Concerns of a societal stigma attached to post-traumatic stress disorder (PTSD), and mental health conditions in general, is not a new phenomenon. However, what is new is the approach to reduce this stigma.
Fearing that people with PTSD may avoid seeking help because of stigma, a change in the disorder’s name and understanding have been proposed. The alternative name post-traumatic stress injury (PTSI) has gained popularity and, despite not yet being an accepted medical diagnosis, many people have begun using this term.
To understand both sides of the PTSD vs. PTSI debate, the differences between PTSD and PTSI must be explored.
What Is PTSI?
The American Psychiatric Association defines PTSD as “A psychiatric disorder that can occur in people who have experienced or witnessed a traumatic event.”
With this definition in mind, what is PTSI? In essence, PTSI refers to the same set of symptoms. The main difference is the conceptualization of what has caused these symptoms. While PTSD refers to a psychiatric disorder, the PTSI definition provided by the Global PTSI Foundation refers to a biological injury.
This organization has stated that PTSI is a biological trauma citing the physical changes which occur in the nervous system in people with this condition. While mental health experts have long acknowledged and understood the physical changes associated with PTSD, some argue that changing the name would change peoples’ perception of the condition.
Who Is Affected by PTSD?
While research is not yet available based on the proposed term PTSI, research into PTSD and PTSD statistics can begin to give an understanding of whose diagnoses may be affected by this name change.
PTSD in the General American Population
- Approximately 60% of men and 50% of women experience a traumatic event at some point in their lives
- In the United States, 7-8% of the total population will develop PTSD at some point in their lives
- Approximately 8 million people develop PTSD in a given year
- Interestingly, PTSD is more common in women, with 10% of women developing the disorder compared to 4% of men. This fact may also be due to the higher probability of a woman to experience a traumatic event.
PTSD in Children and Teens
Among young people, PTSD in children and teens may occur following a trauma, just as it would develop in an adult.
- Approximately 15% of girls and 14% of boys experience at least one traumatic event during childhood
- From this group of children who experience trauma, 3% to 15% of girls and 1% to 6% of boys will develop PTSD
Causes of Post-Traumatic Stress
Frequently, PTSD is most commonly associated with veterans returning from war, but there are many other PTSD causes. For example, PTSD caused by sexual abuse or assault and PTSD caused by domestic violence are both commonly occurring traumatic events.
Other examples of traumatic events which may lead to PTSD include:
- Car accidents
- Natural disasters
- Exposure to acts of terrorism
This condition is not limited to people who experience trauma first-hand. Those who witness an event like these may develop PTSD as well. In some cases, close friends and family members of a person who has experienced a traumatic event will develop PTSD.
PTSI in the Military
The high rate of PTSD in veterans sparked the initial research into this condition. Once referred to as “shell shock,” PTSD was observed in war veterans upon return home. While once considered a sign of weakness, the understanding of PTSD in the military has grown tremendously.
The Department of Veteran’s Affairs recognizes the challenges that veterans face who develop PTSD. Calls to change the name of this condition have sprung largely from veterans who make up a large portion of the total affected individuals. People in favor of the name change believe that having the word disorder in the name of this condition may prevent people — especially veterans — from seeking help, due to societal stigma surrounding mental health conditions.
Renaming PTSD as PTSI: Possible Impact
Both positive and negative potential impacts of changing the name of PTSD to PTSI have been noted. The main argument for the name change has focused around alleged PTSD stigma.
While the former Army Vice Chief of Staff, Peter Chiarelli, states that he feels the word “disorder” is what inhibits veterans from seeking treatment, others have argued that changing the name without making any other modifications would not do anything to change the stigma. Dr. Matthew Friedman, Senior Advisor at the National Center for PTSD, has challenged Chiarelli, citing how the military handles traumatized soldiers as the greatest contributor to PTSD stigma.
Concerns About PTSD and the Purple Heart
One controversy surrounding the military’s approach has to do with PTSD and the Purple Heart, which is a U.S. military decoration awarded to people who are wounded or killed in the line of duty.
At this time, veterans diagnosed with PTSD are not eligible to obtain the Purple Heart. Some people believe that changing the name would allow veterans affected by this condition to receive the Purple Heart while others suggest the rule should be changed, not the condition’s name.
Canada’s Approach to PTSD
In Canada, the military approach to PTSD is to reduce the stigma around the condition. The Canadian military uses the term Operational Stress Injury to refer to a range of effects of the psychological trauma of warfare, including PTSD. Individuals with this diagnosis can receive the Canadian equivalent to the Purple Heart.
People who are opposed to changing the condition’s name state that Canada’s approach gives the best of both worlds: working to reduce stigma for military veterans without changing the diagnosis. The people who argue that the name should remain the same believe that changing the name would create undue confusion.
Key Points: PTSD vs. PTSI
Anyone interested in the PTSD vs. PTSI debate should understand the following differences between PTSD and PTSI:
- A change to the name of PTSD has been proposed, mainly out of fear that people — especially veterans — may avoid seeking treatment due to stigma
- PTSD is a psychiatric disorder which occurs after experiencing or witnessing a traumatic event
- The proposed name, PTSI, hopes to change the perception of this condition from a psychiatric disorder to a biological trauma that affects the nervous system
- People who want the name changed believe the word disorder discourages veterans from seeking treatment
- People who want the name to remain the same believe this change would not do anything to change the stigma and that the condition needs to be approached differently, especially by the military
Keynan, Irit; Keynan, Jackob. “War Trauma, Politics of Recognition and Purple Heart: PTSD or PTSI?” ResearchGate, September 2016. Accessed May 27, 2019. Jaffe, Greg. “New Name for PTSD could mean less stigma.” The Washington Post, May 5, 2012. Accessed May 27, 2019. National Institute for the Clinical Application of Behavioral Medicine (NICABM). “Leading Psychiatric Doctor Claims Re-labeling PTSD as PTSI will bring ‘Unintended Consequences.’” (n.d.) Accessed May 27, 2019. Global Post Traumatic Stress Injury Foundation. “PTSD vs. PTSI.” Accessed May 27, 2019. American Psychiatric Association. “What is Posttraumatic Stress Disorder?” January 2017. Accessed May 27, 2019. U.S. Department of Veterans Affairs. “Combat Exposure.” (n.d.) Accessed May 27, 2019. U.S. Department of Veterans Affairs. “How Common is PTSD?” (n.d.) Accessed May 27, 2019.
Keynan, Irit; Keynan, Jackob. “War Trauma, Politics of Recognition and Purple Heart: PTSD or PTSI?” ResearchGate, September 2016. Accessed May 27, 2019.
Jaffe, Greg. “New Name for PTSD could mean less stigma.” The Washington Post, May 5, 2012. Accessed May 27, 2019.
National Institute for the Clinical Application of Behavioral Medicine (NICABM). “Leading Psychiatric Doctor Claims Re-labeling PTSD as PTSI will bring ‘Unintended Consequences.’” (n.d.) Accessed May 27, 2019.
Global Post Traumatic Stress Injury Foundation. “PTSD vs. PTSI.” Accessed May 27, 2019.
American Psychiatric Association. “What is Posttraumatic Stress Disorder?” January 2017. Accessed May 27, 2019.
U.S. Department of Veterans Affairs. “Combat Exposure.” (n.d.) Accessed May 27, 2019.
U.S. Department of Veterans Affairs. “How Common is PTSD?” (n.d.) Accessed May 27, 2019.