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KAISERSLAUTERN, Germany — The military services do not always follow Defense Department regulations when involuntarily separating servicemembers for a personality disorder, a condition that can have similar symptoms to post-traumatic stress disorder and disqualifies individuals for combat-related disability pay, according to a recent Government Accountability Office report.

A 2008 review of the personnel records of 371 enlisted servicemembers found that most troops were notified of an impending personality disorder separation, which is required by the DOD, the GAO found. But in many cases, the diagnosis was not made by a psychiatrist or psychologist and/or formal counseling was not provided prior to notification of separation, which are also DOD requirements.

Defined as “a long-standing, inflexible pattern of behavior that deviates markedly from expected behavior,” a personality disorder is considered a “pre-existing condition,” which disqualifies servicemembers from disability compensation.

But accurately diagnosing servicemembers who have served in combat with a personality disorder can be challenging, the GAO report said, because some personality disorder symptoms — irritability, feelings of detachment or estrangement from others, and aggressiveness — are similar to PTSD symptoms.

DOD records show that from Nov. 1, 2001, through June 30, 2007, about 26,000 enlisted servicemembers were separated from the military because of a personality disorder. Of those, about 2,800 had deployed at least once in support of Operation Enduring Freedom or Operation Iraqi Freedom, the GAO report said.

According to the American Psychiatric Association and the American Psychological Association, the only way to distinguish a personality disorder from a combat-related mental health condition, such as PTSD, is by obtaining an in-depth medical and personal history from the enlisted servicemember that is corroborated, if possible, by others such as family members and friends, the GAO said in the report.

Since the 2008 review, the DOD has added requirements to help ensure servicemembers are not incorrectly separated.

For example, the diagnosis of personality disorder for servicemembers serving in imminent danger pay areas must be endorsed by the surgeon general of the respective military service and the diagnosis must also discuss whether PTSD or other mental health conditions are present.

The services also are required to provide reports on their compliance with the DOD regulations.

But the reports for fiscal year 2008 showed that three out of the four services were not in compliance with any of the separation requirements, according to GAO. Only the Air Force was in compliance with two of the three requirements.

In that fiscal year, 2,008 servicemembers were separated because of a personality disorder, with nearly half of them – 946 – coming from the Navy.

To view the full report, go to: http://www.gao.gov/new.items/d101013t.pdf.

svanj@estripes.osd.mil

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Jennifer reports on the U.S. military from Kaiserslautern, Germany, where she writes about the Air Force, Army and DODEA schools. She’s had previous assignments for Stars and Stripes in Japan, reporting from Yokota and Misawa air bases. Before Stripes, she worked for daily newspapers in Wyoming and Colorado. She’s a graduate of the College of William and Mary in Virginia.
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