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Lets Create A Ptsd Diagnosis

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I think that if we are trying to get to understanding and root causes and possible solutions, it would be helpful to somehow say under Criterion A

4. Experiencing repeated or extreme exposure to aversive details of the traumatic event(s) (e.g., first responders collecting humanremains; police officers repeatedly exposed to details of child abuse).

*to be added somehow as well the legal systems, including the very bodies we expect to protect human rights, with regards to sexual violence in all forms, I say this because I have had to recount and relive events for nine years endlessly and counting with no real resolve and matters related due to red tape and beaurocratic nonsense, delays, I know this has only exacerbated my PTSD and telling the people involved does not matter to them even remotely. I feel like I am invisible. I feel like I am stuck and trapped in hell and no one understands and I am crazy for feeling this way. This has destroyed my life and health.

I was ordered to tell the truth so, I feel that I am forcibly being stuck and trapped, harmed and reliving is pretty much constant, waiting to testify so it is over in reality and not being allowed

I am not sure if this is helpful Anthony
 
police officers repeatedly exposed to details of child abuse).
This falls under the bracket of secondary or vicarious trauma in the caring professions particularly and is different to PTSD although some of the signs are the same. I don't know that it's helpful to lump it together with Criterion A trauma.

I do think having a definition for Criterion A trauma is helpful because it does help limit bracket creep. Different people have different tolerances to adversity, having a clear criterion gives a frame of reference that isn't about how bad I feel, or how betrayed I've been. I think too that trying to find a definition wide enough to account for developmental trauma could be counterproductive. Speaking from my own point of view I've experienced both developmental trauma and classic criterion A trauma and while the effects of both have overlaps, the impact of each is distinctly different.
 
@Thematrix - I was conscious of the complete neglect of exposure to chronic stressors in my proposed definition. I could take your example, or (very common) domestic violence...neither seem to fit.

But I'm actually in favour of treating disorders arising from an immediate event (PTSD) and disorders arising from chronic exposure to trauma or severe stressors differently, because they are.

@Chava has talked above about using a diagnosis that advances our understanding of trauma disorders. I like that approach.

We know all about the way the brain & body responds to threat (increased heart rate, sweaty, andrenalin released, etc). We also know that the body & brain can only sustain this for a finite period, and that the brain and body actually go through very different changes (physiological, neurological, cognitive) when the trauma/stressor is chronic. If the brain and body are doing something completely different in situations of chronic stress/trauma, then IMHO it's more helpful to distinguish the two so we can treat them more effectively.

Kind of like, 2 people might both have cancer, but if one's bowel cancer and the other is brain cancer, you distinguish them and treat them differently...
 
I'm working off 4 hours sleep but I think keep it simple, if you feel traumatised by something, regardless of what it is and it effects your day to day life then you have PTSD. If its multiple reasons, more then one trauma then it's CPTSD. I think the effect is more important then the cause, the whole 'my trauma is worse then yours' is A bullshit and B like the root of the healing problem. I don't give a shit what your trauma is, you need help then you need help. I hope that makes some kinda scenes. Your cat died and its f*cking you up then come stand next to me and heal with me. You spent years as a POW and had some seriously nasty shit happen you come stand next to me too.
 
Articulating parameters for Criterion A is, right now, a best guess at what kind of situation will cause the brain to be 'afraid' enough in order to develop PTSD. And so far, everyone is pretty sure it has to do with experiencing mortality-grade fear.
Solving a problem typically entails understanding the problem. This is fundamentally why, in essence, we have no solution to PTSD because we don't understand why it happens.

There is no evidence to support PTSD at present. We have the problem, just no idea what the problem really is or how it occurs.
This is so completely true, and incredibly important to remember. I do think that in order to have a functional diagnosis, we need to roll with what the current scientific hypothesis is: the brain registers extreme fear/pain and imprints a fear response that will be 'triggered' whenever aspects of the inciting incident are remembered. To eliminate PTSD, you engage in 'fear extinction' - literally erasing the initial fear response from its neurological moorings.

That's the prevalent hypothesis. It's not the only hypothesis, but they all have that line of thinking in common: big shock/fear/pain, some lump of memory that is messing up cognition, work around or erase or otherwise navigate the lump.

Without any kind of restrictive description of the initial trauma, it becomes even more subjective than it already is.

I'd propose the following edits and changes to A:

A. Exposure to actual or immediate threat of death, catastrophic injury, or sexual violence in one (or more) of the following ways:
  1. Directly experiencing the traumatic event(s),
  2. Witnessing, in person, the event(s) immediately as it occurred to others,
  3. Learning that the traumatic event(s) occurred to a close family member or close friend. In cases of actual or threatened death of a family member or friend, the event(s) must have been violent and accidental.
  4. Experiencing repeated and extreme exposure to aversive details of the traumatic event(s) (e.g., first responders collecting human remains; police officers repeatedly exposed to details of child abuse).
Note: Criterion A2 does not apply to exposure to electronic media, television, movies, or pictures, unless the exposure is work related.[/QUOTE]

Immediate threat of vs. threatened: I believe 'threatened' is not specific enough. There is no time constraint.
Catastrophic vs. serious (injury): catastrophic is a medical term, and it does draw the line between certain things. Serious injury has too much latitude.
(witnessing) Immediately vs. as they occurred - is just to point out, again, that you need to have been there in the moment it occurred. I'm not sure the other language is exclusionary enough.
Scratch number 3.
Scratch number 4. Why? (4) is included within (2), and does not need it's own line.
 
Scratch number 4. Why? (4) is included within (2), and does not need it's own line

Disagree with this piece here, to a degree. The immediacy works for drone pilots or hostage negotiators, but not for myriad other crisis & aftermath fields. Like the people who have to watch children being raped for hours on end day in and day out, dealing with catching or prosecuting child porn; crime scene & evidence; arson & disaster / insurance investigators; genocide & war crime investigators; torture & human rights violation footage; etc.
 
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