title: Stigma associated with PTSD: perceptions of treatment seeking combat veterans.
abstract: OBJECTIVE
  Although stigma associated with serious mental illness, substance abuse disorders, and depression has been studied very little is known about stigma associated with Posttraumatic Stress Disorder (PTSD). This study explored stigma related to PTSD among treatment-seeking Operation Enduring Freedom and Operation Iraqi Freedom (OEF/OIF) combat veterans.
  
  
  METHODS
  Sixteen treatment-seeking OEF/OIF veterans with combat-related PTSD participated in focus groups. We used qualitative methods to explore PTSD-related stigma.
  
  
  RESULTS
  Common perceived stereotypes of treatment-seeking veterans with PTSD included labels such as "dangerous/violent," or "crazy," and a belief that combat veterans are responsible for having PTSD. Most participants reported avoiding treatment early on to circumvent a label of mental illness. Participants initially reported experiencing some degree of self-stigma; however, following engagement in treatment they predominantly resisted these stereotypes. Although most participants considered combat-related PTSD as less stigmatizing than other mental illnesses, they reported difficulties with reintegration. Such challenges likely stem from both PTSD symptoms and veterans' perceptions of how the public views them. Most reported that fellow combat veterans best understood them.
  
  
  CONCLUSIONS
  Awareness of public stereotypes impacts help seeking at least early in the course of illness. Peer-based outreach and therapy groups may help veterans engage in treatment early and resist stigma.
authors.affiliation: VA Health Services Research and Development (HRS&D), Center for Mental Healthcare and Outcomes Research, Central Arkansas Veterans Healthcare System, 2200 Fort Roots Drive, North Little Rock, AR 72114, USA. Dinesh.Mittal@va.gov
authors.forename: Dinesh
authors.initials: D
authors.lastname: Mittal
authors.forename: Karen L
authors.initials: KL
authors.lastname: Drummond
authors.forename: Dean
authors.initials: D
authors.lastname: Blevins
authors.forename: Geoffrey
authors.initials: G
authors.lastname: Curran
authors.forename: Patrick
authors.initials: P
authors.lastname: Corrigan
authors.forename: Greer
authors.initials: G
authors.lastname: Sullivan
mesh_terms: D000328:Adult; D055826:Afghan Campaign 2001-; D005260:Female; D017144:Focus Groups; D006801:Humans; D054542:Iraq War, 2003-2011; D008297:Male; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D010379:Peer Group; D036301:Qualitative Research; D012649:Self Concept; D057545:Social Stigma; D012944:Social Support; D013240:Stereotyping; D013313:Stress Disorders, Post-Traumatic / Q000523:psychology* / Q000628:therapy; D014481:United States; D014728:Veterans / Q000523:psychology*