Does a diagnosis of PTSD include the potential for violence? Where do we begin, in order to address this question?
Simply put, PTSD is “fear” based, not “aggression” based. The DSM-IV-R (Diagnostic Statistical Manual, Revised) is clear. In brief, the primary features of the this illness DOES NOT INCLUDE VIOLENCE!
First, we need to remember that PTSD is an injury—both emotional and physical. While it is listed as a mental illness, it is the only one listed in the DSM (Diagnostic Manual of Mental Disorders) as being caused by an external cause. Second, PTSD is caused when a person is exposed to a catastrophic event (or series of events over time) involving real or threatened death or injury to themselves or others. During exposure to that trauma, one experiences intense fear, feelings of helplessness, or horror.
There is likelihood that most people will experience a traumatic event at some time in their lifetime. Not all will suffer from PTSD, depending on a number of factors that include their individual backgrounds, their relationship to the type of trauma, the degree and manner of exposure, and other factors. Military combat and police work are particularly high-risk areas for PTSD, however, because of the intensity of the types of trauma, the frequency of traumatic events and, particularly in the case of law enforcement, the fact that traumatic events are accumulated over years and decades.
But what about the actual PTSD symptoms? What are they, and do they typically include violent behaviors, like murder?
Simply put, PTSD is “fear” based, not “aggression” based. The DSM-IV-R (Diagnostic Statistical Manual, Revised) is clear. In brief, the primary features of the this illness DOES NOT INCLUDE VIOLENCE!
First, we need to remember that PTSD is an injury—both emotional and physical. While it is listed as a mental illness, it is the only one listed in the DSM (Diagnostic Manual of Mental Disorders) as being caused by an external cause. Second, PTSD is caused when a person is exposed to a catastrophic event (or series of events over time) involving real or threatened death or injury to themselves or others. During exposure to that trauma, one experiences intense fear, feelings of helplessness, or horror.
There is likelihood that most people will experience a traumatic event at some time in their lifetime. Not all will suffer from PTSD, depending on a number of factors that include their individual backgrounds, their relationship to the type of trauma, the degree and manner of exposure, and other factors. Military combat and police work are particularly high-risk areas for PTSD, however, because of the intensity of the types of trauma, the frequency of traumatic events and, particularly in the case of law enforcement, the fact that traumatic events are accumulated over years and decades.
But what about the actual PTSD symptoms? What are they, and do they typically include violent behaviors, like murder?
Simply put, PTSD is “fear” based, not “aggression” based. The DSM-IV-R (Diagnostic Statistical Manual, Revised) is clear. In brief, the primary features of the this illness are:
· flashbacks
· withdrawal
· numbing
· hyperarousal
· and isolation.
Violence is not included. In fact, not one single research study exists linking violent behavior with the diagnosis of PTSD. While, anger and agitation are common symptoms of PTSD, these feelings tend to be turned inward, contributing to making it the terribly painful disorder it is. Combined with depression, it is not unusual for the sufferer to become suicidal. But a diagnosis of PTSD, in itself, does not make a person violent towards others. Again, the concern should be more that they will be a danger to themselves, not others. There is a possibility, of course, that unintentional harm could come to others as the result of a suicide attempt, not only by gunshot, but though an intentional automobile accident, jumping from a building, or any other number of self-destructive acts. John Violanti, Ph.D., in his book, “Police Suicide: Epidemic in Blue,” points out the interesting phenomenon of “suicide by suspect,” in which an officer consciously or unconsciously wishes to die and willfully involves himself in situations of extreme danger or confrontation with a criminal, thereby increasing the risk of death. Even so, in these situations the danger to others is indirect and unintentional.
The unfortunate result of this misinformation is that more and more cases are erroneously using the defense that PTSD is to blame for murders by veterans when, in fact, there were other emotional disorders and problems involved, including prior anger issues, Traumatic Brain Injury (TBI), and substance abuse, that were more likely responsible for the individual’s violent behavior. Society already views the mentally ill as "dangerous"--we need to be very careful not to further stigmatize these people via this illness by suggesting that a violent/murderous potential exists or was the primary factor until everything has been examined.
