George Harris, Ph.D. Kansas City Star Reader Advisory Panel 2008

After the shootings at Fort Hood, people understandably speculated about what caused the alleged shooter Major Hasan to attack. Was it Muslim ideology? psychosis? Or was it post traumatic stress disorder?

Without drawing a conclusion about the Fort Hood situation when all facts are not yet known, I think it is reasonable to discuss whether post traumatic stress disorder (PTSD) is a possible explanation. Doing so may help readers develop a broader understanding of PTSD as it affects soldiers and domestic first responders.

Mental health professionals use a diagnostic and statistical manual (DSM) developed by the American Psychiatric Association. The DSM comprises all psychiatric diagnoses and the criteria that must be met for diagnosis.

The criteria for PTSD state that a traumatic stressor can be a direct personal experience of actual or threatened death or serious injury or threat to physical integrity. PTSD can also result from witnessing such an event or from learning about such an event occurring to a family member or other close associate.

It is the last phrase that opens the door to the claim that a psychiatrist could develop PTSD after listening to repeated accounts of the horrors of war. Some have referred to such a disorder as "secondary" PTSD, but there is no official category of such in the DSM.

Here's the problem as I see it: There aren't many psychiatrists, psychologists, social workers or counselors in the military, or in the U.S. for that matter, who haven't frequently heard about horrible events. As a psychologist who works with police and fire departments, I routinely listen to accounts of such events from police officers, firefighters and soldiers returning home to rejoin their departments. Therapists regularly listen to accounts of physical and sexual abuse, domestic violence and other traumas that are a fact of life.

So how many mental health professionals have you read about who went berserk and went on a shooting rampage? Depending on how one counts, there are easily several hundred thousand mental health professionals in the country, and no doubt some have psychiatric disorders (depression, etc.) But the incidence of so called secondary PTSD, especially that resulted in a shooting rampage, is statistically improbable.

Mental health professionals may get jaded, burned out, cynical, or just plain tired from their work. Some develop depression or anxiety, sometimes from working with difficult or suicidal patients.

But post traumatic stress disorder diagnoses should not be casually diluted by including people who have been bothered by listening to accounts of horror.

PTSD is not a mild case of the jitters, nor is it an illness someone can control by trying to shake it off. It is not an emotional problem of someone who is weak or cowardly. People with PTSD have flashbacks and uncontrollable intrusive thoughts, sleep disruption and overwhelming anxiety. It is a very real, physical disorder that can happen to anyone directly exposed to severe trauma. And it ruins lives.

Treatment helps and should be encouraged. We should not say anything that soldiers or first responders would hear as diminishing the significance of their experiences or the reality of their illnesses. There are plenty of other DSM diagnoses to go around for the rest of us.