Kevlar for the Mind: Separations for personality disorders are on the decline - Off Duty, Military Health and Fitness - Air Force Times

Kevlar for the Mind: Separations for personality disorders are on the decline

Q. A soldier in my platoon is being discharged for a personality disorder. What is that, and why would it be cause for separation?

A. Personality disorders are a class of psychiatric conditions in which typical behaviors, emotions, perceptions and thoughts differ significantly from cultural norms.

Someone with a personality disorder is likely to be rigid in his thinking, resistant to changing his behavior — even when the behavior is problematic for others — and have difficulty understanding that the interpersonal, social and occupational problems he encounters are indeed due to his personality makeup.

Mental health professionals generally view personality disorders as difficult to treat and requiring extensive clinical time and effort.

The American Psychiatric Association identifies 10 separate personality disorders and includes a category for others not specified. One of the more recognizable is narcissistic personality disorder — a pervasive pattern of feeling overly important or skillful, an excessive need for admiration, and lack of empathy, all of which are present by early adulthood.

Other well-known personality disorders include Antisocial personality disorder (pervasive disregard for the law and rights of others) and dependent personality disorder (extreme neediness and psychological dependency on others).

Along with other mental health disorders such as post-traumatic stress, schizophrenia and depression, a service member can be separated as a result of being diagnosed with a personality disorder. The primary rationale is that because personality disorders are relatively stable, difficult to treat, and contribute to disruptive and inappropriate behavior, service members with a personality disorder are unlikely to succeed in the military, and their presence likely will detract from the mission.

The number of troops separated because of a personality disorder has dropped in the past few years. The most significant reason for the decline is related to a congressional inquiry that suggested personality disorder-based military separations were being used inappropriately.

The belief was that this type of separation was seen by some commanders as an avenue for ridding “problem” troops from the ranks. Consequently, mental health providers felt pressured to oblige these commanders.

There is a clear and linear process for separating someone with a personality disorder. A service member has rights, and it’s important that these rights are respected.

As with any military separation, if there is confusion and uncertainty, consulting legal counsel is advised.

Bret A. Moore is a clinical psychologist who served in Iraq and is the author of “Wheels Down: Adjusting to Life after Deployment.” Email kevlarforthemind@militarytimes.com. Names and identifying details will be kept confidential. This column is for informational purposes only. Readers should see a mental health professional or physician for mental health problems.