Lets Create A Ptsd Diagnosis - Off-topic Discussion

[anthony]

There is some evidence in terms of brain imaging and bits and pieces regarding trauma behavior

I don't want this becoming a debate about off-shoots. I think people need to do their own research about such statements. There is no evidence to substantiate PTSD diagnosis. Yes, there are lots of snippets of information, however, for every piece of information you think is relevant, there is counter information that discards it. There is no 100% brain imaging for PTSD to date. There are people claiming many things, and neuroscience is saying different.

We need to stay focused on PTSD diagnosis and creating one based on what we know and what is available to us for use, in an attempt to create an accurate diagnosis, and even sub-type to include complex trauma and such.

 

[anthony]

Studies on dogs might have some correlation.

They may, however, mice are the most common to humans.

 

[Deleted member 28740]

mice are the most common to humans.

Mice are not generally companions. Canine before and after changes from a traumatic event often require a veterinarian / trainer to manage behavioral symptoms. Dogs are also social and emotive with humans. Mine can not 'talk' but her communication skills are eloquent and clear. Not to derail this thread I'll start one that has links to the info I am finding on canine PTSD. They served in wars, work with police, live in our homes, observable changes from trauma and canine PTSD is a veterinary medical diagnosis and field of study.

The canine aspect is intriguing also in that a dog does not know about PTSD. Triggers reactions are observable as are the distinct changes in personality/behavior.

 

[Chava]

There is no evidence to substantiate PTSD diagnosis.

Okay, so like there is no evidence to substantiate depression, Autism, etc (like we don't have a blood test and ..."aha!"). I think the symptoms themselves, along with Criterion A, is the "evidence" enough...guess that's where I was going. But to stay on topic...

We need to stay focused on PTSD diagnosis and creating one based on what we know and what is available to us

Since I fit a few of the proposed categories (PTSD, CPTSD, and DTD), I'm not sure how it would sort out even in sub-categories. I think if working with a trauma specialist it all fits decently (or good enough) in the current DSM description. Lack of criterion A would make it a mess. The only added thought I have is a different way to word criterion A for children. Chronic neglect is felt as life threat to a young child. Witnessing chronic violence in the home wires them into chronic hypervigilence because they cannot escape. Direct abuse is obviously more likely connected to the more globalized symptoms suggested under complex trauma proposals.

I'd probably call them all disorders of extreme stress (NOT an anxiety disorder), as a heading, and break it down into PTSD, CPTSD, DTD (specify early, developmental trauma), and DESNOS (like traumatized responses from cops after witnessing too much violence) ??? . Many people would find overlap, but that happens with a whole bunch of mental illnesses anyway.

The diagnosis option of DTD might give professionals another angle to study before diagnosing things like ADHD, ASD, and ODD (oppositional-defiant) in children. Obviously these are real issues too, but I'm always a little suspicious when a youngster has a list of like four to seven separate mental health diagnosis that all relate to nervous system and emotional dysregulation. But with DTD as a proposal, the politics involved are likely gnarly. Like do you have to prove a trauma or can you treat as trauma-informed and not just jump to assuming a kid needs to be removed from their homes? And if you dig for the trauma and find it, who pays for those treatment services? Right now most children who struggle, in any way, end up getting special education services through their school and lumped somehow into one of those categories. I don't love it. Van Der Kolk's proposal had support of the other major experts involved in the proposal process...and then DTD mysteriously did not show up in the DSM. There are a lot of unturned rocks here.

 

[anthony]

I have never really identified with sexual abuse victims and never got why until I watched Steven Stayner's movie

This applies to you too, stay on topic or I will thread ban you. Criterion A i the discussion point, not all other random PTSD aspects.

 

[UnKnown-Self]

@anthony: I respect and understand your goal.
In regards to PTSD we still live on a world that is flat and can fall off at some unknown spot. Any opinion outside what is currently believed by professionals will be dismissed. While we might not believe the world is flat, unless we can "prove" otherwise it is useless to say so and expect to be taken seriously.
Working within the confines set by the "professionals" is the only way for even a remote chance of getting one's foot in the door.

That being said, my previous post was not very helpful towards your objective. I do ask you consider my suggestion of more group therapies for those with similar experiences if and when you get as far as presenting treatment options. The only option now is individual therapy and a previous article written by you addressed the problems with the 45 - 60 minute sessions. For anything involving a group there are the AA type programs, not having it professionally monitored is problematic. Group therapy (along with individual) is cost effective enough to go beyond the standard 45-60 minutes and and both the patients and professionals have a learning opportunity.

Any other thoughts I have not relating directly to the wording of the DSM, I will simply create a separate thread. You have inspired me to do some research and while I am unsure how it will pan out, you can be sure if I think it worthwhile, I will certainly post it in this forum.

 

[anthony]

Any opinion outside what is currently believed by professionals will be dismissed.

I don't think this is true, to be honest. Professionals and experts are not silly about this, but by their own admissions, they also don't have better solutions to the problems. If you scrap the system which has no real evidenced foundation, yet does seem to work at some level, then we create chaos. The very experts which cite such statements, clearly also cite they do not have a better alternative either. The only better alternative I know about, that is evidenced, is symptom base... which we're not at yet, so I will discuss that when we are.

 

[anthony]

But to me, this wouldnt cause PTSD, it would cause fear but not PTSD. I think thats why it needs to have wording of like horrific nature as like myself, pictures and videos of murders, pretty horrific ones at that, not like you'd see in a Netflix movie.

There is plenty of evidence to support people turning up to therapy with full PTSD symptoms from events in their lives, but they simply don't meet criterion A. This is the entire issue for criterion A in the world.

Do you diagnose the person with PTSD when they meet every aspect other than their trauma doesn't meet criterion A?

 

[lostforgottensoul]

Do you diagnose the person with PTSD when they meet every aspect other than their trauma doesn't meet criterion A?

Good question. I dont know the diagnosic structure (or really fully understand PTSD) but if i were that therapist & they meet whatever # out of whatever # of sympthoms, i would, reguardless of criterion A.

But then that tells me more than it needs to be re-worded to include these things that people are going through but arent in A. Just in my opinion.

 

[Sideways]

IMHO, "Adjustment disorder with depressed mood" is under-utilised when people don't quite meet Criteria A.

 

[anthony]

To be perfectly honest, I think a criterion need be added for duration, i.e. a minimum symptom experience of 3 months for PTSD diagnosis.

Evidence substantiates that approximately 40% - 60% of people diagnosed with PTSD fully recover and no longer meet diagnostic criterion within 6 months, with no intervention.

There are an abundance of wait group studies where this is demonstrated.

 

[lostforgottensoul]

Evidence substantiates that approximately 40% - 60% of people diagnosed with PTSD fully recover and no longer meet diagnostic criterion within 6 months, with no intervention.

:wideeyed: Maybe the kids watching horror movies? Joking. :p

I do agree being 40% - 60% is very high!