DSM IV & V Identify Different Groups of Veterans with PTSD


Walter Reed Army Institute of Research psychiatrists have found that many different veterans have Posttraumatic Stress Disorder depending on whether the criteria from the previous or most recent editions of the Diagnostic and Statistical Manual of Mental Disorders are used. In an editorial accompanying the study published in The Lancet Psychiatry, the findings are described as “worrying” in part because “these criteria are used in legal jurisdictions and for the determination of pensions.”

The study found that of 221 soldiers who met DSM-IV-TR criteria for PTSD, 67 (30%) did not meet DSM-5 criteria. At the same time, 59 additional soldiers met only DSM-5 criteria. Overall, 126 or 45% of 280 soldiers meeting either criteria had discordant results. “[T]he new PTSD symptom criteria do not seem to have greater clinical utility, and a high percentage of soldiers who met criteria by one definition did not meet the other criteria,” the researchers wrote in their conclusion. “Clinicians need to consider how to manage discordant outcomes…”

The prevalence of post-traumatic stress disorder (PTSD) in US combat soldiers: a head-to-head comparison of DSM-5 versus DSM-IV-TR symptom criteria with the PTSD checklist (Hoge, Charles et al. The Lancet Psychiatry. August 14, 2014. doi:10.1016/S0140-6736(08)61345-8)

PTSD and DSM-5: unintended consequences of change (McFarlane, Alexander C. The Lancet Psychiatry, Early Online Publication, 14 August 2014. doi:10.1016/S2215-0366(14)70321-9)


  1. What a sick joke doctors make of the world when they vote “diseases” into existence. War is hell, and disgust at war is not a “disease,” it’s common sense and logical. And tranquilizing or putting all our war heroes on mind altering, psychotropic drugs is sick, and wrong. Those instigating and promoting the wars needs to change, our war heroes are right to be disgusted by the horrors they’ve seen and been apart of. Those leading our society are wrong, not those disgusted by it.

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    • Nevertheless, night terrors, flashbacks, hypervigilance, dissociation, and other symptoms that fit the label can be debilitating to the degree that it is, at times, impossible to function normally. It’s normal abnormality and I think it’s a mistake to dismiss it. Talk therapy can help, and maybe some drugs can help for part of the time; but the pain is going to come when it comes and it’s likely to f*ck us up.

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  2. Surprise, surprise… Of course the results differ because PTSD is not an illness, it’s just personal reaction to severe stress and trauma, in case of vets, brought about by war experiences. How about providing people with psychological and social support from war-related traumatic experiences and help them to reintegrate to society (provide adequate medical treatment for any injuries, counseling if they feel need for any, peer support groups, help with housing and jobs).
    I personally wonder if people who are involved in organizations such Veterans against the war are not doing psychologically better simply by staying close to their comrades and working towards long-term solutions to what caused their problems in the first place than people who get 20 prescription meds and a kick in the butt from the system.
    “our war heroes are right to be disgusted by the horrors they’ve seen and been apart of”
    Well said. Getting “PTSD”, however awful, only speaks well about one’s humanity.

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    • this is all so ridiculous to me – I was treated for PTSD using EMDR therapy and after so many years, I finally feel so much better – this is from a terrible childhood growing up under a mentally incompetent mother/dysfunctional family – everyone on this planet is different and different things are troubling them and different methods help them and therefore let’s treat each individual for what they need and stop labeling and trying to fit us all into some peg “they” deem appropriate. “They” do not seem to know much about this or else it would be understood that trauma and stress-related disorders affect us all so differently. Whether you are a veteran or not – ANY trauma can have lasting affects and we need good treatments for our people instead of pills, booze and drugs. My psychologist treated the pain I was bearing, not my addiction. The addiction stems from the need to hide the pain and confusion. I was easily able to overcome my addiction after alleviating alot of my pain. There is always hope if we keep trying. What I get tired of is all the talk talk talk by experts who have their head in some hole and never actually work with patients and/or people and have this greater than thou ego. I think that is their addiction and that they need to alleviate their pain and free their soul … peace!

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  3. Prior to the early 1980s, every veteran presenting symptoms now associated with PTSD received a diagnosis for another “mental illness”, like schizophrenia, manic-depression, depression, etc., and of course the drug or drugs of choice for that diagnosis. The DVA and the APA fought the acceptance of PTSD as a diagnosis foe years. When PTSD was recognized, the vast majority of veterans previously diagnosed with “mental illness” were never re-evaluated, their stigmatizing diagnoses stuck to them like glue.

    I have posted this in the past, but perhaps the recent disclosures of VA impropriety will make it more relevant and believable.

    I am a US Navy veteran of the Vietnam Conflict. In the 1970s, before the diagnosis of Post Traumatic Stress Disorder was developed, I was diagnosed with schizo-affective disorder by Veterans Affairs psychiatrists. After eight years of unsuccessful treatment with psychiatric drugs which severely damaged me both physically and emotionally to the point of suicidal ideation, I was extremely fortunate to recover completely within a few months. I had learned about Orthomolecular Therapy based on tissue mineral analysis of a hair sample and Creative Psychology through my own research and in 1982 was able to obtain a source of these treatments independent from the VA and at my own expense.

    My VA psychiatrist, who later rose to the presidency of the American Psychiatric Association, refused to acknowledge my use of Orthomolecular Therapy, the hair test results, or Creative Psychology and termed my recovery a “spontaneous remission”. From 1982 to 2007, I lived a healthy, productive life, free of not only psychiatric drugs, but all other prescription medicines as well.

    In 2007, concerned about the suicide rate of veterans diagnosed with PTSD, I began to attend a PTSD group at a VA Community-Based Outpatient Clinic. After only a few meetings where I shared my story with other veterans, I was taken aside by a VA psychologist and psychiatrist and diagnosed with paranoid schizophrenia in a twenty minute interview and banned from further participation in the PTSD group.

    When this new diagnosis affected the renewal of my life insurance policy, I requested the medical records of my recovery in the 1980s. I discovered that all such mental health records in DVA VISN 1, in the 1978 to 1990 time period, had been spoliated. No records remain. I am convinced that thousands of veterans could have made recoveries similar to mine, with thousands of lives saved, had VA psychiatrists run studies on Orthomolecular Therapy and Creative Psychology instead of destroying all evidence of a veteran’s drug-free recovery. I have recently been examined and tested by well-qualified civilian forensic psychiatrists, who find in me no evidence of any mental illness.

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  4. There are studies being done on combat veterans and refugees who gained asylum after fleeing their homeland where they were tortured. Speculation that PTSD might include psychosis has lead to these studies and they are assuming that any combat veteran who has a diagnosis of schizophrenia or bipolar disorder who has had a psychotic episode suffers from a psychotic illness because genetics. So, even though my psychotic episode was like a long waking night terror with the substance of my trauma, it doesn’t count. Seems that being diagnosed with a mental illness is an illness.

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