Ft. Campbell soldier's suicide leaves widow angry at Army

[guruoo]

The military must have worked hard to keep the whole truth from
surfacing, as the only mention of this in the local media up until
today was an incidental crimebeat blurb noting a suicide that occured
downtown. (be sure and note the outrageous reader comments @ the story link)

Why did Sgt. Rand die?
Soldier's suicide leaves widow angry at Army
By MATT RENNELS
The Leaf-Chronicle

Dena Rand pulled out a manila file folder as thick as a dictionary and set it on the table.
Inside were mental health records of her husband, Brian Rand, from the U.S. Department of Veterans Affairs.

Sgt. Brian Rand, a 26-year-old Army veteran with the 96th Aviation Support Battalion, shot and killed himself the morning of Feb. 20 in the Cumberland RiverCenter Pavilion, and his wife wants to know where the Army was when Brian Rand asked for help.
"If these people would have done their job, this may not have happened," she said. "There's just a need for change. This system hasn't worked."

<snip>

Sgt. Rand wrote in the assessments that he had combat-related nightmares, felt down or hopeless at times, and had mood swings.
"When someone checks 'yes' to these types of things, clearly they should be evaluated for mental help," she said. "But according to them, he never requested help."

Deputy Commander for Clinical Services Lt. Col. Michael Place said the Army can't comment on specific cases such as Rand's, but said these cases are taken seriously.

Story: http://theleafchronicle.com/apps/pbcs.dll/article?AID=/20070422/NEWS01/704220359

[babylonsister]

1. Damn them to hell for their shitty way of supporting the troops. NOM. nt

[Monkeyman]

2. Anger Grows in Military Families Reports like this are all over the Country

[Mnemosyne]

3. They are trying to call PSTD - "personality disorder" now.

My heart goes out to anyone that suffers and the families/friends that suffer along with them and at times after they have already become a suicide statistic. :hug:

[babylonsister]

4. I've seen/read that; bottom line, they don't want to have to pay

disability for life, so now the 'personality disorder' can be considered a pre-existing condition.

[Mnemosyne]

7. How else could they have afforded their

magnificent embassy?!:grr:

[Mnemosyne]

6. Nice try by the military to classify PTSD as BPD.

If there are so many enlisted that were suffering from BPD when they joined, there is little chance they would have made it through basic; more likely basic created it if it exists in such great numbers in the returning troops.

Here are several articles on PTSD and Borderline Personality Disorder:

August 25, 2006

Borderline Personality Disorder: An Overview

John M. Oldham, M.D.

Classification and Diagnosis

DSM-IV-TR emphasizes that patients with borderline personality disorder (BPD) show a "instability of interpersonal relationships, self-image, and affects, and marked impulsivity beginning by early adulthood and present in a variety of contexts," and any five out of nine listed criteria must be present for the diagnosis to be made.

snip>

Gunderson (2001) portrayed DSM-defined BPD as a diagnostic category layered between neurotic and psychotic disorders, and he differentiated BPD from Otto Kernberg, M.D.'s, theoretical concept of intrapsychic structure referred to as borderline personality organization, an umbrella concept that encompasses a number of Cluster A and Cluster B personality disorders that are characterized by the presence of primitive defenses and identity diffusion, yet with the maintenance of reality testing (Kernberg, 1975). It is now clear that DSM-IV-defined BPD is a heterogeneous construct that includes patients on the mood disorder spectrum and the impulsivity spectrum (Siever and Davis, 1991), in contrast to the original speculation that these patients might be near neighbors of patients with schizophrenia or other psychoses. Patients with schizotypal personality disorders are, instead, the genetic cousins of those patients with schizophrenia.

snip>

A general stress/vulnerability conceptual framework is useful in considering varying combinations of predisposing genetic risk factors and stressful life experiences (Paris, 1999). Among the factors contributing to the etiology of BPD that have been suggested are:

* Affective dysregulation (Akiskal, 1981; Akiskal et al., 1985; Klein and Liebowitz, 1982)
Affective responsiveness is the ability of an individual to respond to another with appropriate feelings (Epstein, Bishop, Ryan, Miller, & Keitner, 1993). Affective (emotional) responsiveness is very important because family members interact with one another on a regular basis and often need to support each other during difficult times. Affective (emotional) responsiveness is the ability of an individual to respond to another with appropriate feelings.

* Deficit in impulse control (Hollander, 1993; Links and Heslegrave, 2000; Siever, 1996; Zanarini, 1993)

* Excessive aggression, either as primary temperament or secondary to severe and sustained childhood abuse (Kernberg, 1975; Zanarini and Frankenburg, 1997)

* Impaired development of autonomy, perhaps related to parental separation-resistant pathology, resulting in intolerance in the patient with BPD to being alone (Gunderson, 1996; Masterson, 1972; Masterson and Rinsley, 1975)

* Lack of a stable sense of self or identity, perhaps secondary to inconsistency, neglect or abuse in early parenting (Adler, 1985; Adler and Buie, 1979)

This sounds too much like military basic training objectives, imo.

snip>

Epidemiology and Course

Borderline personality disorder is thought to occur in 1% to 2% of the general population, although there have only been a few large-scale, population-based epidemiological studies that included BPD and utilized structured interview methodology. In a careful analysis of the limited literature on the topic, Torgersen (in press) tabulated the prevalence of BPD in eight published studies, including his own Norwegian study (Torgersen, 2000). Across all eight studies, the median prevalence for BPD in the population was 1.42%, and the mean was 1.16%. The prevalence of BPD was estimated to be 10% to 20% in psychiatric outpatient populations and 15% to 20% in psychiatric inpatient populations (Gunderson, 2001).

http://www.psychiatrictimes.com/Personality-Disorders/showArticle.jhtml?checkSite=psychiatricTimes&articleID=192300212

I believe that debriefing is about all the treatment that many of our troops are given in light of the increasing suicide rates. How many have committed suicide in country? We will never know the truth I fear.

