New Member As PTSD Professional

[britt]

Hello everyone. I am a researcher in data analysis, measurement and methodology, based in the Netherlands. Our current project is doing something for PTSD patients. The major task is to use a better methods (conduct a better questionnaire or use other data model) for doctors/psychiatrists to diagnose PTSD patients in a flexible, quick and precise way.

As we all know that the questionnaires for patients not only PTSD but also other mental diseases are quite time consuming and the face-to-face interviews with psychiatrists are also not flexible from some extent. And also some patients are afraid to tell all the hidden things out to the psychiatrists, which may influence the precision in diagnose. So for a better diagnose way for all the PTSD patients, we would like to ask for your valuable suggestions on the diagnose process.

Do you also feel the diagnose process is quite complex and time consuming? Do you like the questionnaires currently conducted by the psychiatrists? And do you have some further good suggestions for the diagnosing process (e.g. replace the questionnaire by other methods, such as writing down your own self-reports, or answer the questionnaire items in a more flexible way (e.g. at home instead of in the psychiatrists' and etc.)?

We would like to hear your advice~~~ All the suggestions are well appreciated.

Thank you in advance.

 

[cat]

Hi Prof

I really like your idea of writing our own self-report. There was so much I was unable to put into words when I went for diagnosis & I just couldn't think when asked questions on the spot. My appointment was in a psychiatric hospital which made me feel like I was beyond help.

My GP had seen me through a very difficult year at the point of diagnosis & knew me well enough to be able to make that decision herself. Instead due to the poor mental health provision in this area I had to pay for a private diagnosis at £200! If I had been able to complete the questionnaire with my GP it would have saved me a lot of stress & anxiety, I know in that situation I would have been able to be more open about my answers.

 

[Medic]

The actual questionnaire at the Veteran's Hospital is pretty concise, I think there were a total of 10 questions. From there you go in to see an RN or NP and are asked a more thorough set of questions - where you are free to elaborate and all information is documented.

In that, I feel like they're doing a good job in getting concise information. Unfortunately Psychiatrists themselves make considerably more money if they simply do medication consults, and I've often felt that Psychiatrists are not interested in hearing my problems, just giving medication based around the diagnosis of some one else. (In the VA you see a Psychologist and are then referred to a Psychiatrist).

I think an essay style questionnaire coupled with the methods already in place would be useful - but no matter how you slice it nobody wants to dig into detail with their stressors.

 

[jo74]

britt

Yes, I agree the process is time consuming. But if someone has been dealing with their issues for 15 - 35 years...it's pretty difficult to condense the information that is needed for a proper diagnosis.

Although a lot of our symptoms are relatively the same over the years, they do branch out in other directions, thus, adding more diagnosis or manifestations from other diagosis.

Good Luck,

jo

 

[kers]

I don't know if it was part of a formal questionnaire, but the best intake evals I have asked questions in terms of a spectrum rather than yes/no. For example, instead of saying, "Do you have trouble sleeping?" I was asked, "How many nights in a week do you have trouble sleeping?" Questions like that took away, to some degree, the stigma of admitting I had the symptom. When the symptom didn't apply, I could just say, "no issues with that."

 

[valentina]

I'm 31 and I think I've been suffering with PTSD since childhood but was only diagnosed when I was 23 after my brother committed suicide because I was a total wreck and wouldn't let the Mental Health Professionals in NHS (UK) fob me off anymore - I'd been asking for help since my early teens. The questionnaires make me panic and feel sick - it's like I have to prove myself again and again - face to face talking through with a senior Psychologist has been my best form of treatment - CBT has helped me to a degree but I know I need more therapy, I'm considering private Hypnotherapy. Home visits are really the best I think - then the therapist can gage the living situation that may be exacerbating the condition.

 

[anni]

It would be tough to do given the various limitations of most medical systems, but a case by case gathering of events and symptoms would be the most comprehensive, hence effective method of ascertaining the scope of the PTSD in any given sufferer. Perhaps a take home set of forms inclusive of the sufferer's recollections of the trauma(s) and their own understanding of the symptoms they feel they might be suffering due to PTSD could be used to compliment the professional's in office assessment tools.

As a long term sufferer who did not seek attention for some time, there were manifestations of this thing which I had no idea were connected to 'what happened'.

Thanks for the interest and study- it would be very nice to hear more from the world of research.

Anni

 

[kimbalas]

britt,

As a PTSD sufferer and healthcare professional, I appreciate the quandary that you find yourselves in. One of the biological issues of PTSD is the block that occurs between our memories and our emotional responses to them. Many complex PTSD sufferers, myself included, not only do not wish to discuss our traumas. We also cannot recall them at will.

One effective way to obtain this history from patients is the use of the genonome. The complex discussion of family relationships over a time period will frequent access the memories associated with these relationships and time periods. For veterans sometimes a timeline can assist with this process. It is the link into the memories, which allows the PTSD sufferer to access the memories, emotions and context contained within them, which forms the basis for the initial diagnosis.

For myself, I know that a simple questionaire given several years ago would not have elicited the needed information for a PTSD diagnosis. With my shame, guilt, minimization of the traumas and poor recall, it is likely that I would not have been a good enough historian to provide the needed information. Even after a year of counselling, I am still recalling details of past events. Another advanatage of the genonome is that it is a form that patients are comfortable with and is not viewed as threatening.

Another thought regarding the questionnaire, include something regarding nightmares and night sweats. I was shocked to read research a few days ago that stated that the average person only has something like 3-5 nightmares in their lifetime. I don't know about anyone else, but I have had periods where I beat that lifetime average on a nightly basis. I suspect that the content of my nightmares is different, as well. I don't know if it is an individual difference or part of the PTSD brain switcharoos. My nightmares are complex, frequently reflecting current situations back into the source of my traumas. For example, current love interests take on the behaviors and mannerisms of a previous abuser, emotionally torturing me despite the current person having demonstrated no propensity towards this type of behavior. Being hunted by unknown predators, human and animal, is another frequent theme.

How the questions are phrased is critical. I denied disassociation and numbness when I first spoke with my therapist. I had no idea to what degree I disassociated. It has always been this way. PTSD has been my reality for so long that I had no idea that there was another way to feel or percieve events. A straightforward do you feel numb? Will likely evoke the answer, "NO." Numb may have been our reality for so long that it is not numb. It is our normal. Direct questions about feelings will generally not obtain the information needed. Accurate descriptions of what those feelings look like and sound like may. For example, "I frequently feel like a soccer ball in a golf ball world?" This statement describes the sense of isolation and acute difference between self and other (a basis for looking at disassociation, isolation and reacting differently to everyday situations.)

My diagnosis procedure lasted for one session. An interview using a genonome and symptom inventory quickly whittled the list. The difficulty with self-report is that by definition PTSD sufferers normalize and internalize their traumas. They remove the emotional content of the experience from their conscious awareness. Hence, their ability to accurately self-report is seriously impaired. It is not that they are not attempting to tell the truth. It is in fact, that they are not aware of what the truth is or was. It has taken me 30 years to understand that I was a witness and victim of torture. My self-report, even today, would likely leave that information out.

I hope this was helpful. I really support your efforts to create a useful tool. I could have used it 20 years ago when I first sought out therapy and was retraumatized instead. An accurate diagnosis with effective treatment might have saved me untold misery.

Good luck. Thanks for letting me put in my two cents,

 

[gdf]

Hi Kimbalas,

I too am surprised at that average number for nightmares as I am in your range. I would love it if you could maybe post more information on that study in the thread dealing with dreams. Thanks.

Gina