Lets Create A Ptsd Diagnosis - Off-topic Discussion

[EveHarrington]

I'm not asking anyone to jump on any bandwagon. What I do not understand is the undercurrent of dissuasion of discussing PTSD criteria.

Knowledge is power. I don't understand why anyone should try and squash intelligent conversation. If it's for you, then great! If not, then you can always move on.

I really don't like the idea in modern society that anyone who disagrees with another or challenges another's ideas is labeled as a "hater". A hater? I'm not sure what I've said that has earned me this label as I haven't said anything hateful. (If what I have said is interpreted as hateful, I apologize for giving that impression as that was not my intention.)

I am respectfully bowing out of this line of conversation as I very much wish to remain in the diagnostic criteria discussion and do not wish to be thread banned.

Again, to each their own. I am not discounting your views or experiences in any way. Mine seem to be quite different than yours and that is ok. We can have very different views and can coexist.

 

[lostforgottensoul]

Thoughts? Stupidity? Stick with the basics? Go for gold? It's al philosophy after all.

More of a question, you may want to move this to the other one.

When I brought this up to my therapist (amoung a very other things) he had stated that my past as a whole is how I became diagnosed with it. But what confused me is JL was saying, somewhere, that only 1 thing needs to pass the diagnosis.

Did I miss understand that? Like if just one thing happened out of my past and I have X amount out symptoms out of X then im diagnosed or is it like im understanding my therapist, its my past as a whole that matters?

Maybe both are saying the same thing, I just thought Id ask in case I was miss understanding.

Oh and having just one out of 5 or 6 symptoms I also see needs to be changed as I do have comorbility and can see cross symptoms between PTSD & BPD and I can see the two becoming confused and being miss diagnosed if you just have to meet one symptom as PTSD & BPD have some of the same symptoms.

Now if its like one out of each catigory, maybe, but i still see that needs to be tightened a bit.

Again, sorry if this is off topic. Im still trying to understand and wrap my brain around it I think.

 

[anthony]

You only need one trauma to meet criterion A, yes.

 

[digger]

Bringing it over here as requested as I think it could be useful to discuss further.

Is there not an alternative word to 'violence'? I accept it is in the DSM but I am thinking that not all child abuse is violent, and I prefer the non-consensual aspect which would cover adults and children (who by definition cannot conse

I do think that, while it seems widely accepted that child sexual abuse can cause PTSD, none of the current diagnostic criteria makes that clear in my opinion.

Criteria A in the DSM V...

A. Exposure to actual or threatened death, serious injury, or sexual violence in one (or more) of the following ways:

...in the ICD 10

A. Exposure to a stressful event or situation (either short or long lasting) of exceptionally threatening or catastrophic nature, which is likely to cause pervasive distress in almost anyone.

...and the proposed criteria from the main thread...

A. An event in which one of the following were present:
(1) Directly experiencing or witnessing actual or immediate threat of death, catastrophic injury, or sexual violence.

Not wanting to go into details of my own experience here, but child sexual abuse doesn't always involve explicit use of threats or violence. The current criteria seem to exclude this and yet it also seems to be accepted that it can, and does, cause PTSD?
The ICD version maybe is more inclusive in that I dont think there'd be any argument that sexual abuse could cause pervasive distress in almost anyone but even then I think it would come down to interpretation of how the word 'catastrophic' is being used in that sentence. In the other thread it was suggested that 'catastrophic' might mean 'life threatening', in which case child sexual abuse where that threat is absent doesn't seem to be included?

 

[anthony]

child sexual abuse doesn't always involve explicit use of threats or violence

But it is child sexual abuse, thus "sexual violence" is anything that is against the persons volition. Child period is against the law and considered violence against the child, unless consensual with another child of the same age -- I believe under many country laws.

 

[Sideways]

@digger - I'm gonna jump the gun and anticipate that you may not get anyone to volunteer an executive summary of the 2 threads!!

'Catastrophic injury', as a specific term, was discussed reasonably early on in the main thread - it is a particular phrase and the reasons it were used are fleshed out more in the posts.

