How Has Military Influence Shaped Our Understanding of PTSD?

What you need to know

• While most PTSD cases are not combat-related, military influence has shaped how we understand, diagnose, and treat this condition
• The diagnostic criteria for PTSD treat combat violence differently than civilian violence, potentially creating disparities in care access
• Understanding these biases could help improve PTSD care for non-military populations

The Military’s Outsized Influence on PTSD

Post-traumatic stress disorder (PTSD) can affect anyone who experiences trauma, whether they’re a combat veteran, a survivor of abuse, or someone who has lived through a natural disaster. However, the way we understand and treat PTSD has been heavily influenced by military perspectives and funding.

This influence shows up in several ways:

• Over 90% of PTSD-related federal legislation between 1989-2009 focused on military populations
• The Department of Defense and Veterans Affairs are major funders of PTSD research
• The diagnostic manual used by mental health professionals (DSM-5) reflects military values in how it defines trauma

How Military Values Shape PTSD Diagnosis

The DSM-5’s criteria for diagnosing PTSD include something called “Criterion A,” which defines what kinds of events can be considered traumatic enough to cause PTSD. The manual treats military violence differently than civilian violence in important ways.

For example, when soldiers engage in violence during combat, this is explicitly recognized as potentially traumatic for the soldier. However, the same consideration isn’t given to civilians who may engage in violence, such as police officers or prison guards. This difference reflects cultural values about military service but may not accurately represent how trauma affects different populations.

Impact on Treatment Access

This military-centric view of PTSD has real consequences for who gets help and how:

Military Personnel:

• Have access to VA disability benefits
• Benefit from government-funded healthcare
• Experience more public understanding and support
• Have access to specialized trauma treatment

Civilian Populations:

• May struggle to get their trauma recognized
• Have less access to specialized care
• Face more stigma
• Receive less research attention and funding

The Prison Population: A Case Study in Disparities

The situation of incarcerated individuals highlights these disparities:

• 18% of male prisoners and 40% of female prisoners experience PTSD
• Many develop a “post-incarceration syndrome” similar to PTSD
• Despite high rates of trauma, they receive far less research attention and specialized care than veterans
• This population often struggles to access trauma-focused healthcare

Following the Money

The phrase “follow the money” helps explain how PTSD research has developed. Military funding has shaped:

• Which populations get studied
• What questions researchers ask
• How findings get interpreted
• Where treatment resources go

This influence isn’t necessarily intentional, but it creates real disparities in care access and quality.

The Role of Values in Research

All research is influenced by underlying values, even when these values aren’t explicitly stated. In the case of PTSD:

• Military experiences are often privileged over civilian ones
• Combat-related violence is treated differently than other forms of violence
• Research funding tends to follow military priorities
• Treatment resources cluster around veteran populations

Conclusions

• Military influence has significantly shaped our understanding and treatment of PTSD, sometimes in ways that create care disparities
• Recognizing these biases is crucial for developing more inclusive and effective PTSD care
• Expanding research and treatment beyond military populations could help more trauma survivors get the care they need