Lets Create A Ptsd Diagnosis - Off-topic Discussion

[Sideways]

@EveHarrington - somewhere back in the 100+ posts (communal forgiveness if you haven't studied all of them!), Anthony & I exchanged similar concerns about the emphasis being placed on Criteria A.

If a person fronts up to the doc with all the symptoms of irritable bowel syndrome, they get diagnosed with irritable bowel syndrome. They don't have to jump through any additional hoops about "is it really awful enough". So why do that with ptsd? It's a medical condition, and if you have an accurate, evidence-based list of symptoms, then what does it matter how the person got it?

I'm still uncomfortable with that question. My current position is, okay, this is how ptsd works, and has always worked, so lets assume the same structure to start with...

But it's a starting point. I think the whole game could change when we start to try and specifically define symptom criteria. There are oodles of studies available on ptsd symptoms, yet people are still very different in their 'clinical' presentation. What symptoms we have, and how we experience them, varies significantly, even with a very tightly defined Criteria A.

I'm wishing them the best of luck trying to nail an accurate, evidence-based symptoms list, because I'm really wondering whether we can do that, based on evidence, and without dubious thresholds and moral judgment creeping in.

Add to that (and given what it's taken to achieve a Criteria A so far), I'm cringing at the prospect that Criteria A may need to change if it is possible to nail a symptoms list.

IMHO, you're not alone with your HO!!

 

[Sideways]

@joeylittle - I'm putting my ignorance right out there with this. I know that the mind boggles at what soldiers have to endure during training in order to prepare them for the field, but surely there's an issue if we're giving soldiers ptsd before they've even got out of training? Surely (happily naive!) it would be in the military's interest to send soldiers into the field without them already having flashbacks and night terrors etc before they've even been deployed??

 

[lostforgottensoul]

Is there a more specific aspect of childhood abuse that isn't being addressed? These questions are important.

I dont know if this is answering this question but at the time I was fighting the PTSD diagnosis, my therapist told me about about a girl (obviously no name) that had a bedroom that had an opened wall, no door, and had to stand in a corner nude for punishment and had to do housework and what not nude...he had said that there wasnt sexual assult (rape/molstation) involved but that she devolped PTSD from it.

I think theres more specifics about it that im first likely not remembering as this was a long time ago that he told me and second he didnt go into her whole trauma but he said he had to convince her that though she wasnt raped or molested, she was still sexually abused.

Would that fit in A?

 

[lostforgottensoul]

it would be in the military's interest to send soldiers into the field without them already having flashbacks and night terrors etc before they've even been deployed??

Maybe anthony is better to answer this as he is ex military & im just an ex military's daughter but ive never heard of the US deloying soliders (post drafting) that have mental or medical issues.

BUT i know that when Obama pulled all the soliders out, there wasnt much if any help, it was throw you back into civilan life and a lot ended up addicts to self medicate.

Ive been to the VA and heard the stories of the younger soilders of how long it took and what we did; or more so what we didnt do.

I also have an annoyumous app on my phone called Whisper, A TON of very hurting soilders in there!

Ive just never heard of it in boot camp, even in things like Seal training which is insane. Most dont make it and may end up traumatized but i dont believe they're then deployed.

But again, im not ex military, so maybe not the best to answer this.

 

[Sideways]

I dont know if this is answering this question but at the time I was fighting the PTSD diagnos...

I know plenty (omg, plenty!) of the feminist persuasion who would have not problem arguing that was sexual violence.

The point about child abuse, including neglect and emotional abuse, is you tolerate what your parents do (or fail to do), and obey them no matter what, because you are actually under threat of death. As a child, your survival literally depends on your parents. You know. They know it. Criteria A? Tick.

 

[anthony]

What member were you referring to in the above posting?

Depends, there where a few -- but I then moved all off-topic content to this one for off-topic discussion, as thoughts come to people for back reference and so forth... so this is no issue now, providing people don't start wandering this thread with complete nonsense that has nothing to do with creating our own version of diagnosis from a sufferers view.

 

[lostforgottensoul]

because you are actually under threat of death.

For me, i guess thats what i struggle with but maube i just dont remember feeling like they were going to kill me?

I do remembering, at times, wishing they would and trying to do it myself.

I guess the 'threat of death' is what im struggling with myself...for myself.

Im sorry, thats like super off topic, i sometimes speak things rolling in my head without thinking...sorry...

 

[anthony]

To me it seems to be an actual disorder and needed for the 'smaller' type of traumas or stressors

You may think that, but ASD is useless and rarely used. PTSD should be rarely used, instead other diagnoses made for such aspects are rarely used... specialists go straight for PTSD.

