Complex PTSD Diagnosis

[Kizzie]

Despite trauma professionals/stakeholders using the term Complex PTSD since Judith Herman first identified it in 1992, until recently it has not been an official diagnostic construct in either of the two main diagnostic manuals (the American Psychological Association's DSM or the World Health Organization's ICD). This changed in 2018:

In June of 2018, the World Health Organization (WHO) diagnostic system, the International Classification of Diseases and Related Health Problems (ICD) formally introduced a diagnosis of complex PTSD (CPTSD). In ICD-11, PTSD and CPTSD fall under a general parent category of Disorders Specifically Related to Stress.  PTSD consists of 3 core elements or clusters: re-experiencing of the traumatic event in the present, avoidance of traumatic reminders, and a sense of current threat. This formulation conceptualizes PTSD as a conditioned fear response and emphasizes symptoms that tie the disorder directly to traumatic events (Brewin et al., 2009).  CPTSD includes the 3 core elements of PTSD as well as 3 additional elements that reflect the impact that trauma can have on systems of self-organization, specifically problems in emotion regulation, self-concept, and relational domains under conditions of sustained, multiple or repeated traumatic exposure.

Hopefully this will mean that being 'officially' diagnosed will get easier now and we will have coverage for the treatment & services we need.

Reference

ISTSS Position Paper on Complex PTSD in Adults

[Three Roses]

 

[Kizzie]

A great article by Bessel van der Kolk "The Politics of Mental Health" which does a lot to explain why Complex PTSD/Trauma has not been included in the APA's DSM.  Here's an excerpt:

PTSD was a pretty good diagnosis for war veterans, but it was clear that there's a much larger population of traumatized people. For every vet who comes back messed up, there are at least 30 kids who get abused, molested, abandoned, and neglected at home. Even though they're quite different from combat vets in many ways, they show many of the same symptoms. In response to our lobbying, the American Psychiatric Association funded a field trial for a new diagnosis: complex PTSD or DESNOS. After that study was completed, the PTSD committee voted 19 to 2 to create a new diagnosis in the DSM. But to our amazement, that diagnosis was eventually left out of the DSM-IV, despite overwhelming research evidence for a much more complex developmental response to trauma.

[Gromit]

I found a reference to ITQ International Trauma Questionnaire in one of the groups I am in. It helps to distinguish between PTSD and CPTSD, has anyone come across it before?

G

[Kizzie]

It's here for download Gromit - https://static1.squarespace.com/static/56983ac169492ecf0c7dc1c7/t/5ba262de575d1f6ea0cf4298/1537368799744/International+Trauma+Questionnaire.pdf. 

[SeattleGirl]

I feel that treatment can be more effective when the therapist and the patient can dig deep to find the root cause of the diagnosis. I found a therapist who was also a Psychiatrist back in the late 90's early 2000's who understood what was happening to me. I have been a victim of scapegoating in my family so he helped me manage my triggers from the abuse. For many years thereafter, I was unable to find a counselor or therapist who can do this intellectual work to help me, until now. I recently found a therapist who has extensive knowledge in this area of abuse. Often when a victim is scapegoated early in life, they continue to be scapegoated throughout their lives by society. It's a cruel dysfunctional dynamic to experience. My current therapist is working with me to change my mindset so that I eject myself from the scapegoating role. Thus far, I found a really good job that I am successful at. I am able to pick up on the dysfunctions at work and handle it with intellect instead of emotion. It takes a lifetime for victims to undo all the abuse that was inflicted upon them but eventually, we all reach a point where we become more peaceful.

[Kizzie]

Sounds like you have managed to tame the emotional dysregulation we're understandably prone to and identify what triggers you & what you can do about it.       

[Pisa]

I really liked what you said about the need for certain skills in a therapist.
Also, I've had similar experiences as the family's identified patient/scapegoat. I'm really interested to know how things have gone for you. Have you found peace? I need to change my mindset, also, before it eats me alive.