Download

Download Free Electronic Document

FormatFile SizeNotes
PDF file 0.2 MB

Use Adobe Acrobat Reader version 10 or higher for the best experience.

Purchase

Purchase Print Copy

 FormatList Price Price
Add to Cart Paperback16 pages $9.95 $7.96 20% Web Discount

Research Questions

  1. Would changing the term reduce the stigma associated with the condition?
  2. Would changing the term increase the number of service members seeking treatment for the condition?
  3. What are the other intended and unintended consequences of this change in terminology?

Recently, the American Psychiatric Association (APA) board of trustees voted on changes to the new edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM). Among the decisions was one to retain the word "disorder" in the term "posttraumatic stress disorder." U.S. Army leadership initially requested a change in terminology, stating that the word "disorder" is stigmatizing and that removing it would encourage more individuals suffering from symptoms to access care. Although the APA has issued its ruling, the term "posttraumatic stress" is being used informally by some individuals within military communities. It is unclear whether informal use of the term will continue, or whether military leaders will continue to advocate future changes to the DSM. RAND explored the rationales for not changing the diagnostic terminology, and to the extent possible, anticipated what the effects of widespread informal use of new terminology might be.

Key Findings

The Specific Nature of PTSD-Related Social Stigma, Particularly Among U.S. Military Service Members, Is Not Well Understood

  • Few studies demonstrate stigmatization among U.S. military service members with PTSD.
  • No studies measure the extent to which PTSD-related social stigma reduces the utilization of treatment.

Changing the Term Is Unlikely to Result in a Significant Increase in Individuals Willing to Be Diagnosed or Treated, and Could Have Deleterious Consequences

  • Adopting the term "injury" may have implications beyond its effect on the likelihood of stigma that could, in theory, reduce the utilization of treatment.
  • Psychiatric diagnoses are used within institutions such as the U.S. military in ways that may adversely affect how a diagnosed individual is treated — for example, when determining eligibility for security clearances and when determining whether a given service member is fit for deployment — regardless of the diagnostic terminology used.

Recommendations

  • Without changing the broader institutional factors that result in discrimination against those with the label, the new name seems unlikely to result in a significant increase in individuals eager to be diagnosed or treated, and could even have the opposite effect.
  • Any changes to the post-traumatic stress disorder label should be supported by evidence that reflects the perspectives of the mental health treatment and research communities as well as the perspectives of military service members, veterans, and other traumatized individuals who would be directly affected by the change in terminology.

This research was conducted within the Forces and Resources Policy Center of the RAND National Defense Research Institute, a federally funded research and development center sponsored by the Office of the Secretary of Defense, the Joint Staff, the Unified Combatant Commands, the Navy, the Marine Corps, the defense agencies, and the defense Intelligence Community.

This report is part of the RAND Corporation occasional paper series. RAND occasional papers may include an informed perspective on a timely policy issue, a discussion of new research methodologies, essays, a paper presented at a conference, or a summary of work in progress. All RAND occasional papers undergo rigorous peer review to help ensure that they meet high standards for research quality and objectivity.

Permission is given to duplicate this electronic document for personal use only, as long as it is unaltered and complete. Copies may not be duplicated for commercial purposes. Unauthorized posting of RAND PDFs to a non-RAND Web site is prohibited. RAND PDFs are protected under copyright law. For information on reprint and linking permissions, please visit the RAND Permissions page.

The RAND Corporation is a nonprofit institution that helps improve policy and decisionmaking through research and analysis. RAND's publications do not necessarily reflect the opinions of its research clients and sponsors.