Refining of Criteria A, currently On Topic does not address:

Childhood abuse. Or abuse of others less than death……

How so. Define what type of childhood abuse? This is the PTSD diagnosis we're working on, which should cover all types of trauma relevant to PTSD. The idea is to also include the appropriate additional symptoms / symptom clusters to that either PTSD OR CPTSD can be diagnosed accordingly from the one diagnosis.

But it's a starting point. I think the whole game could change when we start to try and specifically define symptom criteria.

This is what I'm working with right now. We start, we draw a line after concluding each aspect, we get something down that is fairly concrete, then we go back and tear any minor aspects apart to improve the outcome / validity of the diagnostic structure and its intent.

Technically, whilst I would like to fit complex trauma into the scope, right now, there is no diagnosis for CPTSD, so if we can't do it, then that is also ok as it doesn't exist anyway. Shit... if we improve what we have to better the scope and validity -- maybe the professionals may take head.

People must remember, we have very diverse feedback occurring in to this, from sufferers of all ages, medical background, university educated persons, to those of all ages on disability and all sorts of socioeconomic groups. Diversity is the spice of life IMHO... more heads the better.

but surely there's an issue if we're giving soldiers ptsd before they've even got out of training?

It does happen... incidents occur in training, however, most militaries only provide disability finance to those recognised as combat deployments. Australia has a strict list of specific deployments they cover, everything else can only obtain what is called a white card, which provides specific health coverage to the effect itself, nothing more, with no real disability cover. I think a white card is about $40 a week or something, because if you can't work as a result, you're discharged and placed into the social security disability system. Without that combat approved deployment... PTSD is meaningless for training injuries in most militaries. Australia, UK, US, this applies to from the top of my head.

military's interest to send soldiers into the field without them already having flashbacks and night terrors etc before they've even been deployed??

You would be quite surprised that those with PTSD, when redeployed, endure no symptoms. They find war, chaos and operational zones more relaxing, because with PTSD they understand them and can deal with whats around them. Its civilian society that screws soldiers PTSD mostly. It is difficult to integrate again. It is very common many vets go live in countries where hostility occurs, because it calms them and they know how to handle it.

That may sound scary to a civilian, unfathomable even, but not to a combat veteran. It makes perfect sense to them, because they know how to handle it and their skill set is effective again. They feel useful, like they have purpose, even if all they're doing is living a life in a hostile country. The brain accepts what it knows easier than what it struggles to understand. Military are trained with useful symptoms already... but yes, if a soldier did display flashbacks or nightmares where noise was made, they would be removed from any operational zone. It would be a threat to everyone else, let alone bring down moral.

 

[lostforgottensoul]

You would be quite surprised that those with PTSD, when redeployed, endure no symptoms.

Oh I agree with redeployment (Chris Kyle "American Sniper" is the perfect example) I was thinking like first boot camp & first Seal training etc.

Def redeployment many have PTSD and scooted under the rug. Sad, very very sad but true.

 

[lostforgottensoul]

specialists go straight for PTSD.

That crazy, to me anyway. It took me 5 ish yrs in therapy to be diagnosed but to go straight there is crazy when it could be so many other things.

Im very much loving what we're doing here cuz its helping me to understand PTSD so much more. CPTSD is another story. Simplifying it makes it a lot easier to understand and I think many others will find it very helpful as well!

 

[Deleted member 28740]

Define what type of childhood abuse?

Remembering a sociology course in college. One study taught was done at an orphanage. (Difficult as being new to my own diagnosis, I am still learning about PTSD.) The study had two test groups. One group the infants received only basic survival needs of feeding and cleaning. The Second group were given physical nurturing (being held while feeding, played with, etc.) in addition to the basic needs. Result was group One over time exhibited many psychological issues including brain impairment, specifically IQ. The orphans were tested for at least a decade at the time of the study being released (70's). The resulting brain damage documented in all of group One, and was considered to be irreversible and a direct result of the lack of nurturing.

Any correlation to PTSD? IDK. Can't find info on the study, or if any followup was done. Study was in Eastern Europe during the 50's or 60's.

No threat of death but the infants did undergo a brain altering experience. Perception of survival altering brain chemistry?

 

[joeylittle]

The orphans were tested for at least a decade at the time of the study being released. The resulting brain damage documented in all of group One, and was considered to be irreversible and a direct result of the lack of nurturing.

There is a lot of writing about this phenomenon. Significantly decreased hippocampal volume is noted when nurturing is withheld, and the same effect has been measured in some PTSD studies. But I think that the absence of nurturing creates a whole different battery of psych and developmental issues - they symptoms those kids get, if they survive, are broader than PTSD.
http://www.sciencemag.org/news/2015/01/childhood-neglect-erodes-brain
Dead Link Removed