Soldiers being misdiagnosed ?

Hundreds of PTSD soldiers likely misdiagnosed

August 15, 2010, Associated Press

WASHINGTON - At the height of the Iraq war, the Army routinely fired hundreds of soldiers for having a personality disorder when they were more likely suffering from the traumatic stresses of war, discharge data suggests.

Under pressure from Congress and the public, the Army later acknowledged the problem and drastically cut the number of soldiers given the designation. But advocates for veterans say an unknown number of troops still unfairly bear the stigma of a personality disorder, making them ineligible for military health care and other benefits.

"We really have an obligation to go back and make sure troops weren't misdiagnosed," said Dr. Barbara Van Dahlen, a clinical psychologist whose nonprofit "Give an Hour" connects troops with volunteer mental health professionals.

The Army denies that any soldier was misdiagnosed before 2008, when it drastically cut the number of discharges due to personality disorders and diagnoses of post-traumatic stress disorders skyrocketed.

Unlike PTSD, which the Army regards as a treatable mental disability caused by the acute stresses of war, the military designation of a personality disorder can have devastating consequences for soldiers.

Defined as a "deeply ingrained maladaptive pattern of behavior," a personality disorder is considered a "pre-existing condition" that relieves the military of its duty to pay for the person's health care or combat-related disability pay.

According to figures provided by the Army, the service discharged about a 1,000 soldiers a year between 2005 and 2007 for having a personality disorder.

But after an article in The Nation magazine exposed the practice, the Defense Department changed its policy and began requiring a top-level review of each case to ensure post-traumatic stress or a brain injury wasn't the underlying cause.

After that, the annual number of personality disorder cases dropped by 75 percent. Only 260 soldiers were discharged on those grounds in 2009.

At the same time, the number of post-traumatic stress disorder cases has soared. By 2008, more than 14,000 soldiers had been diagnosed with PTSD - twice as many as two years before.

The Army attributes the sudden and sharp reduction in personality disorders to its policy change. Yet Army officials deny that soldiers were discharged unfairly, saying they reviewed the paperwork of all deployed soldiers dismissed with a personality disorder between 2001 and 2006.

"We did not find evidence that soldiers with PTSD had been inappropriately discharged with personality disorder," wrote Maria Tolleson, a spokeswoman at the U.S. Army Medical Command, which oversees the health care of soldiers, in an e-mail.

Command officials declined to be interviewed.

Advocates for veterans are skeptical of the Army's claim that it didn't make any mistakes. They say symptoms of PTSD - anger, irritability, anxiety and depression - can easily be confused for the Army's description of a personality disorder.

They also point out that during its review of past cases, the Army never interviewed soldiers or their families, who can often provide evidence of a shift in behavior that occurred after someone was sent into a war zone.

"There's no reason to believe personality discharges would go down so quickly" unless the Army had misdiagnosed hundreds of soldiers each year in the first place, said Bart Stichman, co-director of the National Veterans Legal Services Program.

Stichman's organization is working through a backlog of 130 individual cases of wounded service members who feel they were wrongly denied benefits.

Among those cases is Chuck Luther, who decided to rejoin the Army after the Sept. 11 attacks. He had previously served eight years before being honorably discharged.

"I knew what combat was going to take," he said.

Luther, who lives near Fort Hood, Texas, said throughout his time in the Army, he received eight mental health evaluations from the Army, each clearing him as "fit for duty."

Luther was seven months into his deployment as a reconnaissance scout in Iraq's violent Sunni Triangle in 2007 when he says a mortar shell slammed him to the ground. He later complained of stabbing eye pain and crippling migraines, but was told by a military doctor that he was faking his symptoms to avoid combat duty.

Luther says that he was confined for a month in a 6-by-8 foot room without treatment. At one point, Luther acknowledges, he snapped - biting a guard and spitting in the face of a military chaplain.

After that episode, Luther says, the Army told him he could return home and keep his benefits if he signed papers admitting he had a personality disorder. If he didn't sign, he said, he was told he would be kicked out eventually anyway.

Luther, whose account was first detailed by The Nation, signed the papers.

