Cptsd Vs Ptsd

[theshadowoftheliving]

Regarding the age issue - this is why van der Kolk suggested the idea of Developmental Trauma Disorder. Different from the idea of just Complex PTSD in the sense that it disrupts the child from developing normally, which prevents normal developmental milestones from being reached. This has nothing to do with the severity of the trauma in some ways (meaning an adult could go through much, much worse but could potentially fair better since their core self developed normally) and more to do with the lack of internal resources the child has to deal with what is happening.

Here is more info: http://www.traumacenter.org/products/pdf_files/Preprint_Dev_Trauma_Disorder.pdf

I wonder if this is what we are actually speaking of?

 

[joeylittle]

Hi JoeyLittle. I don't think I articulated what I meant re DSM and insurance very well. Will come back if I can find the words!

Oh, it's OK - I think I know what you meant, in that the DSM is two things: an organization of diagnoses, including criteria, names for the things, exclusions, etc. And, it's a set of numbers that are attached to each thing.

The numbers are insurance codes. Any problem a patient has must be describable by a code that is applicable. Codes can be mixed and matched, to a certain degree - codes that exclude each other can't appear on the same diagnosis.

If there isn't a code for it, it's not 'real', as far as insurance goes.

But, there's no connection between insurance companies wanting to control or maneuver how the codes work. Nor is there incentive or even reason for the DSM to change codes or leave codes alone, according to what the insurance company may want. The insurance company doesn't really care. And everyone - insurance, doctors, patients - is effected when the codes change, it's just a hassle across the board.

The DSM (if anything) is trying to provide a structure to the organization and classification of mental disorders, so that it's in the long run easier - not harder - to identify the correct diagnosis, which ties to the correct code, which ties to the approved treatment, which the insurance company pays for because the medical community says so.

On the other hand, the research medical community is under pressure by insurance companies to leave novel or new treatments outside of the current recommendation. They go to war with insurance frequently, in order to help patients get access to new types of care - because the new things cause the insurance company to spend more money. And the drug companies pressure the practicing physicians to use new drugs that are under patent and thus easy for insurance companies to exclude, and they do (because they can force the patient to try the cheaper option first), and if they end up needing to approve the drug, they pay more to the drug company (instead of the patient). That's a whole situation, very frustrating for the person who needs the care.

None of that has to do with DSM coding, really. The codes are being applied all over the place, but they just exist, as information.