Wow - The Apa Really Got The New Ptsd Diagnosis Right

[Tinyflame]

Yay! Somebody has listened! :)

Very clear and inclusive.

 

[anthony]

I just hope you are right and practicioners will be well informed about these changes. It is really good news.

They won't really have a choice, as once the new one comes out, the old is useless for all insurance and legal aspects, thus nobody can be diagnosed with the older diagnosis from a certain point. No doubt each country will have a buffer zone.

What you must also factor, is that this book is actually in draft circulation now around the world, being used by psychiatrists to diagnose based on these exact criterion, then they provide their feedback to the APA... 50,000 + medical practitioners are having a say in this book globally.

In essence, you will begin to see the new diagnosis popup from time to time, before the book is even released... part of the trial phase of drafting.

 

[Deleted member 1860]

TY for posting! Although I doubt this is going to put a rest to the CPTSD issue. There will STILL be those pushing for it, and there will STILL be those practitioners who incorrectly give out this Dx.

Sidebar... Yes, I have had quite a few practitioners say I have CPTSD, although it doesn't really seem to quite fit. Well, whatever it's supposed to be, as there's no real consensus! I wouldn't even qualify for the prominent dissociative symptoms sub-type as I've only had three bad dissociative episodes that weren't drug fueled (my worst episode was at the hands of medication)... And bad for me might mean mild for others. These episodes were few and far between. But I digress...

 

[anthony]

I have zero doubt that there will be a minority who reject the complex component of this reformed version, and still want a unique label. End of the day... it is dead, and now this is out, it will be squashed harder here to remove the perpetuated myth. I would rather people challenge their practitioners with fact than listen and absorb their practitioners BS. If they BS to a client about a diagnosis that doesn't exist, then to me... what else are they sugar coating and BSing to their clients about.

I would rather an honest, factual practitioner... not a mythical one that is trying to be unique and push for nonsense.

It will be interesting, I can see that. Whilst a minority of practitioners use that label, that is still a significant number who are going to be upset over not getting their label they love giving clients.

I suspect that will also go for some clients who want to cling to CPTSD, instead of using the correct diagnosis of PTSD - With Dissociative Symptoms. I can see an easy solution to that one already, being PTSD-DS. :D :ninja:

 

[rainy_daze]

I like the changes as well. I saw myself in the DSM-IV diagnosis criteria, but I really see everything I struggle with included here.

Ditto Kers.

Thank you for posting this Anthony. I find it very helpful to know I am not crazy or sort of delusional in some way (for example, D. 1 to 7). I can use this in therapy to challenge myself - I will print this and take it with me to my next session. The APA have obviously put a great deal of research into this, which can only mean less misdiagnosis and hopefully greater acces to appropriate treatment for those suffering.

 

[anthony]

Here is one of the leading documents that helped shape this new shift (attached). You have some familiar experts in trauma stress studies to thank overall for these changes.

Here is the rationale for changes:

1. Revision of Criterion A1 – to remove ambiguities and tighten the definition of “traumatic event”
2. Deletion of Criterion A2 – because it has no utilitity
3. Slight revision to Criterion B
   
   B1 clarified to define “intrusive recollection” and eliminate depressive rumination
   B2 slight changes make the criterion more applicable across cultures
   B3 clarified to indicate that flashbacks are dissociative symptoms that occur on a continuum
   
   
   
4. Dividing DSM-IV Criterion C into two separate clusters (e.g., DSM-5 Criteria C and D) Thereby resulting in four, rather than three distinct diagnostic clusters.
5. Revising and adding diagnostic symptoms for Criterion D (Negative Cognitions and Mood)
   
   D2 (DSM-IV “foreshortened future”) clarified & expanded to encompass exaggerated negative beliefs and expectations about the future
   D3 (new symptom) –persistent distorted blame of self or others
   D4 (new symptom) – persistent negative emotional state
   
   
   
6. Revising and adding diagnostic symptoms for Criterion E (“Alterations in Arousal and Reactivity”)
   
   E1 – clarifying that this pertains to behavior (“irritable or aggressive”)
   E2 (new symptom) = reckless or self-destructive behavior
   
   
   
7. Eliminating the Acute vs. Chronic specifier
8. Addition of a Preschool Subtype
9. Addition of a Dissociative Subtype.

 

[rainy_daze]

I didn't realise "reckless or self-destructive behaviour" was a new one. I could write a book on that as well - I had always thought that one was a given, because I certainly wasn't like that before the big trauma. This will really help those who do not suffer from PTSD to understand it better, as I have difficulty explaining it a lot of the time.

 

[anthony]

I think it closes / redefines a lot of prior holes and issues with the diagnosis, especially when there are therapists abusing diagnostic medicine in general by giving clients a diagnosis of PTSD due to their relationship breakdown and such nonsense.

 

[simpletruth]

I'm confused. I've had all the symptoms of Ptsd but I don't think my trauma meets these criteria. I dealt with repeated emotional and verbal attacks from my husband/ex which totally frightened me -especially with regard to my children's emotional safety. There were also physical attacks but the emotional ones are the most damaging. Physical heals easier. I still feel intimidated - more generally now.

 

[anthony]

I'm confused. I've had all the symptoms of Ptsd but I don't think my trauma meets these criteria.

Then you may want to seek a psychiatric assessment from another psychiatrist.

 

[simpletruth]

Hmmm... no thanks. I'm not questioningmy diagnosis. Its fits. Just that the new criterian doesnt
My traumas were domestic violence. Ive healed fine from the physical. But the psychological abuse was so much worse and that's what myflashbacks are about. The lies he told and having no voice or power. Being scared of what he d do next. That's what still haunts me. Yet the criteria is only concerned with physical trauma. I had that but I wasn't scared of dying and there was no gun to my head. It is very traumatic to be controlled by someone who takes away your money your children and your sanity. Would you rather be shunned by those youlove or punched in the gut? Which will heal? Which memoty will haunt?

 

[anthony]

You sure you're reading the criterion correctly? The a. criterion is very specific to both physical and mental: Exposure to actual or threatened a) death, b) serious injury, or c) sexual violation, in one or more of the following ways.

The rest are symptoms... if you don't meet the requirements for the symptoms, then you don't have PTSD / won't have PTSD by next year based on the diagnostic criterion.

Stating domestic violence means you squarely meet a. already. Symptoms are symptoms, they do not speculate between the type of trauma.