His case highlights the irony in many personality discharges. A person is screened mentally and physically before joining the military. But upon returning from combat, that same person is told he or she had a serious mental disorder that predated military service.

As in the civilian world, where many insurance companies deny coverage for illnesses that develop before a policy is issued, the government can deny a service member veteran health care benefits and combat-related disability pay for pre-existing ailments.

Despite the Defense Department's reforms, groups such as the National Veterans Legal Services Program say they don't have enough manpower to help all the veterans who believe they were wrongly denied benefits.

Stichman says his organization has more than 60 law firms across the country willing to take on the legal cases of wounded veterans for free. But even with that help, the group doesn't know when it would be able to take on even one new case.

A congressional inquiry is under way to determine whether the Army is relying on a different designation - referred to as an "adjustment disorder" - to dismiss soldiers.

Sen. Kit Bond, a Missouri Republican, wants the Pentagon to explain why the number of these discharges doubled between 2006 and 2009 and how many of those qualified to retain their benefits.

As for Luther, he got lucky. After about a year, he says the Veterans Administration agreed to reevaluate him and decided that he suffers from post-traumatic stress syndrome coupled by traumatic brain injury. The ruling gives him access to a psychologist and psychiatrist every two weeks, despite his discharge status, he said.

But Luther acknowledges that he still struggles. In June, he received word that the Army had turned down his appeal to correct his record, which means he could never return to the service or retire with full benefits.

A week later, he says, he lost his job delivering potato chips because a superior felt threatened by him. Luther says he misses the Army.

"When I was in uniform, that defined me," he said. "It's what made me, me."

---

Online:

U.S. Army Medical Command: http://www.armymedicine.army.mil

Department of Veterans Affairs: http://www.va.gov/

"Give an Hour": http://www.giveanhour.org

National Veterans Legal Services Program: http://www.nvlsp.org/

Bullying affects academic performance ?

Victims of Bullying Suffer Academically as Well, Psychologists Report

ScienceDaily (Aug. 20, 2010) — Students who are bullied regularly do substantially worse in school, UCLA psychologists report in a special issue of theJournal of Early Adolescence devoted to academic performance and peer relationships.

The UCLA study was conducted with 2,300 students in 11 Los Angeles-area public middle schools and their teachers. Researchers asked the students to rate whether or not they get bullied on a four-point scale and to list which of their fellow students were bullied the most -- physically, verbally and as the subject of nasty rumors.

A high level of bullying was consistently associated with lower grades across the three years of middle school. The students who were rated the most-bullied performed substantially worse academically than their peers. Projecting the findings on grade-point average across all three years of middle school, a one-point increase on the four-point bullying scale was associated with a 1.5-point decrease in GPA for one academic subject (e.g., math) -- a very large drop.

Teachers provided ratings on how engaged the students were academically, including whether they were participating in class discussions, showing interest in class and completing their homework. The researchers collected data on the students twice a year throughout the three years of middle school and examined the students' grades.

The study is published Aug. 19 in the journal's online edition; the print edition will be published at a later date.

"We cannot address low achievement in school while ignoring bullying, because the two are frequently linked," said Jaana Juvonen, a UCLA professor of psychology and lead author of the study. "Students who are repeatedly bullied receive poorer grades and participate less in class discussions. Some students may get mislabeled as low achievers because they do not want to speak up in class for fear of getting bullied. Teachers can misinterpret their silence, thinking that these students are not motivated to learn.

"Students who get bullied run the risk of not coming to school, not liking school, perceiving school more negatively and now -- based on this study -- doing less well academically," said Juvonen, who is also a professor in UCLA's developmental psychology program. "But the link between bullying and achievement can work both ways. The students who are doing poorly are at higher risk for getting bullied, and any student who gets bullied may become a low achiever. Whether bullying happens on school grounds or after school hours on the Internet, it can paralyze students from concentrating on academics."

The research is part of a long-term UCLA bullying project led by UCLA education professor Sandra Graham (who is not a co-author on this study) and Juvonen, which is funded federally by the National Science Foundation and privately by the William T. Grant Foundation.

