News Changing Ptsd To Ptsi?

[bright_morning]

Chronologically Delayed Disaster Affliction Syndrome. You heard it here first.

On a more serious note I agree with Anthony that the current terminology is more than adequate to describe both the consequence nature of the condition as well as the more mysterious inherited aspects. Renaming it would just open the doors for more pharmaceutical drugs that don't cure it and the hordes of sales reps they rain on humanity.

 

[Hashi]

Since the whole point is to be careful with words, am I really the only one who thinks it wouldn't make any sense to call it post-traumatic stress injury? One meaning of that would be that you were injured by the stress that followed a trauma... but isn't the "stress" itself the injury? Otherwise it would mean you had a stress injury after a trauma, a stress injury being... um.... what? Given that many people associate stress with things like planning a wedding or meeting a work deadline, and a stress injury with something physical that happens to sportspeople, how would this be clearer, more honourable-sounding or more correct?

The article says that when an injury is earned (sic) in battle, awards are given. But that's not called a post-battle injury.

 

[PTSD sufferer]

A trauma is required to meet the diagnostic criterion for PTSD, however; PTSD symptoms are part of hereditary mental illnesses, such as anxiety, mood disorders, depression and such. Trying to narrow these down to only being external is near impossible.

It would be impossible for the psychiatric community to go that route to "injury" until such time that they had actually empirically ruled out genetics in obtaining PTSD. Right now, that is not the case.

If genetics, cognitive and behavioural factors where not present in PTSD, then every single person when faced with a traumatic event would have the same signs and symptoms, which is not the case.

I get what you are saying Anthony, but I think I will respectfully disagree on the genetic front and say until they prove genetics then it is unrelated. Genetics have been proved in the majority of mental illnesses, but PTSD has not. Most mental illnesses have an element of anxiety and depression, only a handful do not. The conditioning of social and core beliefs throughout life may make us more susceptible to PTSD, which is not genetically inherited but rather environmentally given to us.

To claim genetics is possible then how can we explain the capacity of survivors to deny the behaviours of family abusers and respond in a different way. I assure you my parents have no anxiety or mood disorder, rather they are more sinisterly f*cked up because of how they treated me. Thus, PTSD without co-morbidity is termed Post Trauma and although classifed under anxiety disorder umbrella is different to other anxiety disorders? If there is a co-morbidity and thus CPSTD then that implies a genetic link (non environmental) of mental illness disorders.

How do we account for those VETs who have no family history of anxiety or depression diagnoses and then these poor people see traumatic things and end up suffering? Perhaps the lifetime of social and core belief conditioning makes them more unacceptable as does the after care treatment they receive? Nore does it account for those who do not present with PTSD after one trauma, but then there is further traumas that break the camels back so to speak....

Just conjecture and opinion of course, which is a different perspective or spin to your of course.

Since the whole point is to be careful with words, am I really the only one who thinks it wouldn't make any sense to call it post-traumatic stress injury?

I can see your point Hashi and the use of the word 'post' can be debatable for those who have know nothing but trauma - that is, they were born into a war zone, without training or tools or knowing what it was, rather than 'walking' into trauma or simply experiencing it. Thus, my interest in the clinicians who are raising this in the DSM.

But I do think that Trauma and Stress are the key words that make sense. The cause is Trauma, just like TBI (which has the exact same symptomatology of PTSD is Traumatic Injury, and stress is the negative feeing that perpetuates the illness. I hope that make some sense. I'm a little off my game at the moment, so I may not be articulating as best I could and I recognise that.

 

[Elph]

Hi! I'm new. This is a topic that really interests me. I am in the camp that agrees that changing the terminology to "Injury" instead of "Disorder" would actually carry some weight for us getting better care.

I agree with PTSDsufferer's points. I would also add that the distinction points specifically to naming injurious behaviour on the part of the abuser. It holds those who caused the trauma responsible for their actions, rather than creating a 'mental illness label' that can hand them more ammunition to make their victims 'disordered' and easily discreditable.

