Talk:Complex post-traumatic stress disorder

Section 1.3 Attachment theory, BPD and C-PTSD

Section 1.3 is disjointed and needs some clarification and polishing. Why is this idea controversial? Who is for and who is against this idea? What research backs up either claim? Why does C-PTSD's supposed similarity to BPD "[underline] the fragility of C-PTSD as an empirical diagnostic category separate from PTSD"? What symptoms does C-PTSD share with BPD? (And let's keep in mind that we are encouraged to stay away from "weasel words.") The attempt to use attachment theory to explain a commonality between BPD and C-PTSD is poorly written and unclear, as are the last three sentences that attempt to explain the differences between C-PTSD and BPD. 66.225.163.6 (talk) 22:05, 17 February 2013 (UTC)Creta

I would like to add that there is a source problem in this section. Citation #27 is a citation of a citation. The primary source would be Judith Herman's 1992 book Trauma and Recovery. However, I do not believe that the citation in this Wiki article should be changed until there is verification of the wording in the primary source and a clean up done of this section. 66.225.163.6 (talk) 23:33, 17 February 2013 (UTC)Creta

Introduction

The Introduction does a great job of mentioning various situations/circumstances that can lead to what is known as complex trauma, however, I worry about the emphasis that is placed on interpersonal relationships. The term complex trauma is also attributed to long-term exposure to traumatic situations or situations in which someone's life may be threatened. For example, people who live in war-torn countries and/or children living in violent communities. I would just suggest a broadening of the definition a bit. — Preceding unsigned comment added by CelestePoePhD (talk • contribs) 2017-09-26 (UTC)

My edits

I don't understand why you sir, mr. fainites, are so hostile to any adding of ddp to this page. As i mentioned, i think ddp has some support, a study or two, and is a treatment that has some promising material written about it, so why not allow my edit. I thought wikipedia is supposed to allow multiple views, so even if you disagree, why are you the one to decide? Do you own this page? I didn't think that was how this site worked, but if i am wrong, so be it? PranakanLegion (talk) 01:28, 12 December 2010 (UTC)

As pointed out on your talk page, your editing is very similar to that of prior sockpuppets of a blocked editor. Sorry if any of the comments have appeared hostile.

Sockpuppetry aside, there are other concerns, also pointed out on your talk page: The information you want to add needs to meet WP:NPOV and WP:MEDRS. Can we continue by discussing WP:NPOV and WP:MEDRS? --Ronz (talk) 02:40, 12 December 2010 (UTC)

I have read the articles you recommended and it appears that my edits are consistent. The additions are neutral on tone and adequately sourced. So, I've gone ahead and put that material back in. However, if you disagree, please explain how my edit is not neutral or sourced? Also, wasn't your comment on the article on attachment in children when you and mr. fainites removed my edit a violation of the no personal attacks or bad faith or something? you both accused me of vile behavior. PranakanLegion (talk) 07:44, 12 December 2010 (UTC)

As stated I believe you to be a sock of a longterm sockpuppeteer and banned user who repeatedly attempts to add DDP to articles usually with inadequate or inappropriate sourcing. DDP has one old study using inadequate methodology, plus 4 year follow-up. It falls far below any wiki standard required to start including it as any kind of mainstream treatment on either this page or the Attachment-based therapy (children) page. Fainites ^barleyscribs 16:12, 12 December 2010 (UTC)

Ronz, this fainites continues to respond with bad faith and makes personal accusations, see talk page for Complex post traumatic stress disorder where fainites says, "As stated I believe you to be a sock of a longterm sockpuppeteer and banned user who repeatedly attempts to add DDP to articles usually with inadequate or inappropriate sourcing. DDP has one old study using inadequate methodology, plus 4 year follow-up. It falls far below any wiki standard required to start including it as any kind of mainstream treatment on either this page or the Attachment-based therapy (children) page. Fainites barleyscribs 16:12, 12 December 2010 (UTC)" This is bad faith. I don't understand why he acts as if he owns this page and is do vehement about DDP. My reading of the standards for inclusion in an article is that with all the citations I listed it is clearly adequate. My edit is sources and NPOV. This fainites appears to be manufacturing criteria that have nothing to do with written wiki policies. PranakanLegion (talk) 10:11, 13 December 2010 (UTC)

This seems all fantasy now actually, and CPTSD should be removed from the wikipedia, as the DSM 5 is not picking it up, and from the DSM 5 website, they have expanded PTSD to be more child friendly: http://www.dsm5.org/ProposedRevisions/Pages/proposedrevision.aspx?rid=165# and they have created a specific PTSD diagnosis for children under 6: http://www.dsm5.org/ProposedRevisions/Pages/proposedrevision.aspx?rid=396. Reviewing clinical conditions of focus, CPTSD is not on the table: http://www.dsm5.org/ProposedRevisions/Pages/OtherClinicalConditionsThatMayBeaFocusofClinicalAttention.aspx nor conditions proposed by outside sources: http://www.dsm5.org/ProposedRevisions/Pages/ConditionsProposedbyOutsideSources.aspx. This name has no official status it seems, considering DSM V is now in field trials. If CPTSD was going to be an official diagnosis, it would already be listed and part of the field trials with the newly written PTSD criterion. This name should be removed as a good effort, but it didn't stick. Complex trauma is real, but CPTSD as a diagnosis is not it seems, and the APA seem to have taken that stance. —Preceding unsigned comment added by 58.175.234.37 (talk) 10:15, 10 February 2011 (UTC)

it is an acknowledged condition amongst a fair number of academics in the field. The DSM isnt the final word on everything, there are loads of medical syndromes not listed and it doesnt even mention psychopathy.--Penbat (talk) 12:05, 10 February 2011 (UTC)