"Instruction cannot be effective unless the students are ready to learn, and that includes not being fearful of raising your hand in class and speaking up," said Juvonen, who has been studying bullying for more than a decade. "Once students get labeled as 'dumb,' they get picked on and perform even worse; there's a downward cycle that we need to stop.

"If the academically low-performing students are at higher risk for getting bullied, that suggests one way to reduce bullying is to help those students academically," she added. "Once they get into the cycle of being bullied because of their poor academic performance, their chances of doing better academically are worse."

Reducing bullying is a "collective challenge," she said, and not just a matter of dealing with a few aggressive students. The UCLA team's prior findings show that in middle school, bullies are considered "cool' by their classmates. The high social status of bullies promotes a "norm of meanness that needs to be addressed." Bullying affects millions of students, Juvonen said.

Of the students in the study, approximately 44 percent were Latino, 26 percent were African American, 10 percent were Asian American, 10 percent were white and 10 percent were multi-racial. Fifty-four percent were female and 46 percent were male.

Some anti-bullying programs are comprehensive and effective, while some schools rely on a number of "quick fixes" that do not work, according to Juvonen. Teachers need training in how to address bullying, she said.

Co-authors on the Journal of Early Adolescence study are UCLA psychology graduate students Yueyan Wang and Guadalupe Espinoza. The journal offers new perspectives on pivotal developmental issues among young teenagers.

In previous research, Juvonen and her colleagues found that nearly three in four teenagers were bullied online at least once during a recent 12-month period, and only one in 10 reported such cyber-bullying to parents or other adults. The probability of getting bullied online is substantially higher for those who have been the victims of school bullying. Victims of bullying do not want to attend school and often do not, Juvonen said.

In research from 2005 by Juvonen and Adrienne Nishina, an assistant professor of human development at UC Davis, nearly half the sixth graders at two Los Angeles-area public schools said they were bullied by classmates during a five-day period. In another 2005 study, Nishina and Juvonen reported that middle school students who are bullied in school are likely to feel depressed and lonely, which in turn makes them more vulnerable to further bullying.

Children who are embarrassed or humiliated about being bullied in school are unlikely to discuss it with their parents or teachers, Juvonen and Nishina found. Instead, they are more likely to suffer in silence and dislike school.

Juvonen advises parents to talk with their children about bullying before it ever happens, pay attention to changes in their children's behavior and take their concerns seriously.

Students who get bullied often have headaches, colds and other physical illnesses, as well as psychological problems.

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by University of California - Los Angeles.

Managing Back to School Stress

The lazy hazy days of summer are winding down and that means it’s time to start thinking about going back to school. For some kids and families, this time is an exciting one that they look forward to. For many, it’s a time of stress and adjustment; schedules change, teachers change, classmates differ, kids may transition from elementary school to middle school or high school, there’s added homework responsibilities and back-to-school shopping can all be a challenge.

How can you help?

Parents can help children by providing a setting that fosters resilience and encouraging them to share and express their feelings about returning to school. Attending school orientation programs with your kids can often help ease the fear of the unknown: classmates, teachers, the school building, bus routes, curriculum expectations, etc. Most schools offer these or other kinds of programs to help ease the back-to-school stress that happens this time of year.

In addition, the American Psychological Association offers the following back-to-school tips:

1. Practice the first day of school routine: Getting into a sleep routine before the first week of school will aide in easing the shock of waking up early. Organizing things at home—backpack, binder, lunchbox or cafeteria money—will help make the first morning go smoothly. Having healthy, yet kid-friendly lunches, will keep them energized throughout the day. Also, walking through the building and visiting your child’s locker and classroom will help ease anxiety of the unknown.

2. Get to know your neighbors: If your child is starting a new school, walk around your block and get to know the neighborhood children. Try and set up a play date, or, for an older child, find out where neighborhood kids might go to safely hang out, like the community pool, recreation center or park.

3. Talk to your child: Asking your children about their fears or worries about going back to school will help them share their burden. Inquire as to what they liked about their previous school or grade and see how those positives can be incorporated into their new experience.

4. Empathize with your children: Change can be difficult, but also exciting. Let your children know that you are aware of what they’re going through and that you will be there to help them in the process. Nerves are normal, but highlight that not everything that is different is necessarily bad. It is important to encourage your children to face their fears instead of falling in to the trap of encouraging avoidance.

