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[Abstract]

I am trying to get my head around the adjustment disorder dilemma and it is very complex and difficult. I can see potential problems with almost any decision made.

Would it be possible to have a little more detail about the possibilities being considered? Maybe listed out would be helpful. Like Option A, B etc...

I like the resources directory idea.

Similar threads is a good idea. Thanks.

 

[anthony]

Its simply based on a forum structure that encompasses trauma subjects.

PTSD has been classified an anxiety disorder, and anxiety is a symptom. We have a symptom structure here. That structure will continue for PTSD, it will change slightly to meet the new symptom structure, but overall remains untouched.

PTSD is now a trauma and stressor disorder, so the focus is now taken away from it being symptom structured, and its focus will only further shift towards the cause, being trauma and stressors. It is a structure I have refused to adopt here because it does open things up significantly for interpretation for members to post within. I have refused this because PTSD was an anxiety disorder, which is symptom structured and focused.

Things change, and the forum either changes with the proposed direction or gets left behind, which is another reason why I can't simply do nothing and leave things as they are... because more focus will only continue to shift towards trauma, not symptoms. Trauma is where you heal yourself, and anyone here should have learnt that by now... so its only natural PTSD shifted under a new trauma and stressor category, no longer an anxiety disorder.

The only medical relevance several disorders have had, until now, is symptoms. The focus has shifted to trauma, and whilst ASD has always been PTSD's little brother/sister, AD's are now both their cousin. Off to one side, related, but not full blooded.

This means a forum structure to cater trauma types, and trauma types open up interpretation for who should be supported, and who shouldn't, and what trauma types. Trauma types is exactly where we are with the DSM V, and no longer a symptoms due to trauma approach. You're only going to see trauma and stressors focus expand over the years, becoming more focused and specific because that is the cause of the symptoms, which the DSM now reflects. The ICD will no doubt adopt similar.

PTSD Forum, in other words, must also shift towards a trauma focus... so do we encompass our cousin or not? Is the million dollar question.

Right now we support a person who has been raped and has PTSD from that. We don't support a person who has been raped (same trauma) and has adjustment disorder (same or less symptoms, lesser severity not meeting PTSD). Saying that, because you lost your job also falls under adjustment disorder, equally with the person who got raped and has symptoms, just not severity.

 

[Abstract]

Right now we support a person who has been raped and has PTSD from that. We don't support a person who has been raped (same trauma) and has adjustment disorder (same or less symptoms, lesser severity not meeting PTSD). Saying that, because you lost your job also falls under adjustment disorder, equally with the person who got raped and has symptoms, just not severity.

This is where the dilemma comes in in my mind. I can actually really see the value of the first (especially taking into consideration how often delayed onset PTSD happens and thinking of my own history) but I am not sure about the second and can't get my head around how it would be managed on site. The practicalities.

I imagine almost all of those with PTSD need to deal with issues that could fall into the latter category. They tend to be an important part of healing in my opinion as they can affect our life view. Non traumatic experiences that have greatly changed ones life but which were not traumatic in a true sense. Certain types of childhood emotional/verbal abuse and neglect would come under that too I am guessing.

The trouble I think is that dealing with both and yet separating them on site would potentially increase all the problems we have about evaluating trauma. And not separating them just seems potentially even more problematic to me. Also thinking of what approach is most likely to be the most helpful for different experiences.

I don't know....

 

[anthony]

I imagine almost all of those with PTSD need to deal with issues that could fall into the latter category. They tend to be an important part of healing in my opinion as they can affect our life view.

And there is the crux of why I haven't done this... but really need to do so now due to how the DSM is now structured towards PTSD. The latter affects us with PTSD, to extents it is the current issue in our lives, yet if that is the only issue... it can and will be misconstrued by readers who then register to participate because their partner left them, so forth.

PTSD is now pushed in the direction of trauma, but doing it here means we either all accept lesser traumatic event discussion by those without PTSD, or well... we deal with more blow back by those who do endure events, yet don't have PTSD, though have many of the same symptoms, just lesser severity and lesser trauma in most cases.

I've seen both good and bad instances of this already here... just not sure which would prevail opening it up.

 

[anthony]

It is a pickle... mmm... need a pickle smilie!!! :coffee:

 

[cherryblossom]

Maybe I'm over simplifying things, or maybe I've completely misunderstood. . . . ( this is just my thoughts, take it, or leave it)

The decision should be based on whether you want this to be solely a PTSD forum, or a much broader 'trauma' forum, encompassing every possible diagnosis surrounding trauma?

now 3 diagnoses plus a zero symptom general trauma and stressor diagnosis makes up the new category which all have the cause in common, being a stressor or trauma.

So you're not just talking about encompassing AD into the forum but other diagnosis' too? I have to be honest, I can see more negatives than positives in doing that.

I can see why you have said that you don't want the forum to be left behind, but I don't agree that is the case. I would say that it is good to have a specialist forum for one specific trauma diagnosis. It means that everyone here is understanding things from the same view point. If you throw a whole host of different diagnosis' together, then the forum will become somewhat 'watered down'.

