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Wounded soldiers given false personality disorder
Topic Started: Apr 7 2007, 07:20 AM (977 Views)
otlset
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Dear Prudence
TheSmashedGuitar
Apr 12 2007, 05:05 PM
You are as wrong about this as when you claimed that the listed diagnosis was proof positive of 'malingering/faking the loss.'

The diagnosis does not work that way and even a very simple consultation of sources which are not older than I am would have easily shown this.

At this point, a single area of contention is being cherrypicked to dismiss fair consideration of the article, essentially a classic sign that there's a conscious attempt to dismiss the implications of the article's content. Except in this case, the single point being used for this intent is not actually a fair contention and the grounds for labeling the work an 'agenda driven hack job' don't even stand on their own merit, much less as a justification for junking the article's credibility in total.

Here's the clencher, fella: You are entrenching your mistaken view on the encapsulation of functional non-organic hearing and you are doing so using irrelevant and outdated medical citation.

To gloss the issue over again (as this has already been covered): When a hearing loss is listed as "functional (non-organic)" this only means that there was an outside cause of the hearing loss, in the form of an event and/or environmental complication. The soldier's loss is not listed as an organic cause of functional hearing loss since it was not related to age, disease, or other internal complication. It was related to a battlefield injury.

This means that the diagnosis is not saying that the patient is feigning hearing loss, or suffering it due to psychosomatic/psychogenic issues.. It is actually saying that the hearing loss is actually a complication from an exterior event.

Such as, say, the shock impact of a rocket blowing up two feet away from his head. The inner ear damage that can result from such an exterior trauma would be listed as -- surprise! -- functional non-organic hearing loss.

Yes, the Rintelmann text was from that audiology course I took, however the principles and terminology have changed little, outside of new terminology that has come with new developments in audiology such as otoacoustic emissions and other developments mostly related to brainstem audiometry and surgical monitoring techniques.

In the case of Town's rocket explosion nearby, the concussive damage to the hair cells and basilar membrane of the cochlea would produce acoustic noise trauma, which is a quantifiable injury to the inner ear. This is an organic result. It IS NOT "functional (non-organic) hearing loss" in which no cause is known, and is regarded primarily as referring to malingering the vast majority of times, and rarely psychogenic in extreme cases where the patient is beset with psychological and emotional problems that prevent voluntary response to stimulus that is required in the usual testing procedures. Noise trauma results in organic inner ear damage.

I don't know why you keep trying to belittle me personally in this. I'm only trying to get at the truth.

I wish I had more time, but I'm at work now and have a lot to do. Return later.
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TheSmashedGuitar
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Love Will Tear Us Apart, Again
The article is not seeking balance, it is decrying what they see as a scandal. All the positive things for the VA are assumed already. (at least by the "support the troops" faithful) That's why this article is a big deal. Because it shows that crap is really happening on the sidelines. There is no need whatsoever to say "but the fine men and women are doing their best, really, and some might say the EVER INCREASING MULTITUDE of vets being discharged is lying. It's ridiculous to think that this could possibly be necessary.

Just admit that you saw a negative article, immediately dismissed it, and latched on to the one thing that you thought was an error. When you found it, you thought you could dismiss any other good points of the article. Unfortunately, you latched on to a "fact" that wasn't entirely true, and it blew up in your face. So sorry, but any further argument on functional nonorganic hearing loss, now that we have a clear and concise definition from CREDIBLE (not some friend we know) sources, is pointless.

Move on or get out.

I think the thing that bothers me most about your arguements is that you're willing to assume that large numbers of people who volunteered to serve, and have been in a war, are just lazy bastards trying to cheat the system. Foesn't sound like a very high opinion of our military - and yet, i'll bet you're solidly behind Bush and 'stay the course'.

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otlset
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Dear Prudence
TheSmashedGuitar
Apr 13 2007, 10:42 AM
Just admit that you saw a negative article, immediately dismissed it, and latched on to the one thing that you thought was an error. When you found it, you thought you could dismiss any other good points of the article. Unfortunately, you latched on to a "fact" that wasn't entirely true, and it blew up in your face. So sorry, but any further argument on functional nonorganic hearing loss, now that we have a clear and concise definition from CREDIBLE (not some friend we know) sources, is pointless.

Move on or get out.

I think the thing that bothers me most about your arguements is that you're willing to assume that large numbers of people who volunteered to serve, and have been in a war, are just lazy bastards trying to cheat the system. Foesn't sound like a very high opinion of our military - and yet, i'll bet you're solidly behind Bush and 'stay the course'.

Why do you continue to try and belittle me? I remain respectful to you.

Please offer evidence that acoustic noise trauma causes functional hearing loss from credible, up-to-date sources.

