Does anyone else have PTSD from different traumatic experiences?

[joeylittle]

Two studies that are relevant to this thread...

From Finalizing PTSD in DSM 5 (Journal of Traumatic Stress, MJ Friedman, 2013), Abstract:

Specific issues discussed about the DSM-5 PTSD criteria themselves include a broad versus narrow PTSD construct, the decisions regarding Criterion A, the evidence supporting other PTSD symptom clusters and specifiers, the addition of the dissociative and preschool subtypes, research on the new criteria from both Internet surveys and the DSM-5 field trials, the addition of PTSD subtypes, the noninclusion of complex PTSD, and comparisons between DSM-5 versus the World Health Association's forthcoming International Classification of Diseases (ICD-11) criteria for PTSD.

From Trauma and Stressor-Related Disorders: Diagnostic conceptualization in DSM 5 (The Neurologist/Der Nervenarzt, HP Kapfhammer), Abstract:

The former A2 criterion of an intense emotional reaction to trauma has been removed. A deliberately broad approach to clinical PTSD phenomenology has created an empirically driven new cluster of persistent negative alterations in cognition and mood due to experiencing traumatic events. The ASD has been reconceptualized as an intense stress syndrome with a clear need of acute treatment during the early course after traumatic exposure. Adjustment disorders continue to emphasize maladaptive emotional and behavioral responses to unspecific, non-traumatic stressors in an intensity that is beyond social or cultural norms. Neither complex PTSD nor prolonged grief disorders have received an independent diagnostic status within DSM-5. With respect to stress-related disorders major divergences between DSM-5 and the future International Classification of Diseases 11 (ICD-11) are to be expected.

The full papers are also really interesting. But the abstracts do a good job.

@siniang - re: your question here -

I'm really just trying to understand the difference between "natural unexpected traumatic death" and "accidental/violent unexpected traumatic death" of someone close from a biological standpoint.

The things that are categorized under 'natural unexpected traumatic death' will all be connected to the human body malfunctioning from within. Accidental/violent etc. death will source from outside the organic physiognomy.

It's important to remember that determining these things isn't philosophy, its taxonomy - which is a much narrower science, and entirely about reducing something to its component parts. It doesn't allow for interpretive nuance. Physicians are free to introduce that nuance, if they believe its warranted/will help them treat their patient.

But - lets say they don't think it's PTSD - that doesn't mean one is left diagnosis-less, or without a code for their diagnosis. DSM-5/ICD-10 have multiple options under the trauma and stressor disorders umbrella.

• Other specified trauma- and stressor-related disorder is the diagnostic for something that meets a lot of the PTSD criteria, but is sub-threshold in a certain area (including not aligning with Criterion A)
• Unspecified trauma- and stressor-related disorder is nearly the same - the only difference is, in this instance the physician (or patient) is unable to identify what the inciting traumatic incident was.

But how many people are denied (specific) treatment by insurance because they don't quite fit a diagnosis?

I honestly don't think this is a real concern. I quickly read the article you linked to (before it went behind a paygate) - and while I understand why those individuals expressed worry over the further narrowing of criteria in ICD-11, they weren't taking a broad look at the entire trauma and stressor area. Conditions that no longer meet PTSD criteria invariably are addressed elsewhere.

Finally (and others have said this too) - it's a moving target. More research creates more data, creates more specificity, creates new understandings. Traumatic grief, for instance, is something that is fairly recognized in the field pf psychology. There's still a struggle to get the taxonomy right, and make sure it's differentiated properly from the adjustment disorder subtypes, etc, etc .... but it's not like people don't think it exists.

 

[AnnieMae]

I usually have two lines that encapsulate my trauma and I have used them with friends/family who know I have PTSD.

One line is that I have been raped, choked, beaten several times before the age of 11.

The other line is that I grew up in a dysfunctional family and had bad luck. One is obviously more dramatic than the other.
After reading people's stories here, I certainly have not had it as bad, though playing trauma poker seems ridiculous.
People here are so full of courage and insight, that is what I like about this forum. It really underscores what it means to be human.

I find it interesting that you wrote this:


I can relate, that the emotional/psychological abuse is extra corrosive for me, though I often invalidate it. I grew up with a narcissistic mother and sociapath step father. He would threaten my life on the daily and choked me a few times. But it was those threats that really f*cked me up.

It was the verbal insults and mind games that eroded my identity, so I do a lot of identity work in therapy. My T says that a loss of identity and low self esteem can really fuel anxiety.
Btw you are not a joke of a woman, you are a survivor.

Verbal insults and mind games are exactly what my ex did to me. And it really, really messed me up. Not to mention when I called the police because he pulled a gun on me after he attacked me and I defended myself, and he LIED about it. They believed him. I got into so much trouble for it. When he tackled me, I lost it completely. He then apologized to me, and contacted me when he wasn’t supposed to, but I thought he loved me. Then he would berate me and cheat on me again, tell me that I made him do those things. Then would apologize, then do the same thing. One minute he would tell me not to be so hard on myself, then he would tell me that it was all my fault because I didn’t listen to him. He told me he did it all to be vindictive. Mind games suck! They are the worst, and no one gets how hard it is to pull yourself out of that when it was someone you trusted.