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  #1  
Unread March 6th, 2007, 10:29 PM
James Pretzer James Pretzer is offline
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Default Controversy regarding PTSD

The new edition of the Journal of Anxiety Disorders (2007, Volume 21, number 2) is a special issue "Challenges to the PTSD Construct and its Database." Apparently, recent research raises a number of questions regarding PTSD such as: Is PTSD caused by traumatic stress? How is dissociation related to PTSD? Why does the NVVRS study show that 30.9% of Vietnam Vets developed PTSD when only 15% of them were assigned to combat units? Is there a problem with "pseudo-PTSD"? and Do diagnostic criteria for PTSD need to be revised?

This certainly is a topic with potential for heated debate.
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Unread March 8th, 2007, 11:09 AM
Fionnula MacLiam Fionnula MacLiam is offline
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Default Re: Controversy regarding PTSD

I had a look at the Journal. There seems to be controversy around the diagnosis. This is of interest, but on this side of the Atlantic, where CBT therapists are generally psychologists/mental health nurses with M.Sc in CBT (though quite a few psychiatrists are now and have been CBT trained, often on the same courses) it may not be quite so interesting or relevant. Many of us regard psychiatric diagnoses, whether DSM or ICD, to be derived from a map of a fictional world. We do not work with diagnoses, but with formulations. I wonder if the differences between CBT in the US and Europe are to do with training or with the health care systems or some other factor/s or interplay between all? (this may be a completely different thread...but equally interesting!)
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Unread March 15th, 2007, 09:38 PM
James Pretzer James Pretzer is offline
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Default Re: Controversy regarding PTSD

I don't know if there's a significant difference between the two sides of the Atlantic on this or not. We base our interventions on an individualized formulation but if the problem is one where a body of research has accumulated and there are treatment protocols that usually are effective, we take this into account in developing our formulation and coming up with a treatment plan.

In the case of PTSD, it has been assumed by many that PTSD is a direct result of experiencing trauma and a number of treatment approaches have been developed that emphasize some form of prolonged exposure. Some of the recent research raises questions about the connection between trauma and PTSD. Does this mean we need to revisit the rationale for exposure-based treatment?

I don't think we'll need to re-evaluate exposure-based treatment for PTSD, but if we can understand why trauma sometimes leads to PTSD and sometimes doesn't, this may help us find ways to increase the effectiveness of treatment.
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