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National Guard Association of the United States

One Mind for Research

National Alliance on Mental Illness

Brain Injury Association of America

Iraq and Afghanistan Veterans of America

Tragedy Assistance Program for Survivors

Comfort for America's Uniformed Service

Code of Support Foundation

Army Wife Network

Yellow Ribbon Fund

United Children of Veterans

Operation Never Forgotten

National Center for Victims of Crime

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39 States and both Houses of Congress drop the “D” to diminish stigma

A WOUND NOT A WEAKNESS     

     In 2012, the APA held an open hearing to debate the name change of post-traumatic stress disorder (PTSD) to, or include, post-traumatic stress injury (PTSI). Regrettably, the APA’s decision was to not change or add to the name for DSM 5. Shortly thereafter Honor for ALL launched a grassroots campaign to publicly rebrand the term as PTSI by petitioning federal, state and local officials to declare June 27 as Post-traumatic Stress Injury Awareness Day. Our ultimate objective was, and still remains, to gather enough support among governing bodies, the press, and the electorate, to motivate the APA’s Scientific Review Committee to revise the DSM to include PTSI as an alternative name for PTSD.    

      The diagnostic term PTSD was crafted in 1980 by the APA to commonly describe and categorize the psychological aftermath of combat stress on Vietnam veterans. Honor for ALL believes the use of the word “disorder” has since been shown as counter-productive to seeking care. And, as the result of intensive electro-magnetic imaging research, it has been revealed that severe post-traumatic stress, combat induced or otherwise, causes physical changes within the brain which more accurately describe an injury than a disorder – a treatable wound calling for definitive treatment.

     Beyond the harmful affect it has on cure, the dispassionate use of the word “disorder” furthermore assails the sense of honor due the brave men and women who have received these wounds in action against an enemy of the United States and similarly fails to acknowledge the gallantry exhibited by first-responders while putting themselves at risk on a regular basis. At the community level, its use can inadvertently disparage the character of victims of crime and abuse, as well as survivors of life-threatening accidents and natural disaster. Plainly, there is room for advancement here. The elimination of stigma and an elevation of recognition here can translate into increased care and decreased hardship.

     HFA Medical Advisor, Dr. Frank Ochberg, former Associate Director of the National Institute of Mental Health (NIMH) and member and chair of APA councils, committees and task forces in the late 1970s and early 1980s materially responsible for advancing the creation and modification of the original diagnosis known as PTSD agrees, “As far as I am concerned, the name PTSD, was never important.  The concept was important.  We knew before 1980 that research would help us adjust the diagnostic criteria through time.  We knew that later versions would reflect evolving scientific knowledge.  And now, evolving knowledge leads us to a modification in the name as well as modifications in criteria.  The basic concept remains. Some details have changed.  The fact that profound trauma creates injuries to brain function, brain physiology and brain anatomy is well established.  The fact that calling this phenomenon an injury, not a disorder, confers honor rather than stigma is now established.

     Our first state resolution for PTSI Awareness Day came from Michigan in 2014. In 2015 we gained the support of the National Guard Association of the United States (NGAUS) and the Adjutant Generals Association of the United States (AGAUS) enabling us to better network with state legislatures nationally; that year we counted participation from 7 states. In 2016 we were joined by 27 states; in 2017, 34. In 2018 we had 39 states, as well as the US House of Representatives, officially proclaim support by designating Post-traumatic Stress Injury Awareness Day through bill, resolution and/or proclamation. The US Senate went so far as to adopt a resolution for PTS Awareness Day.

     Although any movement away from the word “disorder” can be considered intellectual growth, we do not support merely dropping it from the title, leaving that as post-traumatic stress or PTS. We do not wish to create any unnecessary confusion concerning the APA’s existing distinction between common post-traumatic stress and the more debilitating, unrelenting embodiment of that condition. As specified in DSM 3 through 5, under paragraph A of the PTSD criteria, it is normal to have post-traumatic stress (PTS) after directly or indirectly experiencing a traumatic event or stressor – only when symptoms persist and conform additionally with criteria B through H, is disability confirmed.  A traumatized, yet only slightly injured, brain stays in appropriate alarm mode as needed, returning to normal within a month. A critically injured brain, remaining in alarm mode for more than a month, has been physically altered and requires timely medical attention.

     Initially a veterans focused organization, our concern has grown to include all who suffer from the psychological and moral injuries now grouped together under the term post-traumatic stress disorder (PTSD). Removing the “D” takes away from the stigma and that is good. Adding the “I” for injury introduces honor and that is better. 

     For individual Bills, Resolutions and Proclamations in 2018 go to *Supporters*.  

   PTSI RESOLUTION TEMPLATE 

WHEREAS, all citizens of the United States possess the basic human right to the preservation of personal dignity;   

WHEREAS, all citizens of the United States deserve the investment of every possible resource to ensure their lasting physical, mental, and emotional well-being;

WHEREAS, the diagnosis known as Post-Traumatic Stress Disorder (PTSD) was initially formulated in 1980 by the American Psychiatric Association to more accurately assess and assist veterans who had endured severe combat stress in Vietnam;

WHEREAS, combat stress is an invisible wound which has historically been unjustly portrayed as a mental illness caused by a preexisting flaw of character or ability, and that the word “disorder” carries a stigma which perpetuates this misconception;

WHEREAS, it has been shown though electro-magnetic imaging that these invisible wounds can cause physical changes to the brain which more accurately describe an injury than a disorder;

WHEREAS, referring to invisible wounds as a disorder can discourage the injured from seeking proper and timely medical treatment;

WHEREAS, referring to invisible wounds as post-traumatic stress injury (PTSI) is less stigmatizing and viewed as more honorable, and this designation can favorably influence those affected and encourage them to seek treatment without fear of retribution or shame;

WHEREAS, post-traumatic stress injury can occur following exposure to extremely traumatic events other than combat such as, but not exclusive to: interpersonal violence, life-threatening accidents and natural disasters;

WHEREAS, post-traumatic stress injury satisfying criteria A through H of the diagnosis for post-traumatic stress disorder in the Diagnostic Statistical Manual deserves disability compensation equal to that allowed for PTSD under the law;

WHEREAS, all citizens suffering post-traumatic stress injuries deserve our compassion and consideration, those brave men and women of the United States Armed Forces who have received these wounds in operational action against an enemy of the United States further deserve our clear and obvious recognition; and

WHEREAS, timely and appropriate treatment of post-traumatic stress injury can diminish complications and avert suicides:

NOW, THEREFORE, be it RESOLVED that the (Senate/House/Assembly):

designates June 27th of each year is designated as (state) Post-Traumatic Stress Injury Awareness Day;

designates June as (state) Post-Traumatic Stress Injury Awareness Month;

respectfully urges our Departments of Public Health, Military and Veterans Affairs to continue working to educate victims of interpersonal violence, combat, life-threatening accidents or natural disasters and their families, as well as the general public, about the causes, symptoms, and treatment of post-traumatic stress injury and

respectfully directs that this resolution be transmitted to the Governor for appropriate proclamation and execution and to the Secretary of State for appropriate publication and preservation.