james etterlee mug.jpg
Kevin P. Casey
John Etterlee
Last week's feature story by Keegan Hamilton on PTSD diagnosis in the military included the story of John Byron Etterlee,

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Comment of the Day: PTSD Comes from Combat Day after Day

james etterlee mug.jpg
Kevin P. Casey
John Etterlee
Last week's feature story by Keegan Hamilton on PTSD diagnosis in the military included the story of John Byron Etterlee, a chemical weapons specialist stationed at Joint Base Lewis McChord (JBLM). Etterlee's case was also fodder for a blog post last Friday - a blog post that inspired feedback that only reaffirms the debate at hand.

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As the post notes:

Those who struggle with trauma-related issues but don't quite meet the criteria for PTSD are typically diagnosed with adjustment disorder. To a layperson, adjustment disorder sounds an awful lot like PTSD. It is defined as "the development of emotional or behavioral symptoms in response to an identifiable stressor," followed by "marked distress" and "significant impairment in social, occupational, or other important areas of functioning."

In Etterlee's case, one doctor said he qualified for PTSD. Another said he had adjustment disorder. It's a fine line, but a look at the reasoning for each diagnosis is revealing.

The VA psychologist, Lawrence W. Smith, noted that Etterlee suffered from "anxiety and constant tension" and sleeplessness as a result of his deployment to Iraq in 2008. Etterlee had limited combat experience, but was exposed to a handful of traumatic events, which caused a host of problems later on, including "intense distress at exposure to similar events."

The forensic psychiatrist at Madigan -- part of a unique Army team created to review PTSD disability claims -- noted that Smith relied on "the service member's subjective report of alleged events," which were, "unverified by any collateral source of information." The suggestion is that Etterlee exaggerated his story. Since Etterlee also showed "an understanding of the secondary gain potential" of being diagnosed with PTSD (i.e. increased disability payments), Dr. Thomas Danner concluded with "a reasonable degree of psychological certainty" that Etterlee did not have PTSD. Danner never met Etterlee in person.

Upon further review, after the policies at Madigan were made public, Congress got involved, and Etterlee had his original PTSD diagnosis restored.

Etterlee's situation riled at least one Daily Weekly reader.

As toms writes:

this guy certainly does not have ptsd. 99 % of soldiers in a combat zone have sleep problems, 50 % or more non service people have sleep problems. He gave no example of heavy combat to justify his ptsd. ptsd comes from combat day after and day, not just i hear it or a one time deal.

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