5. Get involved and ask for help: Knowledge of the school and the community will better equip you to understand your child’s surroundings and the transition he or she is undergoing. Meeting members of your community and school will foster support for both you and your child. If you feel the stress of the school year is too much for you and your child to handle on your own, seeking expert advice from a mental health professional, such as a psychologist, will help you better manage and cope.

Veterans and Suicide

A recent New York Times article on Veterans and Suicide reveals that according to the CDC, veterans account for at least one out of every 5 suicides every year. Ohio has the 4th highest veteran population of all of the states, according to the U.S. Department of Veterans' Affairs.

Psychologists play a critical role in suicide assessment and prevention, as do suicide prevention hotlines. Here are some important websites and phone numbers to have available if you know someone who is suicidal.

National Suicide Prevention Lifeline: 1-800-273-TALK
Ohio Suicide Prevention Foundation
Ohio Department of Mental Health: Suicide Prevention

Please also consider supporting research for suicide prevention by donating to or participating in the "Out of the Darkness" Suicide Prevention Walks.

Easy Yoga Poses for Depression

• 

  Setu Bandha Sarvangasana (Bridge Pose)

  Calms the brain and rejuvenates tired legs.

• 

  Dolphin Plank Pose

  A modification of Plank Pose, Dolphin Plank Pose strengthens and tones the core, thighs, and arms.

• 

  Sukhasana (Easy Pose)

  Don't let the name fool you. If you're used to sitting in chairs, Sukhasana can be quite challenging.

• 

  Pincha Mayurasana (Feathered Peacock Pose)

  This pose is also commonly called Forearm or Elbow Balance.

• 

  Adho Mukha Vrksasana (Handstand)

  The alignment in Handstand is exactly the same as it is in Mountain, the only difference being in the position of the arms.

• 

  Uttanasana (Standing Forward Bend)

  Uttanasana will wake up your hamstrings and soothe your mind.

• 

  Salamba Sarvangasana (Supported Shoulderstand)

  This version of Shoulderstand is performed with blanket support under the shoulders.

• 

  Urdhva Mukha Svanasana (Upward-Facing Dog)

  Upward-Facing Dog will challenge you to lift and open your chest.

• 

  Camatkarasana (Wild Thing)

  One poetic translation of this pose means "the ecstatic unfolding of the enraptured heart."

• 

  Savasana (Corpse Pose)

  Savasana is a pose of total relaxation--making it one of the most challenging asanas.

• 

  Dolphin Pose

  A nice shoulder-opening. Also strengthens the core, arms, and legs.

• 

  Uttana Shishosana (Extended Puppy Pose)

  A cross between Child's Pose and Downward Facing Dog. This pose lengthens the spine and calms the mind.

• 

  Agnistambhasana (Fire Log Pose)

  Stretches the outer hips intensely, particularly the piriformis, which is often the main culprit of sciatic pain.

• 

  Janu Sirsasana (Head-to-Knee Forward Bend)

  A forward bend for all levels of students, Janu Sirsasana is also a spinal twist.

• 

  Salamba Sirsasana (Supported Headstand)

  Standing on your head in proper alignment calms the brain and strengthens the body.

• 

  Urdhva Dhanurasana (Upward Bow or Wheel Pose)

  Strengthens the arms, legs, abdomen, and spine, and gives a boost of energy.

• 

  Prasarita Padottanasana (Wide-Legged Forward Bend)

  The pose as described here is technically known as Prasarita Padottanasana I.

  
  

  
  

click here for more details on the poses http://tiny.cc/hi93w

Pot and your Sex Life

Recently, I listened as a prominent sex researcher summarized the sexual impairment caused by dozens ofdrugs, both legal and illicit. Her list included marijuana. Afterward, several in the audience asked why.

"Because it's sex-inhibiting," she replied. "No it isn't," several countered. They all agreed it was sex-enhancing.

The presenter immediately pulled out her citation, one lone report published 40 years previously showing that marijuana reduced testosterone by up to half, enough for many women and some men to suffer libido loss.