Unfortunately, many vets are like the general population. A few (more than I'd like to admit as an American citizen) are ne'er-do-wells who try to get something they aren't entitled to. And according to the audiologist here in this medical mall, more common than one might suspect.
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TheSmashedGuitar
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You mean I HAVEN'T already? I've provided you with links that you apparently didn't read. I'll post some more sources if you like:

An AP article.
A US News & World Report article.



It seems more like I gave a shitload of evidence to the contrary, told you what you thought didn't give proper cause to dismiss the entire article, gave you links to other articles which had the same information from more reliable sources, and asked you, quite clearly, if this definition was the only problem with the article you had.

Your response, each time, has been "No, you're wrong"

If any further argument with you requires agreeing with arguments that I believe have quite clearly been proven false, than I don't see any point in continuing.

Really, it'll just be "he wasn't lying!" "yes, he was" "no he wasn't" and so on.

I will go looking for more reliable sources on audiology to prove my point.

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otlset
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Dear Prudence
TheSmashedGuitar
Apr 13 2007, 11:17 AM
You mean I HAVEN'T already? I've provided you with links that you apparently didn't read. I'll post some more sources if you like:

An AP article.
A US News & World Report article.



It seems more like Igave a shitload of evidence to the contrary, told you what he thought didn't give proper cause to dismiss the entire article, gave you links to other articles which had the same information from more reliable sources, and asked you, quite clearly, if this definition was the only problem with the article you had.

Your response, each time, has been "No, you're wrong"

If any further argument with you requires agreeing with arguments that I believe have quite clearly been proven false, than I don't see any point in continuing.

Really, it'll just be "he wasn't lying!" "yes, he was" "no he wasn't" and so on.

I will go looking for more reliable sources on audiology to prove my point.

No, you haven't provided any source that defines noise-induced (acoustic trauma) hearing loss as a "functional (non-organic) hearing loss."

Noise induced acoustic trauma results in an organic loss, characterized by the forced separation of receptor hair-cells from the basilar membrane in the cochlea. Organic means there is a physical reason for the hearing loss. It is explained in terms of cilial hair-cell damage from the loud noise trauma.
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TheSmashedGuitar
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Whilst I search for more on that info, please read the other two articles I linked. They were talking about completely different soldiers. You seem to be hung up on the one single case the first article started with, the one with hearing loss, and believing that the whole article is faulty, because that single person may not really have the injury he claims. You're missing the fact that _many_ soldiers are claiming that they have been improperly discharged or denied proper disability status.

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otlset
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Dear Prudence
TheSmashedGuitar
Apr 13 2007, 11:52 AM
Whilst I search for more on that info, please read the other two articles I linked. They were talking about completely different soldiers. You seem to be hung up on the one single case the first article started with, the one with hearing loss, and believing that the whole article is faulty, because that single person may not really have the injury he claims. You're missing the fact that _many_ soldiers are claiming that they have been improperly discharged or denied proper disability status.

Yes I read them, one of them was in this morning's local newspaper. I hope for the best for deserving vets needing increased and more efficient care. I too would like to know if any of the medical personnel involved in VA or active military care for vets are themselves being dishonest, and denying eligible and deserving vets the best care they can get. As medical providers, I would be even more upset at them for such actions than the vets dishonestly trying to obtain disability benefits, because they truly would hurt the innocent and deserving if that were the case.

Yes, as I tried to explain, the author loses credibility if any part of his story is false, intentionally or not. It's a journalist's responsibility to make sure his facts are straight, and terms clearly defined. But it's a personal decision. You may overlook such journalistic shenanigans, and try to ferret out the true parts of each article if you wish.
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TheSmashedGuitar
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otlset
Apr 13 2007, 12:14 PM
TheSmashedGuitar
Apr 13 2007, 11:52 AM
Whilst I search for more on that info, please read the other two articles I linked. They were talking about completely different soldiers. You seem to be hung up on the one single case the first article started with, the one with hearing loss, and believing that the whole article is faulty, because that single person may not really have the injury he claims. You're missing the fact that _many_ soldiers are claiming that they have been improperly discharged or denied proper disability status.

Yes I read them, one of them was in this morning's local newspaper. I hope for the best for deserving vets needing increased and more efficient care. I too would like to know if any of the medical personnel involved in VA or active military care for vets are themselves being dishonest, and denying eligible and deserving vets the best care they can get. As medical providers, I would be even more upset at them for such actions than the vets dishonestly trying to obtain disability benefits, because they truly would hurt the innocent and deserving if that were the case.

Yes, as I tried to explain, the author loses credibility if any part of his story is false, intentionally or not. It's a journalist's responsibility to make sure his facts are straight, and terms clearly defined. But it's a personal decision. You may overlook such journalistic shenanigans, and try to ferret out the true parts of each article if you wish.

