The Scapegoat: Personality Disorders


Since World War I, the US military has been pre-screening applicants for psychological abnormalities; since officials often questioned whether or not those with mental illnesses could adequately perform military tasks (Leroux, 2015). As a result, those with pre-existing mental illnesses, especially personality disorders, have been heavily scrutinized.

Personality disorders are described in the DSM-V as an enduring pattern of maladaptive patterns of behavior, cognition, and inner experience, exhibited across many contexts and deviating markedly from those accepted by one’s culture (American Psychiatric Association, 2013). Personality disorders are one of the most common mental illnesses, affecting 5-15% of the general population. Despite its high prevalence, personality disorders are among the most misunderstood and stigmatized mental illnesses (Sheehan, Nieweglowski, & Corrigan, 2016). This is added to the fact that they are also some of the most difficult mental illnesses to treat (Furnham, Lee, & Kolzeev, 2015). Psychiatrists often require extensive interviews with the patient and their loved ones. Not only that but the characteristics of one’s personality disorder can be integrated into a person’s behavior and mindset to the point where altering it becomes challenging. Symptoms can also worsen when a person sustains traumatic head injuries and develops post-traumatic stress disorder. It is for this reason that individuals with personality disorders are prohibited from serving in the military. Those who are found to have or are diagnosed with a personality disorder are immediately discharged.

Although the Department of Veterans Affairs (VA) attempts to protect those suffering from both personality disorder and PTSD or traumatic brain injury, personality disorder discharges are often abused in order to prevent personnel from receiving military payments (Leroux, 2015). Between 2001 and 2007, approximately 26,000 service members from the U.S. Department of Defense (DoD) were discharged after being diagnosed with a personality disorder. Prior to 2007, diagnosis for a personality disorder was the quickest and easiest way to get someone out of the military (Human Rights Watch, 2016). In 2006, Susan Carlson, a social worker, had volunteered to counsel soldiers deployed to Afghanistan. While there, a soldier reported that Carlson had allegedly been making sexual remarks. She underwent a psychological evaluation, was diagnosed with a personality disorder, and was discharged. During her attempt to dispute the diagnosis, she discovered that her psychiatrist was asked to specifically test her for personality disorder. Veterans, particularly those who have reported being sexually assaulted during their service, have been disputing for years that the U. S. military officers had been falsely diagnosing troops with personality disorders (Dao, 2012). Following the discovery of this abuse, the DoD has changed the requirements for a discharge due to having a personality disorder and the number of diagnoses has declined from 4,264 in 2007 to 1,078 in 2010 (Human Rights Watch, 2016).

Various policy reforms have been proposed in order to prevent cases like Carlson’s from occurring. Human Rights Watch recommends that Congress create the right for applicants who were not able to be heard at the Discharge Review Board to be able to present their case in front of the Boards for Correction for Military Records. Investigative reporter Joshua Kors has stated that the “personality disorder discharge” should be completely eliminated as it has no purpose aside from denying benefits to veterans. Although the number of personality disorder discharges have dropped, military branches are finding different ways in order to discharge soldiers, including by diagnosing them with adjustment disorder (Kors, 2016).

Military personnel who possess illnesses such as post-traumatic stress disorder, dissociative disorders, and mood disorders can potentially be compensated for their service. It brings up the question of why personality disorders are excluded. Personality disorders have been classified by the military as a pre-existing disorder originating from a person’s youth (Dao, 2012). This allows VA to effectively avoid providing military members with disability and medical payments, as pre-existing conditions do not qualify as “service-related.” They can also be dishonorably relieved from duty, something which can be detrimental for a person’s integration back into society (Dao, 2012).

Once a veteran is branded as having been dishonorably relieved of duty, they are looked upon with disrespect. When they seek employment, attempt to get health care, and apply to schools, their brand leaves them feeling judged. Given that over 85% of military personnel are honorably discharged, anything less results in one facing discrimination and negativity. They are left with an even heavier strained sense of identity by their diagnosis and the stigma attached to personality disorders.

Dishonorable discharges because of personality disorders are classified in three ways: fraudulent enlistment, failing to meet medical or physical standards, or erroneous enlistment (Leroux, 2015). Stating that a member of the military was discharged for these reasons gives the implication that that person was aware of their condition prior to enlisting. However, this is unlikely due to the fact that personality disorders are relatively unknown in society compared to other illnesses such as depression or obsessive-compulsive disorder. In a study conducted in 2015, a group of 102 participants were given a description of various psychological disorders and then asked to identify the illness. Although 72.5% could identify depression and 65.6% could recognize schizophrenia, only 2.3% could identify borderline personality disorder (Furnham, Lee, & Kolzeev, 2015). This lack of knowledge increases the prejudice against those with personality disorders and can lead to the inability to correctly diagnose or recognize it early.

Stigma has the potential to influence the perception towards some of the most revered members of society. Possessing or being diagnosed with a personality disorder complicates their transition into their civilian life and strains their relationships with those around them. It is unjustified in its purpose of denying benefits that veterans are entitled to and it is reckless for one to purposely give a misdiagnosis. We must be willing to educate ourselves regarding mental illnesses, as it is a part of preventing this stigma.

 

References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.

Dao, J. (2012). Branding a Soldier With ‘Personality Disorder’. Retrieved from http://www.nytimes.com/2012/02/25/us/a-military-diagnosis-personality-disorder-is-challenged.html?_r=0

Furnham, A., Lee, V., & Kolzeev, V. (2015). Mental health literacy and borderline personality disorder (BPD): what do the public “make” of those with BPD?. Social psychiatry and psychiatric epidemiology, 50(2), 317-324.

Human Rights Watch. (2016). Booted. Retrieved from https://www.hrw.org/report/2016/05/19/booted/lack-recourse-wrongfully-discharged-us-military-rape-survivors

Kors, Joshua. (2015). How to Uncover a Military Conspiracy | Joshua Kors | TEDxVanderbiltUniversity. Retrieved from https://www.youtube.com/watch?v=tgbPTwQnCLQ

Leroux, T. C. (2015). U.S. Military Discharges and Pre-existing Personality Disorders: A Health Policy Review. Administration And Policy In Mental Health And Mental Health Services Research, 42(6), 748-755.

Sheehan, L., Nieweglowski, K., & Corrigan, P. (2016). The Stigma of Personality Disorders. Current Psychiatry Reports, 18(1), 11.

 


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