I firmly believe that I wasn't born with tendencies toward the symptoms that I've developed and that what I've experienced is a result of brainwashing and maltreatment. That makes it an injury, and it makes it something that can be healed with proper treatment. Calling something a 'disorder' makes it sound like its inborn and permanent part of someone's character, which IMO PTSD is not.

The points that ppl have made about costs to make the change are well taken. Personally I think that it would be worth the cost to have footing in a more accurate description, and then advocate from that position. Having worked in healthcare myself, I'm familiar with how health professionals specifically seek out certain labels for political reasons to gain an advantage over patients they want off their roster, and witnessed the impact on how those labels directly impact how those patients can then access care for other health problems that have nothing to do with the PTSD. On the other hand, ppl with TBI weren't subject to the kind of health care cut offs that ppl with 'disorders' are.

 

[anthony]

I get what you are saying Anthony, but I think I will respectfully disagree on the genetic front and say until they prove genetics then it is unrelated. Genetics have been proved in the majority of mental illnesses, but PTSD has not.

Actually, it has. Please provide the evidence that it has not.

Anxiety and depression are the two largest aspects of PTSD, both being proven to have genetic foundations within each group.

You cannot take a larger name (PTSD) then dismiss what it comprises, stating genetics have not been proven specifically for the larger name (PTSD), even though you admit they have been proven elsewhere. Anxiety and depression both having such empirical genetic data available via a simple search. It stacks up that genetics have a role.

If you want to discuss PTSD as the greater role, then actually there is no empirical data to what PTSD exactly is, however; that does not change the underlying empirical data for specific elements of PTSD itself.

That is like dismissing all empirical data about hyper-vigilance being a learned behaviour, even though it is a component within itself in a PTSD diagnosis.

Sorry... you need to do better than just respectfully disagree, as the evidence does not agree with you.

Again, if you look at only PTSD the diagnosis, then yes, you are correct and I am not disagreeing, that that as a category has to date no proven genetic markers on who gets it and who doesn't, nor is it passed within twin pairs or families.

Anxiety and depression though... unfortunately you need to do a bit more research and learn about the genetics at play in both... especially considering both comprise a huge chunk of PTSD.

In the research I have in front of me right now, being from some of the top experts in the field of traumatology, the summation is simply that PTSD can be screened for specific risk factors that are both genetic and behavioural traits. They cannot state whether a person will, or will not, get PTSD when exposed to trauma, however; the evidence is quite complete in regards to narrowing people through both genetic and behavioural assessments to those in an increased risk group of developing PTSD when exposed to a significant trauma.

This is study data from people like Bremner, Breslau, Elhers, Friedman, Keane, Kessler, Resick and more... over a hundred study data set considered of the highest accuracy.

 

[anthony]

I actually just found a really good summation from True & Lyons on genetics in correlation to PTSD:

Research has indicated that there is a genetic influence on most human characteristics. It is misguided to ask whether a trait is determined either by genetic factors or by environmental factors. For virtually any trait of interest to psychologists and psychiatrists, both genetic and environmental influences are likely to be important. A better question is, What are the relative contributions of genetic and environmental factors, and how do each of these sets of factors operate?

It is particularly interesting to apple this question to PTSD because, by definition, environmental determinants are a necessary factor in its etiology. Indeed, PTSD may be seen as the quintessential environmental determined psychopathology, since it is the only form of mental illness that requires the presence of an environmental risk factor (i.e., a traumatic event) as a criterion for the disorder. However, even when the environmental risk factors that are necessary for development of pathology have been identified, the possibility remains that genetic factors also contribute to liability for developing a disorder. For example, not all cigarette smokers develop lung cancer, even when the smokers undersr consideration use the same type and amount of tobacco. Similarly, not all individuals exposed to the same degree of trauma will develop symptoms of PTSD or the full-blown disorder.