'Sexual violence' was given some attention much later in the discussion, but only briefly, and it was mentioned earlier on in this thread a few times not long back.

As for how it applies to the case of child abuse where there is no explicit threat, there were a couple of examples that were used to explain how the definition will apply to children even without explicit threats. Again, that came fairly late in the discussion.

Just offering some pointers if you're willing to scan through the main thread. I think you'll find the answers you're after, but in case you don't, it'd be good to hear your ideas if you're still seeing holes:)

 

[digger]

you may not get anyone to volunteer an executive summary of the 2 threads!!

I wasn't asking for that ;) I have been trying to follow both threads but admit to finding it very hard to digest the longer posts here and most of the semantics stuff unfortunately went over my head. So, if it's already clearly there, I apologise that I missed it.

"sexual violence" is anything that is against the persons volition. Child period is against the law and considered violence against the child

Thank you. I guess it mostly comes down to my perception of the word violence. Thinking about this has come up with my T before too where she has described something as violent and I've done 'Eh?!!'. I think things don't register in my head as having been violent unless it's in an out of control or angry kind of way! :rolleyes:

 

[Sideways]

Mmm, less an issue or "what's violence?" and more an issue that you were a child.

The super-short version is that as a child, actually your life and personal safety is at real risk if you don't do what mum & dad tell you & put up with whatever crap they lay at your door...v simplified version!!

 

[Lucycat]

more an issue that you were a child.

True, but being told to eat up your dinner against your will would not be considered violence even though it is against your volition. A lot of what children are 'told to do' is quite healthy and normal and a part of their education. That is why it can be so hard for children to understand that sexual abuse is wrong at all as there may be no coercion other than what is used in everyday language. You are taught - or groomed - to do as you are told. It is far later that it is perceived as abuse.

 

[Sideways]

@Lucycat - take an example of a child that develops ptsd from frequent and abusive verbal tirades from their mum during their childhood. If the child goes on to exhibit all the symptoms of ptsd, they meet the criteria A trauma definition because, as a child, their life depended on tolerating how their mother treated them, even though at the time, the child had no conscious awareness about why they were tolerating the abuse. A child needs their mother to survive, which is why they meet the criteria.

The example of a child being told to eat their breakfast doesn't interfere with the diagnosis, because a child isn't likely to develop ptsd from that alone.

 

[digger]

If the child goes on to exhibit all the symptoms of ptsd, they meet the criteria A trauma definition because, as a child, their life depended on tolerating how their mother treated them, even though at the time, the child had no conscious awareness about why they were tolerating the abuse. A child needs their mother to survive, which is why they meet the criteria.

actually your life and personal safety is at real risk if you don't do what mum & dad tell you & put up with whatever crap they lay at your door.

I'm even less sure about this. :confused: I do understand that as children we are dependant on other people for survival, but I think there would have to be some perception of that for it to register as a threat? Not saying that you're wrong, just that I don't understand it. Are you saying that children have some kind of innate sense of needing to do as their told for survival?

I genuinely don't believe my life was in danger from either of my parents. Both of them were abusive in different ways. I have no recollection of ever feeling that level of threat from either of them, or of that being a possible consequence of not putting up with it. Life being made even more difficult as a consequence - yes. Death - no.
I don't have complete memories of all of it, and clearly something sometimes caused levels of dissociation that would indicate a significant level of distress, but not a threat to life... I don't think. Who knows. I think I probably just need to step away from this one as I'm getting more confused by it. Thanks for trying to explain how you see it simpler though.

 

[Sideways]

Yep, that's exactly what I'm saying!

When you're a iddy biddy tot, is there anything in your brain that you were actually aware of that told you, "running low on nutrition and energy - time to cry so that mum comes and feeds me..."? Nope. We just come out that way, instinctively knowing that mum & dad = me staying alive.

That instinct doesn't actually go away until much much later, when you and your brain are developed enough, and have enough survival skills of your own. So yes, you're right on the money. That's basically exactly whatt I'm saying:)