There are other emotional disorders and problems involved, including prior anger issues, Traumatic Brain Injury (TBI), and substance abuse, that are often more likely responsible for the individual’s violent behavior.
A note of caution, however. On the one hand, we must be intelligent enough to understand that a diagnosis of PTSD or the suspicion that a person may have PTSD alone does not label them as violent. On the other hand, we cannot be so foolish as to ignore the fact that there may be other factors at play (in addition to the PTSD) that could make the person a threat or that may have played a role in a crime already committed. A person with PTSD may have a variety of other concomitant problems, such as other emotional disorders or substance abuse issues that could make a radical difference in their behaviors.
The purpose of this article is not to suggest that a person diagnosed as having PTSD can never be violent. Nothing, in the real world, is that predictable. We are, however, attempting to make it clear that the established criteria of symptoms of PTSD do not include violence.
We can all play an important role in the education and understanding of this very serious psychological disorder by being attentive when these cases arise and draw attention to medical facts without hasty conclusions. We owe that to those who have given so much in service to their country, whether it was in military service, as police officers or, increasingly today, both.
This article was found at PTSD Break the Silence Facebook page...all credit belongs to them.
· flashbacks
· withdrawal
· numbing
· hyperarousal
· and isolation.
Violence is not included. In fact, not one single research study exists linking violent behavior with the diagnosis of PTSD. While, anger and agitation are common symptoms of PTSD, these feelings tend to be turned inward, contributing to making it the terribly painful disorder it is. Combined with depression, it is not unusual for the sufferer to become suicidal. But a diagnosis of PTSD, in itself, does not make a person violent towards others. Again, the concern should be more that they will be a danger to themselves, not others. There is a possibility, of course, that unintentional harm could come to others as the result of a suicide attempt, not only by gunshot, but though an intentional automobile accident, jumping from a building, or any other number of self-destructive acts. John Violanti, Ph.D., in his book, “Police Suicide: Epidemic in Blue,” points out the interesting phenomenon of “suicide by suspect,” in which an officer consciously or unconsciously wishes to die and willfully involves himself in situations of extreme danger or confrontation with a criminal, thereby increasing the risk of death. Even so, in these situations the danger to others is indirect and unintentional.
The unfortunate result of this misinformation is that more and more cases are erroneously using the defense that PTSD is to blame for murders by veterans when, in fact, there were other emotional disorders and problems involved, including prior anger issues, Traumatic Brain Injury (TBI), and substance abuse, that were more likely responsible for the individual’s violent behavior. Society already views the mentally ill as "dangerous"--we need to be very careful not to further stigmatize these people via this illness by suggesting that a violent/murderous potential exists or was the primary factor until everything has been examined.
There are other emotional disorders and problems involved, including prior anger issues, Traumatic Brain Injury (TBI), and substance abuse, that are often more likely responsible for the individual’s violent behavior.
A note of caution, however. On the one hand, we must be intelligent enough to understand that a diagnosis of PTSD or the suspicion that a person may have PTSD alone does not label them as violent. On the other hand, we cannot be so foolish as to ignore the fact that there may be other factors at play (in addition to the PTSD) that could make the person a threat or that may have played a role in a crime already committed. A person with PTSD may have a variety of other concomitant problems, such as other emotional disorders or substance abuse issues that could make a radical difference in their behaviors.
The purpose of this article is not to suggest that a person diagnosed as having PTSD can never be violent. Nothing, in the real world, is that predictable. We are, however, attempting to make it clear that the established criteria of symptoms of PTSD do not include violence.
We can all play an important role in the education and understanding of this very serious psychological disorder by being attentive when these cases arise and draw attention to medical facts without hasty conclusions. We owe that to those who have given so much in service to their country, whether it was in military service, as police officers or, increasingly today, both.
This article was found at PTSD Break the Silence Facebook page...all credit belongs to them.
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