Do you think C-PTSD will make it into the DSM in your lifetime?

[tofubreadcoriander]

As the title says, Do you think C-PTSD will make it into the DSM in your lifetime?

I saw a trauma therapist for a few months whom diagnosed me with C-PTSD, extreme anxiety and dissociation. However, when I asked an official letter for the diagnosis from him, he wrote PTSD and not C-PTSD even though C-PTSD is recognized in ICD-11. When I challenged him about this, he said it shouldn't be a problem when clearly C-PTSD is different from single instance PTSD.

Personally, I don't think it'll make it into the DSM in my lifetime despite me being in my 30s even if there are modalities specifically designed to address it such as somatic experiencing which can address developmental trauma or NARM therapy.

What's your take on it?

 

[No More]

I was trying to clear up the differences between them with the AI thing. I got myself very confused. Think I still am pretty confused!!

As I understand it, you can be diagnosed with ptsd with multiple instances of trauma, or complex trauma.
Cptsd has additional symptoms ontop (relational/self identity etc from what I could work out).

I think the problem now is that it’s kind of gone from being a therapists term to a not-quite diagnoses to a diagnosis-in-certain-areas. I think it should go in the dsm if it’s in the icd with enough significant differences to ptsd to make it a different diagnosis, they’ll have to, it’s just getting confusing with it being half in/half out

 

[somerandomguy]

It sort of doesn't even matter because most insurance companies in the USA use ICD codes to bill, and as you noted CPTSD is recognized in the ICD. So we can and do treat CPTSD even though it's not officially recognized.

 

[tofubreadcoriander]

It sort of doesn't even matter because most insurance companies in the USA use ICD codes to bill, and as you noted CPTSD is recognized in the ICD. So we can and do treat CPTSD even though it's not officially recognized.

In Europe, we lack the infrastructure in treating it (systematically). I think recognizing it in the DSM will allow for this infrastructure to exist. Take my college for example. Let's pretend for a moment they had a psychologist (they don't, but let's pretend they had), if I would have come with a diagnosis of C-PTSD they would know that my triggers would be relational, instead they got PTSD which according to the DSM isn't relational. See my point?

 

[Friday]

As the title says, Do you think C-PTSD will make it into the DSM in your lifetime?

If treatment changes (the reason it was disincluded in the DSM5 is that treatment for PTSD & CPTSD is identical, just with a longer timeframe)… sure.

Or???

If neuroscience/psych evolves enough to include more differences &/or to become a hard science, instead of a soft science.

The DSM & ICD ? Are both living documents: both in general, as well as in specific; including a baby-soft-science (psych) in addition to a hard-science (medicine).

Complex trauma? Is already included in the DSM. Across a dozen different disorders. (CPTSD is NOT as simple as having experienced complex trauma). As well as with PTSD. Complex trauma? Has complex consequences. So does singular, repeating (like CSA, domestic violence. etc,) & other traumas.

- Trauma can cause, or exacerbate, MANY different disorders.
- Complex Trauma can cause, or exacerbate, MANY different disorders.
- BOTH trauma & complex trauma that result in PTSD? (Instead of OCD, or ED, or PD, etc.) Have the exact same treatment.

That trauma can cause both PTSD/Complex PTSD (amongst MANY other disorders)? Are just 2 parts of a very complicated puzzle.

So, to me, it makes sense both why the ICD includes it (different causes) AND why the DSM disincludes it (same treatment),

 

[tofubreadcoriander]

So, to me, it makes sense both why the ICD includes it (different causes) AND why the DSM disincludes it (same treatment),

If the DSM fails to include C-PTSD won't this mean that repeated trauma that results in C-PTSD and that is relational won't be recognized?

 

[Sideways]

If the DSM fails to include C-PTSD won't this mean that repeated trauma that results in C-PTSD and that is relational won't be recognized?

No. Cptsd is a variant of PTSD. It’s PTSD + extra, not an entirely different disorder.

There’s plenty of legitimate psychiatric diagnoses that don’t make it into the DSM. Arachnophobia is a legitimate diagnosis, but it’s not in the DSM. Instead, there’s Specific Phobias, and that includes all the variations of Specific Phobias, even though they aren’t actually listed in the manual.

Similarly, the DSM doesn’t need Chronic PTSD or Combat PTSD or Developmental PTSD in order for those variations to also be legitimate diagnoses. They’re variations of PTSD as well.

