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- W1972503769 abstract "Frueh et al. raise important concerns regarding possible iatrogenic consequences of current Department of Veterans Affairs (VA) policies for posttraumatic stress disorder (PTSD).1 Although space constraints likely limited their focus, it would have been desirable for Frueh et al. to have taken their arguments further. They could have pointed out, for example, that the validity of the PTSD diagnosis remains an open question, with concerns of possible iatrogenic effects flowing from the construct itself.2,3 It also could have been stated more strongly that there should not be anything controversial in the observation that VA policies likely interact with disability convictions and chronic presentations of PTSD. After all, issues concerning malingering and factitious disorders have been recognized for centuries.4Frueh et al. can expect their call to reevaluate VA policies to be roundly criticized. This observation goes beyond what can be typically expected when differences of opinion or interpretation of fact are debated. Experience has shown that “traumatologists” can confuse an open airing of issues with the abandonment of victims. When in 1987 Breslau and Davis critiqued the rationale for defining traumatic stressors (criterion A),5 Lindy et al. wondered if the analysis was harmful on ethical grounds for suggesting that victims of trauma be ignored.6 When in 1996, Rosen discussed the issue of feigned PTSD,7 Nesbit suggested he had a “flip” attitude toward genuine sufferers.8 More recently, Kilpatrick expressed concern that excessive debate among professionals may be harmful to the interests of those who survive traumatic stress.9 Perhaps related to the misguided apprehension that scientific debate is against the interests of victims, the Institute of Medicine published a review on the validity of the PTSD diagnosis without providing a hint of the problems that exist with this diagnosis.10 In the context of current sentiments, Frueh et al. have shed light on matters that require continued examination and discussion." @default.
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- W1972503769 date "2008-05-01" @default.
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- W1972503769 title "VA DISABILITY POLICIES AND POSTTRAUMATIC MORBIDITY" @default.
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- W1972503769 doi "https://doi.org/10.2105/ajph.2008.133751" @default.
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