BPD Complex ptsd vs. bpd

[zeldazonk]

Here's an interesting link from the Royal College of Psychiatrists:
http://www.rcpsych.ac.uk/mentalhealthinfo/problems/ptsd/posttraumaticstressdisorder.aspx

 

[zeldazonk]

Sorry, I should have said, these links are about C-PTSD.

Here's one from the Dept of Veteran's Affairs:
Link Removed

And here's one from ISST-D:
http://www.johnpreston.co.uk/pictures/items/4/9/3/100394/synergy comfi range guide.pdf

 

[anthony]

There are lots of links about CPTSD on the web... it still doesn't make it an actual diagnosis.

Until the DSM or ICD actually classify it as a diagnosis, CPTSD does not exist, cannot be diagnosed, as it has no diagnostic criteria, and as of right now, is only a classification to describe complex trauma. The same is said with Combat PTSD, it is a classification to describe combat trauma, it is not an actual diagnosis.

With the change of PTSD to a trauma and stressor category, no longer an anxiety disorder, under the DSM V, then we may well see DESNOS appear in the future, though from reading the experts who decided this stuff, being 50,000+ collective psychiatrists globally, CPTSD as a term did not win and got rejected.

It doesn't take a rocket scientist to understand why the majority rejected it, and why it isn't included in the DSM V... because if you start categorising PTSD for one type, then you have opened the door for every other type of trauma to then be categorised as its own form of PTSD. The next would be, Combat PTSD as a diagnosis due to its heightened symptoms of anger and hyper-vigilance, which technically surpass the symptoms outlined in PTSD... but no other diagnoses adequately suit them... though with CPTSD, other diagnoses do exist.

Its an old adage debate which is futile... CPTSD is not happening any time soon. DESNOS is probably the closest thing to a possible inclusion for diagnosis... though then people diagnosed with it won't have that PTSD name, which pisses them off in its own right, because many want the brand, and DESNOS is not branded, nor will it ever be a big brand of diagnosis compared to PTSD.

Futile IMO trying to quote any webpage on CPTSD.

 

[Sandstone]

The two links above make it clear that
"Because results from the DSM-IV Field Trials indicated that 92% of individuals with Complex PTSD/DESNOS also met criteria for PTSD, Complex PTSD was not added as a separate diagnosis"
and
"there remains debate in the field about the concept of complex PTSD"
So they support Anthony's point. It seems more useful to me to work with what is, rather than what might be. I'm more interested in fixing this than classifying it.

The sentence that interests me though is from the Dept. of Veterans affairs site "However, Complex PTSD may indicate a need for special treatment considerations"

Are there different therapies, or approaches to therapies that work better for trauma of complex origin? and for other specific origins?

 

[anthony]

The sentence that interests me though is from the Dept. of Veterans affairs site "However, Complex PTSD may indicate a need for special treatment considerations"

It's already pretty common that complex trauma requires a different approach. Quite honestly, most forms of trauma actually require a slightly different approach. Military respond to a specific type of treatment. Complex trauma respond to a specific type of treatment. Rape victims respond to a specific treatment method. MVA and random accidents respond to a specific treatment type. The list goes on...

I don't think that is anything new... as all my doctrine on PTSD suggests specific routes depending on trauma type and personality of the person.

 

[Vulnerasti Cor]

Haven't thoroughly read the thread yet but recognize many of the issues. One thing that's frequently neglected in these conversations, I find, is that the history of trauma--and the constant morphing of categories and labels relating to it--has so very much to do with CULTURE and its own worldviews/biases. Psychology is largely a SOFT SCIENCE despite its relatively recent investigations into the biological physiology of trauma; the driving force of inquiry is still psychological symptomology. So many of what are now different categories in the DSM originally were all RELATED TO TRAUMA. Now they're broken into so many separate groups of supposedly primarily biological origin. In my opinion, we've been going backwards based on faulty logic and forgetting history.

btw, think this is my first post at site and now I'm horrified (but also laughing) at the moniker I chose....

 

[anthony]

In my opinion, we've been going backwards based on faulty logic and forgetting history.

I would agree with that opinion... along with mental health has lost its way and become a business of telling people there is something wrong with them, instead of reserving such labelling to those only who have undergone extensive examination by clinical doctors with the expertise and training to make such assessment with accuracy.

Doctors aren't in the business of telling someone they have something, when they aren't confident with such an assessment. Therapists don't have this medical reasoning, instead they just listen to the person then start handing out labels to obtain as much repeat business as possible.

 

[Kb3]

Doctors aren't in the business of telling someone they have something, when they aren't confident with such an assessment. Therapists don't have this medical reasoning, instead they just listen to the person then start handing out labels to obtain as much repeat business as possible.

I'm afraid I can't agree with this statement. I think it very much depends on the individual practitioner. I have had unethical and incompetent psychiatrists, as well as unethical and incompetent therapists. I have also absolutely had the experience of having a psychiatrist diagnose me to obtain as much repeat business as possible.

Insurance based psychiatry is much different than non insurance based psychiatry.

 

[anthony]

I infur a majority... I agree, there are idiot psychiatrists as well, and good psychologists who get diagnostic medicine right, though they are a minority.

 

[Butterflywings]

The two links above make it clear that
"Because results from the DSM-IV Field Trials indicated that 92% of individuals with Complex PTSD/DESNOS also met criteria for PTSD, Complex PTSD was not added as a separate diagnosis"
and
"there remains debate in the field about the concept of complex PTSD"
So they support Anthony's point. It seems more useful to me to work with what is, rather than what might be. I'm more interested in fixing this than classifying it.

I wouldn't say that. Reading Anthony's posts it sounds like he describes CPTSD as just PTSD plus a personality disorder. When in reality the DSM-5 (and by the sounds of it, the DSM-IV) didn't include CPTSD because they just see it as a type of PTSD. That it's purely PTSD (no personality disorder) where the triggering event is of a complex/long term nature.

 

[anthony]

@Butterflywings it isn't just about PTSD + a personality disorder, but the additional symptoms attempted within Complex PTSD proposed diagnosis already exist in better explained diagnoses.

You have to understand the diagnostic system to understand why Complex PTSD did not become...

If the person endured some type of longevity trauma, then trauma is the first key. Now comes PTSD. If the person has an additional problem, being either personality based or dissociative, then that stands alone... thus a comorbid disorder. If they have symptoms, BUT do not markedly distress their life, then those symptoms are discarded OR they may fit the sub-type within PTSD.

The problem with complex PTSD was that the handful of psychiatrists who pushed for it, crossed too far into other diagnoses that better explained the issues as comorbid / singular diagnoses. Making a new diagnosis is not the solution when existing diagnoses already explain the issue. The difference is simply whether they're comorbid or standalone.

CPTSD = PTSD + Personality Disorder OR PTSD + Dissociative Disorder. This is why there is no need for its own diagnosis according to the APA.

 

[junglegirl]

Bpd is a very controversial diagnosis because it is the vague diagnosis. Those professionals unfamiliar with trauma tx lump. Every one they are incompetent to help into. It is notan empirically valid diagnosis which is why real scientists not mental. Health workers at Harvard university among others have fought with the APA to remove from the DSM V. My friend committed suicide after receiving this diagnosis and being mistreated by the ridiculous and mostly unintelligent and incompetent therapists unfamiliar with trauma in the US. I was diagnosed with ptsd because I went to a reputable facility. I am convinced that if my friend got proper tx for her cptsd she would be here now.. what is important is that all are respected when receiving tx this is not the case for those like lisa who are diagnosed with this vaguecatch all diagnosis villified by incompetent professionals who do not recognize trauma when they see it.