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Research Frustrated By Ptsd Data

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Statistics are sketchy at best for PTSD, as they can't really nail down the specifics because medical data is often restricted, and psychological more so. Being treated and what you're being treated for, are different things. Then you have private clients and free clinics that treat, and don't have to report diagnostic statistics or such. You have private practices, public practices, all working off their own reporting requirements.

You have self reporting... which lets be honest, just screws things totally. Nobody should be self-diagnosing to become a statistic. Even if you're right, there are many who would be wrong, for lesser or worse reasons.

Statistics are good to look at... good to have a broad brush direction of things... but for mental health, I don't put a lot of weight into them. They give insight, not necessarily accuracy.
 
(most of us on the forum) are outliers on the bell curve so general assumptions and conclusions don't necessarily apply
I would support that statement. From what I see, the majority of this community are those at the worst end of the trauma and suffering scale... because we don't fit the 12 session therapy model and all is now well, the majority of this community are the difficult to treat group and it takes a lot more and lot longer for minor and major success.
 
The DSM says the diagnostic criterion is duration of symptoms of one month. I don't know where you get 6 months to a year? What guidance are you referring to?
 
The DSM says the diagnostic criterion is duration of symptoms of one month. I don't know where you get...
Maybe it's changed over the years.... the last one I knew of said 6 months from what I remember. Maybe instructors were teaching us wrong, either way I can understand it can be diagnosed earlier, depending on the person.
 
The current and previous DSMs say a month, it sounds like you/your instructors are mistaken or perhaps referring to a particular treatment protocol with a qualifying period or local arrangements around treatment.
 
As per @Suzetig. The qualification period has always been one month for diagnosis.

Previous versions had some different categorisations, i.e. less than 3 months of symptoms was Acute, more than 3 months of symptoms was chronic, but that is as far as duration existed in previous versions... nothing about 6 months in relation to diagnosis.

If you want the facts on the current PTSD diagnosis, read PTSD Diagnosis - What is PTSD? Understand The Signs of PTSD which is the DSM V's current pre and peri requirements, adult and child PTSD diagnosis as current today.
 
I did read up on PTSD quite a bit after being diagnosed. This is what I understood regarding why some people may have some PTSD symptoms early after the trauma, but not later:

When a traumatic event occurs the amygdala signals a threat. At this moment the normal way how perceptions are converted to memories (breaking them up into words and other perceptions and distributing the memory into different parts of the brain for memorizing) is interrupted in order to facilitate a flight, flight or freeze response.

The memory is now stored as a whole, which is why it can come back during a flashback as a whole, e.g. with the smell, the feeling of temperature, the sounds and what was seen as it was. When we remember normal memories they are much more processed than that.

Thus PTSD starts as a memory that has not been properly integrated.

However, not everybody who has a potentially traumatic experience ends up with full PTSD. Many go through a tough time at firs, e.g. with bad memories, the need to talk and to cry and after a while they start to feel better. This is because they integrate the memory through this process of thinking and talking about the incident and slowly do with their brain what a brain normally does when breaking up and storing a memory. This way the traumatic memory becomes a normal memory.

We know from research that people with good social support are less likely to develop PTSD and I think it is because they are more likely to have someone to talk with in this situation, to receive emotional support---all of which helps to address the memory. In many ways, this is what therapists try to do with us, when they treat out PTSD. They help us to integrate the traumatic memory and to make it less scary and more normal.

I think that not all of us get the chance in the first few months after the traumatic event to heal like this, because, we have been dissociating strongly and do not even recall the event. This is more likely to happen, when we experience violence from someone who should take care of us, when we are younger and when it is not our first traumatic experience.

Does this make sense to you? It seems to fit with my experience, but of course everybody does experience PTSD differently. I think that some memories are so well protected by our brain that we will never get to integrate them properly and this is why we may not heal 100 per cent. However, that does not mean that we cannot feel loads better by dealing with those memories that are in our reach.

I wish you the best.
 
I think one needs to be cautious when trying to convince themselves of theoretical hypothesis, as though fact or applicable to how PTSD evolves.
When a traumatic event occurs the amygdala signals a threat. At this moment the normal way how perceptions are converted to memories (breaking them up into words and other perceptions and distributing the memory into different parts of the brain for memorizing) is interrupted in order to facilitate a flight, flight or freeze response.
This is part of the theory.

Memory encoding, theoretically as science presently understands, we take in a memory via one of our senses as our attention is focused, the thalamus and frontal lobe control the processing of attention. Factor in our emotional status, which then determines how fast neurons fire. The more emotional we are, the more focused a sensory sensations is for us, so theoretically a memory then involves the sensory areas of the cortex, processing sensations, and eventually sent off to the amygdala to become a formed single sensation. The amygdala decides what to do with this information, compares it with all other memories (do we need to keep it, yes, no, or merge) and chooses whether long-term memory or short-term, followed by destruction.

