Anthony,

I have a different take on that news article, but of course everyone should be respected for their personal opinion. The criteria for diagnosing PTSD were culled from clinical observation so someone evaluating a person in Boise, Idaho, Miami, Florida, rural, urban, national, or international, could compare the signs and symptoms of their patient and have a reasonable understanding that they were seeing the same clinical picture. Why a diagnosis in the first place? A diagnosis of strep throat and diabetes don't stigmatize an individual whereas "mental breakdown" does, historically to the present. Medicine has come a long way from the days of locking people up, chaining them and beating them to get rid of "evil spirits". If only we could exorcise the spirit of stigma to a far away place.

When a name is given to a condition it raises the possibility that others can add to the knowledge about that condition for better treatment and possibly prevention. Many Gulf War veterans came home with a mysterious rash, reddish vesicles which itched a lot that evolved over time and eventually formed darker areas of skin, with thickening, called lichenification. A crop of these would appear, usually on the lower extremities, and repeat over and over, year after year. Family members also got these but not as severe, or they were self limited and did not re-appear. It raises the possibility of a dose related allergic reaction, altered immune state, . . . hypersensitivity to an unknown allergen? Yet, with so many dermatologists in the world, try to find what you can on the internet about " Gulf War Rash". Why do so many Gulf War veterans develop obstructive sleep apnea, OSA? The list goes on and on.

Past research has shown that emotional trauma shrinks parts of the brain, such as the hypocampus; what was not known was that prolonged anxiety can cause the amygdala to become more sensitive and grow. An action potential or nerve impulse occurs when the threshold for this to occur is lowered to a critical point. Too high a potential and the nerve does not conduct electricity, too low and it keeps firing over and over. The firing itself is caused by the suddent shift between positive and negative ions which quickly cross over nervous membranes in an electrical impulse that has force and direction. Curare raises the potential, causing paralysis of muscles.

Think of a gun having a trigger set to discharge with a specific pressure from the finger. If the safety is on, the gun does not fire. The mechanism for firing has been blocked. Alter this mechanism is some way and you have a hair trigger, the slightest pressure will result in firing. Perhaps if the gun is dropped it will fire.

Lower the threshold for firing in nerves and they will fire easier. Repeated experiencing of strong emotion such as fear and anger causes increased anxiety or stress. The new research suggests this process can lead to a growing possibility of producing greater stress. The most severe form of PTSD, Complex PTSD, occurs when past emotional trauma, such as abuse, can add to combat stress, and produce even greater suffering.

Some stess is manageable, but when this adds day by day from conditions described in Section A of the DSM-IV diagnostic criteria, it is more likely that PTSD can occur. I don't think anyone is suggesting that watching terror attack footage causes PTSD, as " threatened death, serious injury, or a threat to the physical integrity of self or others" is not occuring within the viewer.

Sensitization of the brain from repeated life threatening emotional exposure may pre-dispose to PTSD. Yet who develops PTSD and who doesn't from exposure to the same environment is not known. Genetic predisposition, hard wiring of neural circuits, chemical balances, perhaps even right brain vs left brain dominance all may enter into the equation. Sensory input volume, emotional memory, alteration of neural circuits from emotional trauma, and perhaps yet to be known factors may one day be better know through research.

Research announcements at conferences usually become published in peer reviewed journals. Since this process can take years, significant research findings are shared with the world community so that we may spark dialogue and add to the pieces of the research puzzle.

I am reminded of a saying, " Eyes that do not see, heart that does not feel." Terrorists know that all too well:

“Their ultimate tool is not chemical, biological, nuclear or radiological, but psychological.

“They want to destroy people’s sense of security. Terrorists know that when they kill or maim a thousand people, millions more will have their lives wrecked by fear.”

The world stood still on 911, and I do not want to see a day like that again. It affected us all, and for some it still does.

Roerich