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Published: Friday, March 16, 2012, 1:53 p.m.

Experts: Soldier might have PTSD

Mental health experts say the soldier suspected of killing Afghan civilians could have post-traumatic stress disorder.
The soldier's lawyer said his client had seen a fellow soldier's leg blown off a day before the killings, and had suffered a head injury and lost part of a foot during three earlier deployments to Iraq. The 38-year-old soldier, who has not been identified, left for Afghanistan in December.
"This kind of a person would fit the profile for someone who might well have PTSD," said Dr. Roger Pitman, a Harvard Medical School psychiatrist who heads the PTSD Research Laboratory at Massachusetts General Hospital. He has no knowledge of the case and spoke hypothetically, but said that if the soldier had recently witnessed a major injury to a comrade, it could have been an important trigger.
"A psychologically traumatic event in which a person feels intensively helpless or terrified may result in a post-traumatic disorder," Pitman said. "We've known ever since the Vietnam War that the unfortunate phenomenon of abusive violence often closely follows the injury or death of a buddy in combat. The injury or death of a buddy creates a kind of a blind rage."
On Friday, a senior U.S. defense official said that investigators have determined that the suspect had been drinking alcohol before he left the base the night of the killings. How much of a role alcohol may have played in the attack that killed 16 people is still under investigation, said the official, speaking on condition of anonymity because charges have not yet been filed.
The lawyer, John Henry Browne of Seattle, said the soldier's family had told him that the soldier saw a friend lose his leg -- an account that has not been independently verified. Browne also said, that while in Iraq, the soldier had suffered a concussion in a vehicle accident caused by an improvised explosive device and had to have part of one foot removed after suffering a battle-related injury. The extent of his injuries, the cause of the accident and exactly when the 11-year veteran was hurt were not clear.
The soldier's own injuries put him at risk for PTSD, said Troy Holbrook, a San Diego scientist who has researched PTSD as a consultant for the military. Like Pitman, she has no direct knowledge of the soldier's case.
"The rates of PTSD post-combat in the military run in some studies everywhere from 15 or 18 percent all the way to 30 percent," Holbrook said. A recent study she led found that quickly giving morphine to wounded troops cuts in half the chance they would develop PTSD.
However, "only a small minority of people with post-traumatic stress disorder engage in abusive violence," Pitman said.
Dr. Gregory O'Shanick, a psychiatrist and former medical director for the advocacy group Brain Injury Association of America, said the same is generally true of people with concussions, which can damage impulse-control regions of the brain.
"Traumatic brain injury of any severity is not strongly linked to aggressive behavior," he said.
A top military commander, visiting the home base of the suspect, defended on Friday how the Army handles mental health and the strain of multiple deployments.
"We look at everything on a case-by-case basis and then we design things to help that person overcome challenges if he has those," Army Gen. David Rodriguez told a news conference at Joint Base Lewis-McChord. "There's not a cookie cutter solution. There's no rule that says, 'This guy can handle two or three.' But we pay attention to that very, very carefully."
Rodriguez said there was "sufficient screening" for post-traumatic stress disorders at Lewis-McChord, which has faced a series of violent incidents: Four soldiers were convicted in the deliberate thrill killings of three Afghan civilians in 2010. A former soldier shot and injured a Salt Lake City police officer in 2010. Another veteran shot and killed a Mount Rainier National Park ranger before succumbing to the cold and drowning in a creek on New Year's Day.
Just this past week, authorities accused a 20-year Army officer of threatening to blow up the state Capitol and kill his superior officer, his estranged wife and his girlfriend.
Rodriguez, while not discussing details about the case, called the Afghanistan massacre a "tragedy" and said the military would hold people accountable.
"We are disappointed that it happened and shocked just like everybody else," the general said. "We have a tradition of doing what's right, and we'll do that in this situation, too."
U.S. officials have said the Army staff sergeant was trained as a sniper.
"To be a sniper, you've got to have the ultimate in impulse control. You have to move slowly, you have to inhibit, you have to wait ... to put the brakes on even in situations where the heart is pounding and it's a high-stress environment," O'Shanick said. To be chosen for such a role, he must have been able to control impulses better than the average person, O'Shanick said.
In prisons, there is a high percentage of inmates with traumatic brain injuries, he added. That usually doesn't make them more aggressive, but "when it goes bad, it can go bad significantly," he said.

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