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Icd 11 ptsd diagnosis

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anthony

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I think there will be some interesting times ahead with the ICD taking a vastly different approach to PTSD and cPTSD, than the DSM.

The proposed ICD 11, 2 factor criterion, which is the authorised model for release at this stage, is, well... interesting. The results in a study, I found a little perplexing, but I will leave that for you to read yourself. I would have thought the study results would have been lower for 2 factor than 3 factor criterion approach, but hey... studies are studies and usually full of holes.

Real life diagnostic statistics will show the way, whether this is too strict or not.

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ICD 11 - PTSD

Post-traumatic stress disorder (PTSD) is a disorder that may develop following exposure to an extremely threatening or horrific event or series of events characterized by:

Re-experiencing / Avoidance (2 or more)
  1. re-experiencing the traumatic event or events in the present in the form of vivid intrusive memories, flashbacks, or nightmares, which are typically accompanied by strong and overwhelming emotions such as fear or horror and strong physical sensations, or
  2. feelings of being overwhelmed or immersed in the same intense emotions that were experienced during the traumatic event.
  3. Avoidance of thoughts and memories of the event or events, or
  4. avoidance of activities, situations, or people reminiscent of the event or events,
Hyperarousal (one or more)
  1. Persistent perceptions of heightened current threat, for example as indicated by hypervigilance, or
  2. An enhanced startle reaction to stimuli such as unexpected noises.
Impairment

The symptoms must persist for at least several weeks and cause significant impairment in personal, family, social, educational, occupational or other important areas of functioning.

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Were you expecting more? cPTSD is even more antsy in its present shape.

I have said in places here that WHO were cutting the crap out of PTSD. Whilst I appreciate they believe it will be harder by having less symptoms to choose in meeting criterion, at the same time, people will just focus their attention to what they have to meet, in order to meet, for diagnosis if that is what they want.

I'm not sure whether the goal is to target specific symptoms as though they represent the total effect of post traumatic trauma, or what. Like I said earlier, perplexed a little about this myself.
 
Emotional numbing? That's the 3rd factor, right? So, that's going to be part of CPTSD? I'm a bit confused as that is a part of PTSD. It's not just hyperarosual & avoidance. It's way more then that.

Yeah, perplexed for sure! I do agree though. People will just focus on the new criteria rather then finding what does actually fit.
 
Emotional numbing? That's the 3rd factor, right?
No. In the 3 factor system they split re-experiencing / avoidance, so it was 1 of 2 for each. They simply combined it, where you may endure both re-experiencing only or both avoidance only, not necessarily both.

The cPTSD present draft version, is IMHO, a cluster f*ck.

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Complex post-traumatic stress disorder (Complex PTSD) is a disorder that may develop following exposure to an event or series of events of an extreme and prolonged or repetitive nature that is experienced as extremely threatening or horrific and from which escape is difficult or impossible (e.g., torture, slavery, genocide campaigns, prolonged domestic violence, repeated childhood sexual or physical abuse).

The disorder is characterized by the core symptoms of PTSD; that is, all diagnostic requirements for PTSD have been met at some point during the course of the disorder.

In addition, Complex PTSD is characterized by:
  1. severe and pervasive problems in affect regulation,
  2. persistent beliefs about oneself as diminished, defeated or worthless, accompanied by deep and pervasive feelings of shame, guilt or failure related to the traumatic event, and
  3. persistent difficulties in sustaining relationships and in feeling close to others.
The disturbance causes significant impairment in personal, family, social, educational, occupational or other important areas of functioning.

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They're about to change the majority of combat veterans from PTSD to cPTSD, based on this: "to an event or series of events of an extreme and prolonged or repetitive nature that is experienced as extremely threatening or horrific and from which escape is difficult or impossible"

Every combat theatre deployment meets this. They are both an event, and series of events, wrapped in one. Let alone multiple deployments. They are extreme and prolonged and repetitive. Your exposure is extremely threatening 24/7, high chance it will contain horrific stuff. You can't escape a combat theatre easily.

If veteran administrations choose to use the ICD 11 when it comes around, the severe combat veterans will then change to cPTSD I believe. The severe cases are typically half or more of those who get PTSD from combat operations.
 
I fit that definition for CPTSD almost like a glove it seems. It was a very long trauma, the worst spaning 7 yrs and total 12 yrs. Severe life threatening definitely. Not sure if that could be called 24/7 but I suppose it would be as I would never know when it would happen. Escape was impossible. At least how I viewed it. To the point of planning a very detailed murder suicide.

I mean, I don't know. I am not into self diagnosis. Do you know if there is any sort of different treatment? I am unsure why the spit or what comes out of the split without seperate types of treatment. Or maybe CPTSD would be like more depth sort of treatment then PTSD?

My therapist treats a lot of veterans and he says a lot that my PTSD reminds him of them. Not sure why though.
 
The difference is the approach for complex trauma, hence DBT's effectiveness. Another CBT model, expanded to suit the requirements to stabilise the person in order to then use the same trauma processing models.

Ah, I see. That makes a ton of sense now that you explained that. Thanks!
 
Oh... how good that would be.

The US uses the ICD too. The ICD is not just mental health, but physical too. The ICD is the world reference for all doctors by all countries part of WHO. US being one. Everything disease related is done by WHO (mental health is classified as a disease). The US have simply chosen to additionally capitalise on a DSM and integrate that into US society. The money the DSM generates for the APA is enormous... hundreds of millions per annum. It is often debated online who does more work for mental health, the APA or WHO, as the WHO have often just followed the coat tails of the APA for the most part. More recently, it seems WHO mental health is becoming quite independent and doing their studies to determine effectiveness against even the DSM versions.

WHO may help straighten out the DSM in the decades to come. Fingers crossed.
 
So, does the new criteria make it easier or harder to "have" ptsd. I spend a lot of effort trying to convince myself and my former therapist that I am fine. That I can manage my issues, til I don't.
 
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