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Battle Continues Over Vietnam PTSD Numbers
Date:8/23/2007

ime Victims Research and Treatment Center of the Medical University of South Carolina, agreed that the Dohrenwend paper is a major contribution.

But while critics may contend some sort of mistake occurred with the original numbers, the differences may actually reflect the natural evolution of science and knowledge.

Because Dohrenwend's paper of last year used heretofore unavailable military documents, it enabled the researchers to independently assess whether troops had been exposed to a stressor. That's important, because a diagnosis of PTSD requires that the person be exposed to a traumatic "stressor."

"We were able to check the plausibility of [each] report -- were they in a situation in which it was highly likely they experienced such a stressor?" Dohrenwend said.

They were also able to examine in medical records whether the person with PTSD was impaired. This was not a criterion for PTSD when the NVVRS came out but subsequently it did become a criterion.

"We made these various adjustments for impairment and verification of plausibility of the stressor, and the numbers came out to be somewhat lower than the original," Dohrenwend said. "The stakes are high, and politics get involved, and some people say this is a terrible thing to say -- that the rates were too high -- but there's nothing wrong with those [earlier] definitions. They're just different."

Somewhere in all this heated back-and-forth, Dohrenwend contends that the main messages of his 2006 paper have been lost.

"The most important results have been underemphasized, and that is the dose/response relationship, and that's about as close as you can come to a causal relationship," he said. "The other thing is the rate of 1-in-5 war-related onset of PTSD and 1-in-10 still current after the war of impairing PTSD. That is far from trivial. This is a heavy cost by any count."

McNally said he thinks another critical point is being o
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