Source: Risk Factors for Post-Traumatic Stress Disorder, Edited by Yehuda.

Cited to 17 studies by leading global traumatologists stating the same / similar determinants.

Can't argue with that logic!

 

[PTSD sufferer]

Again, if you look at only PTSD the diagnosis, then yes, you are correct and I am not disagreeing, that that as a category has to date no proven genetic markers on who gets it and who doesn't, nor is it passed within twin pairs or families.

This is precisely what I am saying, there is no evidence to support that it is a genetic disorder and its proven to be an injury triggered illness - thus my observation that the PTSI group have a point.

Anxiety and depression though... unfortunately you need to do a bit more research and learn about the genetics at play in both... especially considering both comprise a huge chunk of PTSD.

A pure PTSD diagnosis would reflect that anxiety & depression are caused by the trauma and therefore a symptom of PTSD. That is, you can't develop PTSD simply by having anxiety and mood disorder without the Trauma, even if you were genetically predisposed to other mental illnesses. Though, I'm not an expert here, I've done some research and found nothing explicitly showing a statical link between genetics and PTSD.

I believe it to be combination of core beliefs, social psychology and the trauma causing the symptoms. That is, the primary factors are external factors hence the 'injury'.

I actually just found a really good summation from True & Lyons on genetics in correlation to PTSD:

A better question is, What are the relative contributions of genetic and environmental factors, and how do each of these sets of factors operate?

It is particularly interesting to apple this question to PTSD because, by definition, environmental determinants are a necessary factor in its etiology. Indeed, PTSD may be seen as the quintessential environmental determined psychopathology, since it is the only form of mental illness that requires the presence of an environmental risk factor (i.e., a traumatic event) as a criterion for the disorder. However, even when the environmental risk factors that are necessary for development of pathology have been identified, the possibility remains that genetic factors also contribute to liability for developing a disorder.

Good question from the author...

Precisely what I am saying and thus I can see the point of the group looking at PTSI.

The environmental factor is the key in PTSD. We can't rule out a predisposition to other genetic mental illnesses because of the existence of co-morbidities. We can question, however, whether without Trauma, a person fits the criteria of PTSD...whether the reaction to the trauma is less or more can be both dependant on prior mental illnesses as well as the cognition of the individual (the individuals perception of the severity of the trauma) and the speed and appropriateness of treatment. The author of the article presents a theory that genetics doesn't help those who suffer environmental trauma, and can contribute to the onset of symptomatology IF Trauma exists.

If we were able to remove all trauma and those that perpetuate it, then there would be no PTSD, rather anxiety and depression disorders. The medication's that exist for anxiety and depression illnesses are already there, so is that a 'cure' for PTSD ? nope because the cause is still Trauma and cognition which is incurable, only manageable through addressing the anxiety and depression that surround it through medication and awareness (primarily).

I think that it is also worth noting, that I am of the realistic view, that I have no ability to change others, I can only change me. This notion is what makes me fight every day to manage my illness through working on enhancing my own knowledge and awareness of my circumstance, cognition and behaviours. You may place me in the camp of 'cognitive behaviourists' on this one as opposed to the 'abnormal psychology' of the psychoanalytical school of thought if you like - I won't mind that at all in relation to PTSD. In saying this, I recognise that it is a side step from the original thread topic, but thought it worth noting based on the subsequent posts.

I can see the point of the PTSI group, and although it is not moving towards a cure, nor will it remove stigma (any illness of the mind and body will have some level of stigma because of the individual choice factor of stigma). What it does have the potential to do is to clarify the primary cause (and not secondary) - this can highly influence how people frame the illness and behaviour/treatment of sufferers. I welcome all the help we can get in this department...

A logical argument goes two ways, and logically I stand firmly on the fence but objectively appreciating the argument of the PTSI group. The additional debate is quite a perk of this thread though :)

I would encourage all involved/ interested to consider both sides to this, as the cost of change may just be worth it...

