force. "The intensity of the trauma," he writes, "whether it is a rape, car crash or horrifying combat, is so overwhelming that it alters the physiology of the brain. In this sense, PTSD is more like a bullet wound or a broken leg than a typical mental disorder or disease."

However, those charged with updating the DSM must decide if injury is the best way to characterize the serious and often life-changing symptoms that some individuals suffer after exposure to a traumatic event, such as sexual assault, dometic violence, combat, and serious accidents. Symptoms of PTSD can be quite severe and may include intrusive memories, nightmares, sleep disturbance, flashbacks, hypervigilance, irritability or angry outbursts, concentration problems, emotional numbing, detachment, and loss of interest in once pleasurable activities. The debate will play out on Monday in Philadelphia, where a group of psychiatrists will hold a public hearing to address the proposed change.

What do you think? Please share your thoughts in the comments section below.

© 2012 Sherrie Bourg Carter, All Rights Reserved

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Sherrie Bourg Carter is the author of High Octane Women: How Superachievers Can Avoid Burnout (Prometheus Books, 2011). 

About the Author

Sherrie Bourg Carter Psy.D.

Sherrie Bourg Carter, Psy.D., psychologist and author of "High Octane Women: How Superachievers Can Avoid Burnout," specializes in the area of women and stress.

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