Study: Secondary PTSD Overdiagnosed

Post date: May 31, 2011 3:40:28 PM

May 31, 2011 by Amy Bushatz

More than half of military spouses who think they are suffering from secondary PTSD symptoms may have been misdiagnosed, a new study finds.

"A lot of times, people see a spouse that's distressed and say it's secondary PTSD," said Keith Renshaw, a psychology professor at George Mason University who authored the study. "There's kind of an over-assumption that this is prevalent, and that anything and everything that comes up for a spouse is due to that."

Secondary post-traumatic stress disorder has become a common catch-all label in the military community for the intense stress many spouses feel while living with a veteran suffering from PTSD. Unlike caretaker stress or stress from traumatic events in their own lives, secondary PTSD has sudden, specific characteristics including vivid dreams about the service member's traumatic event or avoiding reminders of that event, Renshaw said.

The study, due for release this fall, found that up to 41 percent of the 190 spouses it surveyed had symptoms similar to those linked with secondary PTSD. But when questioned further, only about 15 percent of respondents pointed to their husbands' military experience as the sole cause for their stress -- a key trait of secondary PTSD.

The popularity of the term "secondary PTSD" may have been caused by the desire among spouses to give a name to the feelings they are experiencing, Renshaw said. But without mental health expertise to sort through their issues, spouses can easily misidentify their symptoms -- a mistake that may lead to improper treatment, he said.

"The treatment implications are the bigger piece," Renshaw said. "If you say you have secondary PTSD, then you are saying you have to do something very specific that actually is not called for."

While treatment options for some symptoms of secondary PTSD and caretaker stress may cross, others are going to be vastly different, Renshaw said. For example, caretaker stress would never be treated with cognitive processing therapy, a process in which patients are asked to confront their traumatic memories, he said.

But some spouses are worried Renshaw's study may have negative mental health repercussions. Brannan Vines, founder of, was diagnosed with secondary PTSD in 2007 after her husband, who has PTSD, returned from Iraq and retired from the Army. Her organization focuses almost entirely on educating military spouses, families and their caretakers about the realities of the disease. now has about 70 volunteers and works with over 200,000 visitors each year, mostly on secondary PTSD issues.

Rather than being over diagnosed, Vines said she believes the problem is just the opposite.

"In my opinion, through my work, secondary PTSD is not overly diagnosed, it's underdiagnosed," she said. "My concern with this study is that they are about to put out that we don't need to be monitoring caregivers for PTSD. And caregivers that are already having trouble getting people to take them seriously are going to be told 'well this study says you just have caregiver stress, you just need to relax.' "

But Renshaw said that is exactly what they don't want to have happen.

"We don't want to just say [secondary PTSD] doesn't exist, because it does," he said. "What I worry about is that people who are struggling [will] latch onto it as the explanation, when in fact it's actually not going to help them. … But for this to be used to say to people 'you're full of it, you're just struggling with caregiver stress,' that would be the worst possible outcome."