You already deal with some of the different types of stressors by providing My combat PTSD, and My sex abuse forums, (and I believe coming soon - a domestic abuse forum). I don't know about the other forum(s), but My sex abuse is open to non-PTSD sufferers to discuss their trauma.

I genuinely think that when people who are suffering search on line for support, they search for their specific issue, in order to contact others who understand their disorder.

As an example if you suffer from multiple sclerosis, you would look for that rather than just general neurological disorders.

If you were to go down the route of changing the forum to 'general trauma', then you would likely need a lot of subsections for each of the various diagnosis'.

If you were to shift the focus from symptoms to trauma types then you make the other existing forums (Combat, SA, DV) defunct.

At the end of the day, this is your forum, and only you can decide whether you want it to be the leading forum for those diagnosed with PTSD, or whether you want it to become a general trauma forum, encompassing all trauma (big or small), and every possible diagnosis that could result from that.

I'm not against change, but I think this a huge decision for you to make. Because once made, there will be no going back.

There is something to be said about specialising in one subject rather than becoming a 'jack of all trades, master of none'.

 

[Meadowsweet]

I don't envy you having this decision to make. Some thoughts on this:

If a section of the site was inclusive based on trauma type, then discussions would center around the trauma. Therefore, people who were raped, wouldn't be discussing on the same section as someone who has been cheated on. So the choice would be there for people to keep out of sections that they don't like.

However, I could envisage there being some very grey areas regarding types of trauma. For example, there are many types of childhood abuse. Also, abuse that happens in childhood seems to have a different psychological effect than when the same abuse happens in adulthood. Domestic abuse would be another very grey area and people often describe nasty relationship breakdowns as the partner being emotionally abusive.

I do think that having a trauma section would perhaps encourage more talking about the actual traumas, and that seems better for recovery, than talking about symptoms.

 

[JustBe]

I am finding this all quite confusing!:confused:

 

[amethist]

My two penneth for what its worth.

I have running through my mind, "Why fix what's not broken". I feel adding in any other trauma type diagnosis would break what we already have, which is a well run, full of good information, loads of support and all that is needed for those who have or support those with PTSD. It is a specialised forum for all of the above, and to me adding in access to others without PTSD would in a way water down what is a brilliant forum.

 

[Hashi]

Me too, Movin'On.

Maybe I'm over simplifying things, or maybe I've completely misunderstood. . .

The decision should be based on whether you want this to be solely a PTSD forum, or a much broader 'trauma' forum, encompassing every possible diagnosis surrounding trauma?

I’m still trying to get the proposal clear in my head. Sorry! Anthony, if I understand correctly you’re not talking about a complete switchover of the whole forum but want some of it to remain PTSD-specific? I say that because you said:

We have a symptom structure here. That structure will continue for PTSD, it will change slightly to meet the new symptom structure, but overall remains untouched.

Either way, I think the choice has to be as cherryblossom describes - between a site based on having a particular disorder and a site based on various trauma types. I don’t think the two can be combined in one site. It would be unworkable.

There are other online forums which are based on trauma type alone. What diagnosis someone has isn't an issue, it's the experiences and the effects that are discussed. Those aren’t for such a wide range of traumas, though, and I think that’s why they work. Sharing discussions where the whole forum is made up of survivors of a trauma in the same grouping as you, such as sexual assault, it doesn't matter whether the person has PTSD, ASD, AD or whatever. However, if there was a very wide range of trauma type and trauma severity across the membership, there feels like too little common ground/shared experience to make discussions valuable.

The existence of those other forums, focussing on particular traumas but not particular diagnoses, is why I think it doesn’t matter that we don’t support someone who has been raped but doesn’t have PTSD. They have somewhere else to go. I don’t think it’s inconsistent of this forum, either. Lines have to be drawn somewhere, and trying to be too many things to too many people could mean being of little help to any.

What I do think would be helpful would be to add a section for trauma type discussion within the existing forum, but still restricted to those with PTSD. That would meet the benefits that discussing trauma has for recovery, and would also be a shift towards the more trauma-type focus of the DSM, which still separates PTSD out within that. More than that is unnecessary, I think.

 

[Abstract]

I agree with Meadowsweet and MovinOn!

I do think that having a trauma section would perhaps encourage more talking about the actual traumas, and that seems better for recovery, than talking about symptoms.

This is one of the things that stops me. There is something there that seems important. But then I look at all the complications and my head spins. Not on a personal level necessarily but looking at what causes problems and what offends people.

One of the most important parts seems to me to be that people are pushed in the direction of recovery. I can see why such a format could do so or do the opposite. I am not sure which would prevail. Every argument that I can think of to support any decision has an opposite argument that is relevant.

 

[Hashi]

Would you have the same concerns if a trauma type section was PTSD only, ie still within a PTSD-specific site? I'm not clear if you mean it's still a general issue because people might join the site self-diagnosing with PTSD after being cheated on (but no other trauma), then join or start a discussion about relationship abuse.

Would you be willing to say more about how you think the format might push people in the opposite direction from recovery?