Wow - The Apa Really Got The New Ptsd Diagnosis Right

[Shellbell]

If this is a draft and isn't due for publication until 2013, then is that why many psychologists and mental health professionals - particularly outside of America - are still terming it as complex PTSD?

This does seem a much better criteria for correct diagnosis.

 

[anthony]

Complex PTSD was coined by Judith Herman, about 15 plus years ago. There have never actually been diagnostic criterion to it, only recommended criterion from different people. There has never been a CPTSD diagnosis to actually diagnose a person with, EVER. Some physicians simply don't follow mental health guidelines and believe they sit above it, thus they perpetuate nonsense and tell their clients they have something that doesn't exist.

When I've asked people to ask their diagnosing physician about this, they come back with PTSD + Dissociative / Axis II personality disorder, depending on severity, and other comorbid diagnoses. That is because they legally and actually exist, with assessment criterion, a legal title and number. CPTSD, doesn't.

The above is the first time ever complex trauma has been catered within PTSD diagnostic criterion.

The actual criterion above is already in trial and being used to diagnose from, however; it will be only from psychiatrists / limited psychologists who are part of the global APA testing group of 50,000 or so.

Yes, the official publication is out mid next year. The actual criterion will be already used in said offices around the world, providing feedback to the APA on specificity, accuracy, suitability, etc, to assess further refinements for the next publication, after the DSM 5, as all submissions have already closed for the DSM 5... what you see is pretty much what is now.

 

[Shellbell]

Thanks Anthony :)

 

[Ice_Fire]

Thanks for posting this Anthony. It really does seem a lot clearer and cover all the basis...sad how much of this I was 'ticking off' still though. :rolleyes:

 

[Toria]

I never read the original description, so cannot comment on that. But I am very impressed that there is such a comprehensive list of "symptoms" that will be available. Husband was diagnosed by our neighbour's 85 year old father (who was a retired GP) about 6 months before any professional managed to stick a pin in it so giving the professionals a definitive list can only be a good thing in my eyes. Thank you Anthony - this is a great resource.

 

[BlueOrange]

Some of my recent reading indicates that it's the cocktail of terror, guilt and shame that leads to PTSD. ie, if youre terrified but you don't experience guilt and shame, you won't develop PTSD. I guess it's a bit early for that to enter the diagnostic criteria, I don't know how well-proven it is.

The question of whether psychological injury can constitue 'serious harm' is one that will probably be debated more in the lay community than the professional community, I guess. After all, professional psychologists are likely to take psychology seriously. It's tempting to look at the list of traumas and think that it's short, but 'threatened death' or 'threatened serious injury' probably are present in all of the domestic abuse scenarios that traumatise people.

 

[anthony]

Don't confuse PTSD with trauma or symptoms, they are different things.

 

[BlueOrange]

I don't think I understand the point you're making. PTSD is a disorder caused by trauma that results in a set of symptoms (rather frustratingly persistent symptoms). Trauma + guilt + shame -> structural change in the brain -> PTSD symptoms. I accept that the proven view is Trauma + [something we haven't properly identified yet] -> PTSD, but I know what my opinion is.

I have a feeling we're talking past each other. I want to understand what your concern is, the motivation for your advice not to confuse the things.

 

[anthony]

PTSD has been cited as a fear conditioned disorder. That typically revolves around the amydala and other such areas that handle memory processing. MEG has defined PTSD as a psychological disorder that causes a biological problem within the pre-frontal cortex of the brain. What? They don't know.

But wait... there's more!

PTSD is an entity. Once you have it, it doesn't go away. Faced with another traumatic event and PTSD the entity can produce symptoms near on cue, worse than before.

What I'm saying is don't confuse each part of the picture. Trauma doesn't cause PTSD alone. There are biological factors present in combination with trauma. Terror? Absolutely fits the fear conditioning. Guilt and shame are emotions, not fear conditioned emotions at that.

There are lots and lots of studies on this, and what you read is partly true, however; I wouldn't put much stock into anything one or two studies outline. Nobody, and I mean nobody, knows exactly what PTSD is or what causes it, to date. That is empirical data to date. They have lots of guesses and theories, and some are factual at present, though the experts don't truly understand it themselves.

The brain is malleable. Proven empirical some years ago. So we know brain cells die, however; new ones are constantly created. The brain literally can repair itself. The big question many experts are asking, is why isn't the identified issue in the prefrontal cortex regenerating in lifetime PTSD persons?

I believe this is why PTSD has been moved out of anxiety disorders (fear conditioning) and into trauma disorders, so like you cited, other areas can be studied and examined. Saying that... other areas have been studied and examined for decades now, emotions, trauma types, lots of things... yet nothing is conclusive and nothing in relation to such emotion shows anything close to proof for effect towards PTSD.

But wait... there's more!

Basically, it has been stated they may never truly know what PTSD is, or what causes it, because it is impossible to measure the pre-environmental + genetic markers that attribute to getting PTSD when faced with an abnormally traumatic event.

Moral of the story.

The three main areas I just discussed, anxiety (fear conditioned disorder), trauma based disorder and environmental + genetic, all tend to contradict one another to some degree.

What you said first time was a valid opinion. Hell... it was a valid argument. Again though, mixing all those equations into PTSD the entity, suddenly things aren't so cut and dry any more.

Confused? It's why I don't debate what PTSD is... because the experts are too busy still trying to work it out... let alone exactly what causes it beyond an agreed environmental + genetic relationship, being impossible to measure.

 

[surviving_it_all]

I really dislike believing that I have PTSD. Unfortunately, when I read this it reminds me of exactly what I am suffering from. Trauma can really hurt one's life.

 

[BlueOrange]

Thanks very much for that comprehensive, thoughtful and helpful reply!

I realise that I'm interested in having a conversation about what I think is the 'root' of PTSD. When I say 'root', I'm using the term that's used in traditional Chinese medicine: the ongoing cause, the thing that holds the disease in place. (The seed is the 'cause' of the tree, but if you want to remove the tree, there is no point looking for the seed, you remove the root.)

Is that a conversation you would welcome? If so, what is the best part of these forums to start a thread in?

 

[KatB]

So this is stating that it wont be called C-PTSD anymore? It will be under the same category of PTSD but with more definite statements and symptoms, if I'm correct? I have done research of my own also and learned that C-PTSD hasn't been clearly defined. Well, then this comes at a very good time.

I think that this is a very good criteria. Adding the derealization and depersonalization criterias to it definitely makes it understandable because it happens A LOT to me. Also,all the other corrections added is better, but C-PTSD in it of itself, makes sense to me. This draft just makes it more simplified and defined.