anthony
14-04-2006, 05:25 PM
I think this article needs to be highlighed by Dr. Richard J. McNally, Professor of Psychology at Harvard University, because it really depicts what is happening with the assessment of PTSD today, and the misdiagnosis of PTSD coming from many psychiatrists. This coincides actually with a recent thread here from member Dubside on "is this PTSD (http://www.ptsdforum.org/thread96.html)?" PostTraumatic Stress Disorder (PTSD) is supposed to be a disorder that is not curable, though today you here of people saying they have been cured. It is these cases in fact that I generally point out as "not actually being PTSD", and more misdiagnosis from the professional for a lesser illness. Where some people are being diagnosed with PTSD, they should in actual fact be diagnosed with PostTraumatic Stress (PTS), which is simply a name given to the after affect of an incident causing stress.
Doctors are waving their wands far to wide now with diagnosis. Its not a matter of what I perceive PTSD to be, but as Dr McNally outlines,
PTSD was conceptualized as an anxiety disorder that developed following exposure to terrifying, usually life-threatening events -- traumatic stressors lying outside the bounds of everyday experience. Canonical stressors included combat, rape, and confinement to a concentration camp.
What is now occuring though, is what I definately see as misdiagnosis, and even attempting to fake PTSD, just to be branded with it for medical or compensation purposes. Dr McNally goes on to further state:
But in recent years, we've witnessed a conceptual bracket creep in the definition of trauma whereby ordinary stressors are now deemed capable of producing PTSD. The disorder is now being diagnosed among people whose stressful events range from exposure to crude jokes in the workplace to giving birth to a healthy baby -- and much else in-between. Indeed, one study showed that nearly 90% of Americans qualify as trauma survivors -- as trauma is currently defined.
Dr McNally then states why this is a huge problem for the future of mental illness, society and practioners alike.
There are 3 reasons.
First, the broadening definition of trauma threatens to undermine any chance we might have of elucidating the psychobiological mechanisms that give rise to PTSD. A survivor of a fender bender is unlikely to have much in common with a survivor of the Holocaust.
Second, the more we broaden the concept of traumatic stressor, the less credibly we can assign causal significance to the stressor itself, and the more we must emphasize preexisting personal vulnerability factors. But shifting the causal burden away from the stressor undercuts the very rationale for having a diagnosis of PTSD in the first place.
Third, by viewing more and more of modern life through the lens of trauma, we may overmedicalize normal emotional responses to stressors and undermine human resilience in the face of adversity.
The assessment of PTSD certainly needs to be viewed in a more precise range that what some US doctors are currently performing. I know that Australia has an actual checklist with scale and range for PTSD diagnosis, and you basically have to be at the severe end to be diagnosed with PTSD, as anything less, you could in fact be cured with treatments such as medications, EMDR and regular counselling.
You can read the full article or watch the video presentation (http://www.medscape.com/viewarticle/528984) by Dr McNally. You must register at the linked site, it is free though, I would just supply a junk email, as you will most likely be another candidate for email on all medical topics otherwise.
Doctors are waving their wands far to wide now with diagnosis. Its not a matter of what I perceive PTSD to be, but as Dr McNally outlines,
PTSD was conceptualized as an anxiety disorder that developed following exposure to terrifying, usually life-threatening events -- traumatic stressors lying outside the bounds of everyday experience. Canonical stressors included combat, rape, and confinement to a concentration camp.
What is now occuring though, is what I definately see as misdiagnosis, and even attempting to fake PTSD, just to be branded with it for medical or compensation purposes. Dr McNally goes on to further state:
But in recent years, we've witnessed a conceptual bracket creep in the definition of trauma whereby ordinary stressors are now deemed capable of producing PTSD. The disorder is now being diagnosed among people whose stressful events range from exposure to crude jokes in the workplace to giving birth to a healthy baby -- and much else in-between. Indeed, one study showed that nearly 90% of Americans qualify as trauma survivors -- as trauma is currently defined.
Dr McNally then states why this is a huge problem for the future of mental illness, society and practioners alike.
There are 3 reasons.
First, the broadening definition of trauma threatens to undermine any chance we might have of elucidating the psychobiological mechanisms that give rise to PTSD. A survivor of a fender bender is unlikely to have much in common with a survivor of the Holocaust.
Second, the more we broaden the concept of traumatic stressor, the less credibly we can assign causal significance to the stressor itself, and the more we must emphasize preexisting personal vulnerability factors. But shifting the causal burden away from the stressor undercuts the very rationale for having a diagnosis of PTSD in the first place.
Third, by viewing more and more of modern life through the lens of trauma, we may overmedicalize normal emotional responses to stressors and undermine human resilience in the face of adversity.
The assessment of PTSD certainly needs to be viewed in a more precise range that what some US doctors are currently performing. I know that Australia has an actual checklist with scale and range for PTSD diagnosis, and you basically have to be at the severe end to be diagnosed with PTSD, as anything less, you could in fact be cured with treatments such as medications, EMDR and regular counselling.
You can read the full article or watch the video presentation (http://www.medscape.com/viewarticle/528984) by Dr McNally. You must register at the linked site, it is free though, I would just supply a junk email, as you will most likely be another candidate for email on all medical topics otherwise.