Psychological Debriefing Does Not Prevent Posttraumatic Stress Disorder

by Richard J. McNally, Ph.D.

April 2004, Vol. XXI, Issue 4

snip>

Developed originally for firefighters, police officers and other emergency service personnel, debriefing has become standard practice in diverse settings where adverse events sometimes occur, such as businesses, schools, hospitals and the military (Everly and Mitchell, 1999). Indeed, an entire debriefing industry has emerged to meet this need. Hence, Mitchell and Everly's International Critical Incident Stress Foundation trains approximately 40,000 individuals each year to provide debriefing and related services to those exposed to trauma. Moreover, Everly and Mitchell (1999) have argued that businesses may be at risk for lawsuits should they fail to provide services such as debriefing for employees exposed to critical incidents.

snip>

There is no current evidence that ... psychological debriefing is a useful treatment for the prevention of post traumatic stress disorder after traumatic incidents. Compulsory debriefing of victims of trauma should cease.

snip>

Although most studies have failed to uncover any beneficial effect of debriefing, two have shown that it can impede natural recovery from trauma. Bisson et al. (1997) randomly assigned hospitalized burn victims to either a debriefing session or to a no-treatment (assessment-only) condition. Burn victims in the treatment condition received a single one-on-one debriefing session that lasted between 30 and 120 minutes, occurring from two to 19 days after the burn accident. In some cases a partner (usually a spouse) attended the session. The debriefer followed Mitchell's protocol. There were no significant differences between the groups at the initial assessment on questionnaire measures of depression, anxiety and posttraumatic stress. At the three-month follow-up assessment, the rate of PTSD assessed via clinical interview was non-significantly higher in the debriefed group than in the control group (21% versus 15%). At the 13-month assessment, the rate of PTSD was significantly higher in the debriefed group than in the control group (26% versus 9%). Moreover, the debriefed group scored significantly higher on questionnaire measures of depression, anxiety and PTSD relative to the control group. Bisson et al. concluded that even if debriefing is merely inert, rather than toxic, "its routine use should be discontinued."

Conclusions

Despite repeated attempts to document that psychological debriefing can prevent posttraumatic psychopathology, there is no convincing evidence that it does so. Even if the procedure is not harmful, its continued implementation may delay the development of truly effective crisis interventions, while wasting time, money and resources on a method that is, at best, inert.

Dr. McNally is professor of psychology at Harvard University. He has more than 230 publications, many on PTSD, and is author of the book Remembering Trauma (2003), Belknap Press/Harvard University Press.

http://www.psychiatrictimes.com/p040471.html

I wish someone had listened to this doctor. I keep forgetting though - * is the Decider; not the Listener.

April 01, 2003

Global and Social Considerations

Andrei Novac, M.D.

In this introduction to our Trauma Special Report, Dr. Novac places the articles in historical perspective and reminds the reader of the importance of understanding trauma within today's global constructs and impending war.

Psychiatric Times April 2003 Vol. XX Issue 4

snip>

Besides being relevant topics for the contemporary clinician, the articles that follow can be closely linked to major social-historical events of the past 100 years. As discussed in the article by Charles Portney, M.D., intergenerational transmission of trauma as a clinical manifestation became known after the Holocaust and the treatment of its survivors. The article by Rachel Yehuda, Ph.D., reminds us of the Vietnam War and the political upheavals of the 1960s and '70s, when the designation PTSD emerged. In discussing secondary traumatization of mental health care professionals and trauma and violence in childhood, Rose Zimering, Ph.D., and colleagues refer to concepts that underscore the complications of trauma treatment and the need for adequate resources for a more sophisticated mental health care system. Additionally, Yuval Neria, Ph.D., and colleagues bring us to the daunting present.

snip>

As the United States is once again facing another war, consideration has to be given to the long-term and long-long-term consequences of trauma at all levels. We may feel consoled to recognize that during the most perilous times, humankind has concentrated its wisdom, talent and ingenuity to circumvent the catastrophes of war. However, mental health care professionals remain responsible for objectively educating society in an apolitical manner about the effects of witnessing killing and the destruction of civilian life as well as the real effects of trauma on any nation. Prophetic man, imo.

http://www.psychiatrictimes.com/Post-Traumatic-Stress-Disorder-%28PTSD%29/showArticle.jhtml?checkSite=psychiatricTimes&articleID=175802423

Edited to add that most bold and all italics are mine.

[bigdarryl]

5. you won't here this story by the media thats for sure