Army Surgeon General’s Office Questions Use of Tests to Decide PTSD Diagnosis
Two years ago, Fort Bragg Sgt. Jody Lee Piercy was ordered to take a battery of psychological tests to determine whether he was faking his service-related ailments.
After the testing, medical records show, a doctor at Womack Army Medical Center concluded that Piercy was exaggerating symptoms of post-traumatic stress disorder and wrote that a diagnosis of malingering “should be strongly considered.”
Six months later, the records show, Piercy underwent another battery of psychological tests for issues related to traumatic brain injury. This time, a different Womack doctor did not waffle. Piercy, he said, was faking.
The Army’s testing seemed to demonstrate that Piercy was fabricating his problems to get increased benefits once he left the service.
Piercy, a member of Fort Bragg’s Warrior Transition Battalion for wounded soldiers, says nothing could be further from the truth. He’s been trying to fight back against the malingering accusation. And now the Army itself may have given him some ammunition.
This month, the Army’s Office of the Surgeon General issued a new policy on the assessment and treatment of PTSD that discounts the use of psychological tests to determine whether soldiers are malingering.
The policy says incidents of soldiers faking or exaggerating their symptoms are rare - less than 1 percent of the cases, according to one study. It also says that a poor result on a psychological test “does not equate to malingering, which requires proof of intent.”
Piercy said he knows of about 25 other soldiers in Fort Bragg’s battalion who have been accused of malingering, including nine who appeared at a meeting for disgruntled battalion soldiers last month.
For a soldier who was injured while serving his country, Piercy said, the Army could not have come up with a worse label.
“You could have done anything other than call me a malingerer,” he said. “You might as well put a gun to my head.”
PTSD is a mental health condition triggered by a terrifying event. Symptoms may include flashbacks, nightmares and severe anxiety, as well as uncontrollable thoughts about the event. While most people get better over time, symptoms can get worse and last for years.
According to the new PTSD policy, between 5 percent and 25 percent of soldiers who have deployed suffer from PTSD.
The surgeon general’s new policy also addresses one of the other major complaints voiced by soldiers in Fort Bragg’s Warrior Transition Battalion: They say they are being overmedicated for their PTSD symptoms.
According to the policy, which has been distributed to Army medical commanders, the routine treatment of PTSD with Valium, Xanax and other anti-anxiety drugs - collectively known as benzodiazapines - may do more harm than good.
“Once initiated in combat veterans, benzodiazapines can be very difficult, if not impossible, to discontinue due to significant withdrawal symptoms, compounded by the underlying PTSD symptoms,” the policy says.
The number of prescriptions for anti-anxiety drugs issued to Fort Bragg soldiers nearly doubled between 2004 and 2010 - from 3,100 to 5,892, according to figures provided by Fort Bragg last year.
The policy also says the use of Risperidone and other so-called “second-generation antipsychotics” to treat PTSD have “shown disappointing results” and have “potential long-term adverse health effects.”
Instead of using potentially harmful drugs, the policy encourages the use of intensive counseling and other alternatives, including yoga, acupuncture and massage therapies.
On Tuesday, Fort Bragg officials were asked to respond to the new PTSD policy guidelines. Among the questions was whether the policy would result in the re-evaluation of soldiers who have been accused of malingering.
A spokesman for Womack said the questions were sent to the Army’s medical command, which had not responded.
The Army’s Office of the Surgeon General spelled out its new PTSD assessment and treatment policy in a memo dated April 10 to regional medical commanders.
A week later, Fort Bragg commanders announced that an inspection of the post’s Warrior Transition Battalion found areas that need improvement, but they made little mention of the battalion soldiers who were complaining about being overmedicated or being accused of malingering.
Instead, the soldiers were told to take those complaints to their chain of command.
Some of the soldiers had been complaining publicly since Feb. 14, the day Lt. Gen. Frank Helmick, commander of Fort Bragg and the 18th Airborne Corps, ordered the inspection.