PTSD isn’t unique in that regard. For example, people with a depressive mood disorder will often have qualifiers/variants/descriptors as part of that diagnosis. Anxiety is the same.

 

[tofubreadcoriander]

No. Cptsd is a variant of PTSD. It’s PTSD + extra, not an entirely different disorder.

There’s plenty of legitimate psychiatric diagnoses that don’t make it into the DSM. Arachnophobia is a legitimate diagnosis, but it’s not in the DSM. Instead, there’s Specific Phobias, and that includes all the variations of Specific Phobias, even though they aren’t actually listed in the manual.

Similarly, the DSM doesn’t need Chronic PTSD or Combat PTSD or Developmental PTSD in order for those variations to also be legitimate diagnoses. They’re variations of PTSD as well.

PTSD isn’t unique in that regard. For example, people with a depressive mood disorder will often have qualifiers/variants/descriptors as part of that diagnosis. Anxiety is the same.

Yes, it's PTSD + extra and that extra (according to DSM criteria) is not recognized. I would also argue that if c-ptsd would be recognized and given it's due, DSM would become from the size of a book to the size of a pamphlet due to it's developmental nature.

I'd also say that PTSD as it stands now, in the DSM, describes single instance trauma whereas C-PTSD, in it's nature, is repeated trauma. There is a distinction there and needs to be recognized.

 

[Friday]

If the DSM fails to include C-PTSD won't this mean that repeated trauma that results in C-PTSD and that is relational won't be recognized?

The opposite. It already is. Not just with PTSD, but with the dozens of disorders that complex trauma causes or effects.

I'd also say that PTSD as it stands now, in the DSM, describes single instance trauma whereas C-PTSD, in it's nature, is repeated trauma. There is a distinction there and needs to be recognized.

Try reading the text(s) that therapists specialising in each disorder have to read. The PTSD one? Is over 700 pages long. Instead of criterion’s attempting to concise up 700+ pages into a few paragraphs.

Don’t get me wrong, I DO understand how reading something, so concise, so right…. FEELS. It vexed the hell outta me when they removed examples from the DSMIV to just title under the cognitive distortions criterion. But? That’s also the entire point of the diagnostic criteria. Concising shit up. The 700+ page books? Are for the devil and the details.

 

[tofubreadcoriander]

The opposite. It already is. Not just with PTSD, but with the dozens of disorders that complex trauma causes or effects.


Try reading the text(s) that therapists specialising in each disorder have to read. The PTSD one? Is over 700 pages long. Instead of criterion’s attempting to concise up 700+ pages into a few paragraphs.

Do these 700+ pages include the relational nature of C-PTSD?

 

[Friday]

Do these 700+ pages include the relational nature of C-PTSD?

Not all CPTSD is relational. And, yep. They include all kinds of complex trauma, including the many kinds of relational trauma.

The relationship between a torturer & their victim? Is going to be different than the relationship of a family member and their victim, and will further vary between a chosen relationship (like a battered spouse) and an involuntary relationship (like with a child, or kidnap victim, or child born into a cult, or person kidnapped/trafficked into a cult).

The details of EACH of those -and countless other- types of relational trauma? Will be found in smaller books. Exploring the myriad complexities of each.

Those smaller books? Will rarely be specific to PTSD, as PTSD is just one of MANY end results of trauma. Instead, the spectrum of responses common to those specific traumas/conditions. Helping therapists within their own context. Whether it’s PTSD, or OCD, or Phobias, or Personality Disorders, or a delusional disorder, or mood disorder, or whatever.

DOUBLE AGAIN Don’t get me wrong, I think the work of Judith Herman, and others, in looking BEYOND once off trauma & into both complex trauma and PTSD that is “more” than PTSD? Is invaluable. And I agree with BOTH the ICD & DSM for their equal/opposite decisions on classification.

 

[No More]

If treatment changes (the reason it was disincluded in the DSM5 is that treatment for PTSD & CPTSD is identical, just with a longer timeframe)… sure.

I’m probably just being dumb as usual, I get so friggin confused! I need to go and poke the AI again.

How can the treatment be the same when they present quite differently, with cptsd being more relational / similar to bpd would dbt not be indicated over cbt/exposure/emdr etc?