This is all theoretical. You should accept that premise before accepting exactly what goes on in our brain as fact, as the leading neuroscientists can't tell you conclusively exactly how a memory is encoded, stored, retrieved. People who have had physical impact damage to their amygdala, or had it removed, have shown an inability to store any new memories. This gives insight, but does not make memory encoding conclusive.

Anything that goes on in-between all those facets a memory travels, can cause disruption to the memory. Theoretically, we can choose whether the memory goes to short-term and self destructs, without even realising it. We know emotion is involved -- but you can't measure that conclusively either. A horrible memory with heightened emotion may not be stored equally to a good memory with heightened emotion.

We know from research that people with good social support are less likely to develop PTSD and I think it is because they are more likely to have someone to talk with in this situation, to receive emotional support---all of which helps to address the memory. In many ways, this is what therapists try to do with us, when they treat out PTSD. They help us to integrate the traumatic memory and to make it less scary and more normal.
Yes, social support after trauma influences outcome. The better your social support, the higher the chance you improve as an outcome. But again, one factor of many involved. It is a factor, not a conclusive statement.

Socio-economic and environment usually hold a significant key to outcome because those who are abused, especially repeatedly, often do not have that support around them. Now again, not all abused get PTSD. It is the exception, not the rule. So two people with no social support, low economic status, poor environment raised within, one can get PTSD and one does not, as adults. Both are in the high risk group for it.
I think that some memories are so well protected by our brain that we will never get to integrate them properly and this is why we may not heal 100 per cent.
You're working on the premise that the memory was even stored to be recalled. Plenty of studies have shown groups who experience an event, they interview each person about what they experienced, recall, so forth, and they often get all different answers, from the colour of objects, size, exact event that happened, so forth. They have shown each a video of what happened, where immediately upon seeing a video they believe they recalled the pieces they forgot. But did they? Or did they now take in a new memory of the event, add it to their existing fragmented version, and believe they now remember? Versus they just say what actually happened in a video of what they couldn't accurately recall prior?

Memory is complicated, is the moral of the story. If you're trying to convince yourself of a specific scenario for how your memory is a problem, you're really just creating more noise for yourself. The memories you seek may not even be encoded or sent to long-term memory. Time additionally can automate our brain to self-destruct memories we have, yet are not useful to us.

This is far from a simple understanding or discussion, IMHO, based on the theory of memory encoding, storage and retrieval. There is a lot of the brain involved in the entire process, not a single dominant area. There is a lot that can go wrong at any given time within the process.

I hope that helps you think a little broader about this and research far more, and err on the side of this is theoretical, not pure fact.
 
I think one needs to be cautious when trying to convince themselves of theoretical hypothesis, as though fa...

Hi Anthony,

I did not try to make this a methodological discussion, but of course I am referring here to theory. What else could it be? All sensemaking is creating some form of theories of what is going on, whether you are scientist or a layman.

And of course can no researcher tell you anything conclusively. It is their job to question and to doubt. For example, in statistics, we can find evidence that to variables have no systematic relationship (e.g. a linear one), but we cannot prove that one variable causes the variation in the other variable, even if we observe such a relationship repeatedly. This is because of the possibility that there could still be another more accurate explanation for the variation.

You are right that different studies have identified a variety of factors influencing the likelihood of an event causing a PTSD: characteristics of the event, characteristics of the person, the persons socio-economic environment and so forth. We also did not touch on insights from the study on the neurobiology of PTSD here. But we are not writing a book--right?

Regarding the question whether we remember or not remember trauma correctly, I am not sure it is relevant for healing to know this. However it would be vital for anyone who wants to take legal action against an abuser.

But even if I remember something incorrectly, it can cause me distress. Would this distress go away because someone proves to me that this event did not take place? It would probably help processing it, but I still had to deal with the memory and it would probably take some time until I am certain that it really did not happen (e.g. because it was a dream). In fact I know someone (an adult) who had vivid memories created in a coma of being visited by family members in the hospital. He took a few days to process that in fact not all these people managed to travel long distances to see him and give him presents (which he searched for after waking up).

You propose that some traumatic memories may not be stored at all. I think it depends on your understanding of what is memory, in order to say that this is even possible.

I assume that every person perceives an event somewhat differently. I also believe that we make mistakes/distortions when storing and recalling events (and research shows all of that).

However, in order to become traumatised by an event I must have perceived it. And my understanding is that something is a trauma when it changes me in some aspects. It must be more than feeling shortly scared or uncomfortable. Making me uncomfortable in specific situations repeatedly in the future would probably count as traumatic.

So even if I can never recall the event as a memory, the fact that I am not the same as before the event (e.g. there are changes to my nervous system and the part of the brain regulating it) can be interpreted as me having stored/changed some form of information because of the event. This may not be a memory in the traditional sense as being recallable, but is this in your opinion no memory at all?

We may disagree whether this should be called a memory or not, but some academics do use terms such as body memories when discussing traumatic responses and intuitively that makes sense to me.

I hope that clarifies a few points for you and hope that you are having a good day.
 
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