So you've just disproven yourself. Whilst that one article may have been biased and faulted, is it pretty clear now that this is actually happening?

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TheSmashedGuitar
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You haven't really touched on the psychogenic possibility, except to say it's rare in "extreme cases." Why are you so quick to dismiss a psychological explanation? War-related disorders are not exactly a new concept.

What you failed to support in your argument, however, is the leap from "functional hearing loss" to a diagnosis of malingering functional hearing loss - a stance which is not supported by the article. Indeed, considering what I've been reading on psychogenic hearing loss (1,2), the circumstances surrounding the case in question seem to fit fairly well with a psychogenic diagnosis. This also jives with what's known about PTSD and other stress disorders that commonly afflict soldiers. Furthermore, psychogenic hearing loss is considered a conversion disorder in the DSM-IV (the diagnostic manual of mental disorders), which are known to be more prevalent in the military because of the long-term increased stress levels of combat. So, please explain how you made the leap to a malingering classification with the evidence provided by the article.

In any event, if having a rocket explode over your head is not an "extreme case," I fail to see what might be.

1. Qui, William, et al, The Annals of Otology, Rhinology & Laryngology. St. Louis: Aug 1998. Vol. 107, Iss. 8; pg. 638
2. Shigehito Mori, et al, ORL : Journal for Oto - Rhino - Laryngology and Its Related Specialties. Basel: Jan/Feb 2002. Vol. 64, Iss. 1; p. 41

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otlset
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Dear Prudence
TheSmashedGuitar
Apr 13 2007, 07:10 PM
You haven't really touched on the psychogenic possibility, except to say it's rare in "extreme cases." Why are you so quick to dismiss a psychological explanation? War-related disorders are not exactly a new concept.

What you failed to support in your argument, however, is the leap from "functional hearing loss" to a diagnosis of malingering functional hearing loss - a stance which is not supported by the article. Indeed, considering what I've been reading on psychogenic hearing loss (1,2), the circumstances surrounding the case in question seem to fit fairly well with a psychogenic diagnosis. This also jives with what's known about PTSD and other stress disorders that commonly afflict soldiers. Furthermore, psychogenic hearing loss is considered a conversion disorder in the DSM-IV (the diagnostic manual of mental disorders), which are known to be more prevalent in the military because of the long-term increased stress levels of combat. So, please explain how you made the leap to a malingering classification with the evidence provided by the article.

In any event, if having a rocket explode over your head is not an "extreme case," I fail to see what might be.

Another busy day, sorry so late with this reply. And I don't have online access usually on weekends, so here it is Monday (always busy -- hard to devote any time to the ol' forum!).

I did a google search first (just in case) on the authors you referenced. I drew a blank on Qui, and Mori resulted in just one article having to do with the use of otoacoustic emissions testing to corroborate or disprove functional hearing loss.

The patient Jon Town complains of losing his hearing as a result of a nearby rocket blast. From this he states he lost hearing completely in one ear and about 50% loss in the other. Again, this would result in a specific, quantifiable hearing loss due to traumatic noise exposure, known as sensori-neural hearing loss. It varies in its severity depending on how loud or how long the noise exposure. It is an organic result, characterized by definite evidence (can be seen in specialized electron microscope images) of cochlear hair-cell damage.

But psychogenic hearing loss means there is nothing wrong with the auditory system, and can only be explained by a psychological "shutting down" of conscious volitional response. In such cases, rare as I mentioned, often other bodily and volitional systems are rendered inoperative, such as physical paralysis and blindness.

Functional (non-organic) hearing loss is not caused by actual trauma or actual noise. If his loss was genuinely caused by the rocket blast, it would have been diagnosed and shown on the audiogram as a sensori-neural hearing loss. So either the loss was caused by the rocket blast, or by psychological factors. Not both.

I'm sure if he presses his case, the military will authorize brainstem audiometric testing (unconscious physiological neural-trace responses to sound stimuli) that can rough out hearing capabilities without volitional responses, and even the new test for cochlear otoacoustic emissions from sound stimuli to settle things, if they haven't already.

Again, loud noise exposure causes a definite, organic hearing loss easily revealed (if the patient is honest) in standard audiometry. In functional (non-organic) hearing loss, either conscious (malingering) or unconscious (psychogenic), it's all in the head.
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TheSmashedGuitar
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Touche, but the it's still psychological trauma caused by warfare. He should recieve at least SOME benefit.

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otlset
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Dear Prudence
TheSmashedGuitar
Apr 16 2007, 02:20 PM
Touche, but the it's still psychological trauma caused by warfare. He should recieve at least SOME benefit.

Yes, I think he should get everything he has coming to him. The journalist with eyes on the Pulitzer out to right the wrongs of the world as well.
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