Returning home, I delved into the literature and discovered what this researcher had failed to mention. The study she cited triggered a flurry of reports on marijuana and testosterone. Those studies, published in the late 1970s, showed no significant marijuana-induced suppression of the hormone, and no significant loss of libido or sexual impairment in lovers who used it, even frequent users.During the 1980s, several studies considered pot's effects on lovemaking. The results were all over the map, from strongly sex-inhibiting to strongly sex-enhancing. The best report, based on interviews with 97 adults in Kansas City, showed that "over two-thirds reported increased sexual pleasure and satisfaction with marijuana use. About half of both sexes also reported increased sexual desire while using marijuana. Emotional closeness and physical enjoyment of snuggling were also enhanced." But one-third said the drug was not sex-enhancing, and half reported no increase in desire. [Weller, RA and JA Halikas, "Marijuana Use and Sexual Behavior," Journal of Sex Research (1984) 20:186.]

For the rest of the article, please visit Psychology Today.

Can You Ask a Pig If His Glass Is Half Full?

ScienceDaily (July 28, 2010) — Babe may be the most famous sensitive pig in the world but new research from Newcastle University suggests he is by no means the only one.

Experts from the university's School of Agriculture, Food and Rural Development have shown for the first time that a pig's mood mirrors how content he is, highlighting that pigs are capable of complex emotions which are directly influenced by their living conditions.

Led by Dr Catherine Douglas, the team has employed a technique to 'ask' pigs if they are feeling optimistic or pessimistic about life as a result of the way in which they live.

In an experiment reminiscent of Pavlov's dogs, the Newcastle team taught the pigs to associate a note on a glockenspiel with a treat -- an apple -- and a dog training 'clicker' with something unpleasant -- in this case rustling a plastic bag.

The next step was to place half the pigs in an enriched environment -- more space, freedom to roam in straw and play with 'pig' toys -- while the other half were placed in a smaller, boring environment- no straw and only one non-interactive toy.

The team then played an ambiguous noise -- a squeak -- and studied how the pigs responded. Dr Douglas said the results were compelling.

"We found that almost without exception, the pigs in the enriched environment were optimistic about what this new noise could mean and approached expecting to get the treat," she said. "In contrast, the pigs in the boring environment were pessimistic about this new strange noise and, fearing it might be the mildly unpleasant plastic bag, did not approach for a treat.

"It's a response we see all the time in humans where how we are feeling affects our judgement of ambiguous events. For example, if you're having a bad day -feeling stressed and low -- and you're presented with an ambiguous cue such as your boss calling you into their office, the first thing that goes through your head is what have I done wrong? We call this a negative cognitive bias. But on a good day you greet the same ambiguous event far more positively, you might strut in expecting a slap on the back and a pay rise.

"This 'glass half empty versus glass half full' interpretation of life reflects our complex emotional states, and our study shows that we can get the same information from pigs. We can use this technique to finally answer important questions about animal welfare in relation to a range of farm environments, for pigs and potentially other farm animals."

The research, funded by Universities Federation for Animal Welfare (UFAW) was presented at the organisation's annual conference in York last month.

Quality of life of our farm animals is becoming increasingly important to consumers, scientists and government and the study is part of ongoing research at Newcastle to further our understanding of animal welfare and improve the lives of farmed stock.

Sandra Edwards, professor of agriculture at Newcastle University and one of the UK's leading experts in pig welfare, said the next step would be to refine and further validate the methodology so it could be used to help scientists determine what is really important to the pig for its well-being.

"Historically, animal welfare research looked only at alleviating suffering. Now the UK industry itself is going beyond a minimum standard and funding research to explore measuring, and then promoting, quality of life," she explained.

"Although techniques exist to measure stress, in the past we haven't been able to directly ask a pig if it is happy or not. Instead we have assessed production systems based purely on human perceptions and our best interpretations of behaviour.

"Our research, for the first time, provides an insight into pigs' subjective emotional state and this will help scientists and farmers to continue to improve the lives of their pigs in the future.

