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What's In a Name? - Name Change Proponents Say Labeling PTSD a 'Disorder' Prevents Treatment
Friedman, who made his case for keeping the name PTSD at the APA forum attended by Chiarelli, said that a disorder, whether it be PTSD or depression “reflects a disturbance in the biological as well as the psychological and development processes underlying mental function.
“We know from abundant research that PTSD is clearly associated with biological alterations, especially in brain function. So is depression. According to this logic, we should call depression suffered in the war zone a major depressive injury to split it off from all other depressive episodes,” Friedman said. “So to change PTSD to PTSI without changing anything else would, in my opinion, accomplish nothing positive. And, on the negative side, it would confuse the issue and set up diagnostic distinctions for which there is no scientific evidence,” he said.
He suggested that a useful model could be the way the situation is handled in Canada. While the military uses the term “operational stress injury,” the medical diagnosis has remained PTSD.
“These changes are proof that stigma can be addressed successfully without changing the diagnostic label. So, we can have it both ways, keep the PTSD diagnostic term and have it regarded as an injury,” Friedman said at the forum.
Canadian soldiers with PTSD also are eligible for the Sacrifice Medal, he pointed out, but “unfortunately, the DoD decided not to give a Purple Heart for PTSD.
“I realize it is a complicated, contentious issue but I think it would have gone much further in reducing stigma than changing the name of PTSD to PTSI.”
The next DSM is set to be published in May 2013, with public comment accepted for the revisions until June 15, 2012.
Those who support the name change said they will continue their campaign. Ochberg and Shay created a website http://www.posttraumaticstressinjury.org/ that includes endorsements from individuals and organizations that support a name change.
Ochberg said that getting rid of “disorder” in PTSD also is a matter of honor.
“I believe the science already supports injury, [but] if you want to argue it is a draw and that the validity of injury is no more or less valid than the validity of disorder, what about the advantage of the therapist and the patient in doing therapy and what about the advantage to the PTS wounded person in feeling honored and being honored?” Ochberg told U.S. Medicine.
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