 

[Lucycat]

Sorry to lower the tone, but I think if it were called

Chronic Relapsing Anxiety Pathosis

I would feel so much better and everybody would understand my problems :rolleyes:

 

[Elph]

What I've read on the PTSD/genetics issue (which I admit is limited to a few articles about holocaust survivors) is that genetic pre-dispositions in the children of PTSD sufferers are the result of trauma that was inflicted upon the parents, so the the injury model could still be applied. The children of the individual who was traumatized were also injured by the original environmental impact.

I would like to understand more about how I may pass on a tendency toward PTSD to my future children so that I could potentially NOT subject them to the effects of my injuries, if at all possible. I'd also like to know more about how my mother may have passed on a vulnerability to me, and what I can do to heal that vulnerability. Even if I was injured in-utero due to my mother's PTSD, I'm going to consider it an injury that I can heal with rehabilitation until someone can prove to me that it's un-healable. Whether a traumatic injury is more similar to a broken leg vs. a permanent spinal cord injury remains to be seen. The discoveries that have been made recently with regard to the brain's ability to generate new connections later in life to me is very encouraging and suggests the potential for healing, with the right rehabilitation technique.

My current therapist is using EMDR with me and approaches trauma according to an injury model. After more than 2 decades of working with ppl who use the 'disorder' approach it has been a far more effective treatment. My naturopath has also done a lot of work with me to heal my adrenal glands and manage cortisol levels, which also had done a lot to rehabilitate my health and change how my body reacts to stimuli. However given the length of time my adrenals were overstressed, I'm guessing that if anything this is where my more permanent injury lies. I can no longer metabolize certain foods, and caffeine is out of the question if I want to sleep at night. To me, this is a physical injury as a result of trauma (mine and my mother's). Not a 'mental disorder'. Cortisol levels are completely measurable and treatable. It may affect my mental state (as any physical injury can) but the origins were physical damage to a part of my body. I like it because it's specific. But that's just me.

 

[anthony]

there is no evidence to support that it is a genetic disorder and its proven to be an injury triggered illness

You're also trying to mince words here, by adding "genetic" to the word "disorder" as though those two are mutually exclusive. That is not the case and an illogical attempt to speculate your view, still no evidence shown as requested to substantiate, just your opinion.

Disorder has nothing to do with genetics, just like injury has nothing to do with genetics.

Also just the same that an external factor (environmental) is only required to trigger the internal issue (disturbance).

A logical argument goes two ways, and logically I stand firmly on the fence but objectively appreciating the argument of the PTSI group. The additional debate is quite a perk of this thread though :)

That is the exact issue... in that they cannot say "lets go this way" when the current also cannot be proven either way, because you cannot prove or disprove the scale of genetics in the disorder. You can't just accept something can't be proven, when there are also matter that can, and vice versa. This is the exact issue.

Their argument is actually on the fence line. It doesn't clearly jump across the fence to prove an outright point. If they cannot prove that point empirically, then changing names is nothing more than an exercise in political correctness that will cost everyone involved immensely in the pocket on a global scale. Then the next person will give it a crack, trying to be more politically correct and do more financial damage to the industry.

It comes back to the old adage, "If it ain't broke, don't try and fix it." PTSD ain't broke, because PTSI cannot provide the evidence to say it is broke, thus it must change due to being broken.

If PTSD was a broken and flawed convention, absolutely, change away. I think if that were the case, it would have happened long ago though.

This is marketing nonsense with no factual basis. It is speculative and argumentative at every foundational level they have aimed. This group have provided no evidence to substantiate their claims that PTSD actually is broken, just more hypothethis. In other words, more academic BS from someone trying to make a name for themselves.

Doesn't mental health already have enough issues in this regard? I believe it has more than its fair share in stupidity.

 

[PTSD sufferer]

Anthony, perhaps you need to take a step back and re-read the original post and the posts on this thread. I feel that sometimes your fight response is at play and this appears to me as 'flamming'. There have been a couple of topics where you gave 'flammed' me for simply holding a different view from that which is your own.....?