Turning wrongs into rights

Two years ago, this magazine exposed a dark chapter in the life of Nahi Alon, a clinical psychologist who ordered the killing of Palestinians in the Six-Day War. Now he describes the personal journey that resulted, which included emotional encounters with Arab friends and a new approach to resolving the Israeli-Palestinian conflict

By Coby Ben-Simhon

Click here to read the article in it's entirety- http://tiny.cc/7dz06

Expected Changes In DSM-V Leave Some Questioning Who’s Normal

With several new diagnoses expected in the forthcoming edition of the Diagnostic and Statistical Manual of Mental Disorders, a group of leading mental health professionals is questioning whether anyone will still be considered “normal.”

Citing what they call three false epidemics in recent years — high rates of attention deficit hyperactivity disorder, autism and childhood bipolar disorder that emerged after the current DSM-IV was published — several psychiatric experts are taking on the wide variety of new disorders expected to be added to the DSM in the August issue of the Journal of Mental Health.

“In the new edition, temper tantrums among toddlers and heartache over a lost spouse could now be defined as mental health conditions,” says Jerome Wakefield, a social worker at New York University. “One of the most frightening scenarios is the potential for medicating people — particularly children — who haven’t yet shown any signs of illness in a bid to ‘treat’ them for Psychosis Risk Syndrome, as identified by the new draft of DSM-V.”

The DSM serves as the bible for mental health professionals, researchers and insurers by determining what symptoms warrant an official diagnosis. The current edition was released in 1994 and the American Psychiatric Association is presently compiling a fifth version, which is expected to be published in May 2013.

Among the chief concerns outlined in the Journal of Mental Health articles are the stigma that’s associated with mental illness and how that could impact a growing part of the population and fears about over-medication that may result if more and more symptoms are considered worthy of diagnosing.

Revisions to the DSM can be heated and debate emerged about the currently proposed changes even before an official draft was revealed in February. In particular, a proposal to bundle several labels including Asperger’s syndrome under the term “autism spectrum disorders” has proven particularly contentious.

4 Elements of Forgiveness

Theories of forgiveness or like LinkedIn accounts- everybody has one but most people never really use it. Here is an interesting theory on Forgiveness. The benefits, both mental and physical , of forgiveness are well established (tiny.cc/g83c6) but for some reason, its much easier to talk about forgiveness than to actually do it. Why ? All acts of forgiveness should include four crucial parts :

A. Express the emotion: Whatever the crime or injustice or violation, the forgiver needs to fully express how it made her feel. If the transgression elicits anger or sadness or hurt, those feelings need to be deeply felt and expressed. If it's possible to express it to the perpetrator, great. If not, a stand-in, empty chair, heartfelt letter or yelling in the car with the windows rolled down might suffice. Are you expunging all the feelings? Probably not, but enough to allow you to focus on the other areas.

B. Understand why: Our brain will continue to search for some explanation until it's satisfied. Maybe we won't agree with the rationale, but we need some schema that explains why the act took place. In some situations, even an acceptance of randomness can be a sufficient paradigm.

C. Rebuild safety: The forgiver needs to feel a reasonable amount of assurance the act won't recur. Whether it comes in the form of a sincere apology from the perpetrator, a stronger defense against future attacks or removal from that person's influence, safety needs to be re-acquired. To a reasonable amount, of course, because we are never 100% safe.

These three elements help us process the event. It's how I feel, how I understand what happened, how I know it won't happen again. On to the fourth:

4. Let go: This very difficult step is a decision. Letting go is making a promise to not hold a grudge. In the case of a relationship, it means one partner won't refer to that past transgression again: "I'm forgetful?!? Well, you forgot our anniversary once!" It's resolving to refrain from lording the transgression over the other in the future. When it comes to forgiveness, the victim holds all the power. I've even seen a smile creep over the face of someone who has been trespassed upon: "You screwed me over? That gives me a whole year of guilt-tripping." Letting go means surrendering this dominant role; a stepping down from the powerful position of victim to allow equality again. In addition, letting go is making a promise to yourself that you'll stop dwelling/replaying/ruminating/perseverating on the injustice. If letting go feels impossible, it's probably because A, B or C weren't sufficiently completed.

Read the whole article here- http://tiny.cc/h3sfk