I am not going to end up being sucked in by this type of behaviour again, simply because of my ability to see others point of view and talk about the view they take. If you re-read my posts you will note that I acknowledge co-morbidity quite a bit. There is no mincing of words here, just an appreciation for the reasoning behind the PTSI point of view.

I am not the type of person to take a defeatist view and say that mentally we are screwed and we should concede defeat to the illness and everyone around us should just deal with us, because it is genetic and therefore can't help ourselves. I certainly will never use the illness to justify giving up on healing and addressing my own behavioural responses, particularly if they affect others. Perhaps, my point of view on injury is driven by the traumas I have experienced and the achievements i have made in treatment. But this view has been very effective for me and others who feel if they do the work, there will be less suffering and passing on of that suffering than what we have known to date.

I also take the view that scientific enquiry requires the asking of questions, curiosity and sometimes a shaking up of the status quo. If we were to accept that everything is perfect as it is we would be back at the dark ages and PTSD would not exist at all, we would all be thrown into the basement of a nut camp and subjected to electric shocks to take the devil from out of us. Thus contunious improvement gad been and always will be of great value. Is PTSD diagnostically perfect? In my opinion it isn't and I have stated the two points that I feel could be improved - limiting it to one event and only post which doesn't account for life long and during trauma PTSD and the implication of claiming genetic or abnormal psychology in pure PTSD. I will dip my feet into the camp on these areas regardless.

Objectively looking at the points being made and the reasons behind the wording can spark debate as it has here, and it can inspire others to explore further. That is not marketing BS in my mind, it is offering an alternative view to consider and all we have to do is consider the view and it's benefits, even if we don't always agree. It is possible to agree to disagree. That is fine too. Then what might come next is some geneticists doing what they have with many other mental illnesses and looking for a proof of genetics and other scientific enquiry that will add to the body of knowledge and new ideas in how it can be treated. All positives.

But genetic causes is not the 'current' in terms of PTSD and it would be just as stupid to blindly follow the genetic argument without the same proof you require. 'Simon says, jump off a bridge'....would it be stupidity if you said oh ok and blindly leapt? Maybe your decision to leap or not is as influenced by your social psychology and experiences as mine is...mine says run now because if you dont Simon will push you so you'll die anyway, ex military may say follow Simon without question because a bomb is on your arse...our approach may be different but I can acknowledge the benefits of both, if we ok are I'm in the end. This is entirely driven by cognition of course ( thinking and knowledge) and not driven by genetic insanity. Genetically, if related to Simon you would just do as he does and jump.

With 8,000 pages of diagnosis in the DSM, what other way is there than through marketing and groups lobbying the DSM symposium to draw attention to issues of concern of but one disorder? PTSD has been ignored in the past and has been out dated for sometime. DSM is after all a beuracratic institution with a rather large public constituency.

So here is the truth again. Because the illness is not genetic, I can control my reaction to your 'flamming' towards me and manage how I react to you, my reaction towards those around me and the impact it has on my health. Last time you 'flammed' me, I had a negative reaction and a flare up in my illness. This time, I am going to say this flamming is your issue and not mine, be assertive and control my reaction, thus my illness. It seems to be working for me right now despite me already not being at the top of my game :) That to me is enough proof that, by treating as injury and not admitting defeat to the genetics current, i will swim up steam and against the current (samon fishing reference acknowledged) and by doing the work, not only does abuse stop with me, PTSD does too.

 

[Srain]

PTSD may not be broken but I'm of the opinion that it has a long way to go before it is officially "fixed". Psychiatry and Psychology is an evolution and obviously we know more about space than the human brain.

Even as more and more light finally comes to issue of PTSD, the blanketed diagnosis is extremely complex from person to person, despite generalized symptoms. At least there is discussion which can never be a bad thing in my opinion.

Interesting topic, thank you for posting Bloom.
Rain