The ICD isn't picking it up either... so whilst I appreciate the above comments, academics don't make it an actual diagnosis, we aren't talking about a minor thing here, we're talking CPTSD. My point is, its not official, it isn't going to be by the looks of it. Lets face facts, Judith coined the term in the early 90's, and most thought it would make it, I thought it would, but after nearly 20 years of effort, it hasn't. It cannot be diagnosed, because its not recognised in any official capacity for insurance purposes, therefore any legal diagnosis for CPTSD is going to consist as it always has, being PTSD + Dissociative Disorder of some specificity or Axis II + Comorbid Disorders as appropriate, being the only official terms that can be written for insurance purposes. Complex trauma is real, and possibly a more valid subject heading for CPTSD now that both DSM and ICD are not picking it up. There aren't any other diagnostic tools outside those two that the International community really care about in relation to diagnosis. I'm not trying to be argumentative here, but the wikipedia is being speculative by keeping this now vs. factual IAW International diagnostic standards. —Preceding unsigned comment added by 58.175.234.37 (talk) 09:47, 13 February 2011 (UTC)

Complex Trauma hasn't been picked up by DSM V either. I think we need to wait until the final version comes out and then rewrite.Fainites ^barleyscribs 12:16, 13 February 2011 (UTC)

I think the view of many is that CPTSD is too politically awkward to include in the DSM for example it is believed it could open the floodgates for litigation. The DSM is far from perfect and has been strongly criticised for various reasons. CPTSD remains a notable condition amongst some academics. As it stands even regular PTSD is often conveniently glossed over by the authorities. Anyway maybe some aspects of CPTSD will be incorporated into the PTSD defintion for DSM-V. The ICD usually just more or less duplicates the DSM anyway so it would be no surprise that it isnt in the ICD if it were not in the DSM.--Penbat (talk) 12:29, 13 February 2011 (UTC)

It looks as if they're going to expand matters regarding children at least - but necessarily into this vexed area. Any way - this is wikipedia - not DSM-V, or even IV. There is a place for articles about past diagnoses - no longer valid, current controversies, pseudosciences etc etc. Fainites ^barleyscribs 17:29, 13 February 2011 (UTC)

In case anyone's coming here for info, CPTSD is now included in the ICD. https://www.cambridge.org/core/journals/the-british-journal-of-psychiatry/article/icd11-complex-posttraumatic-stress-disorder-simplifying-diagnosis-in-trauma-populations/E53B8CD7CF9B725FE651720EE58E93A4 APA rejected it on money-power-insurance grounds. It's more insidious and entrenched in one's psyche than regular PTSD. 010laura (talk) 23:11, 8 February 2023 (UTC)

Ok, now CPTSD is officially dead from this mythical discussion of a diagnosis, that never contained a single approved medical criterion. The DSM V has included CPTSD as a sub-type of PTSD, called: Posttraumatic Stress Disorder – With Prominent Dissociative (Depersonalization/Derealization) Symptoms. See: http://www.dsm5.org/ProposedRevision/Pages/proposedrevision.aspx?rid=165

There really isn't any more debate on this one now, CPTSD does not exist. PTSD - PDS is the official term coming. There is zero doubt that the ICD will follow suit, thus both mental health manuals will have an official status covering this controversial area. — Preceding unsigned comment added by 120.148.70.125 (talk) 23:18, 15 September 2012 (UTC)

There are still several clinicians who believe C-PTSD is real. The diagnosis is given by psychiatrist in prestigious institutions. To remove the article would be like saying that PTSD didn't exist before 1980. PTSD took almost 100 years to be recognized. C-PTSD as a condition has been out there for a little more than 20 years. You sound like this moderator on a certain PTSD forum. — Preceding unsigned comment added by Sir John Falstaff (talk • contribs) 04:55, 21 September 2013 (UTC)

• • • From someone dx with CPTSD..

---I have my medical records from a prominent psychiatric Hospital in Boston. I took an ink blot test because of proposed hallucinations with my ptsd. Results were; quote: "patient's hallucinations and voices heard are part of the dissociative phenomena associated with of COMPLEX PTSD." My psychiatrist told me i have complex ptsd and it was mentioned by staff many times as I was there for two months. Therefore, in the trauma world of psychiatry, complex ptsd exists. So they put on my chart...dx: PTSD, mood disorder nos, mdd,severe. That's how they do it at this Hospital. On the other hand, DID is in the DSM but there are many skeptical doctors about that diagnosis as well.

203.121.206.252 (talk) 20:37, 14 December 2014 (UTC) - I have a question relating to this information in the opening of the article: "It may be included in the upcoming ICD 11.[citation needed] However, the former includes "disorder of extreme stress, not otherwise specified" and the latter has this similar code "personality change due to classifications found elsewhere" (31.1), both of whose parameters accommodate C-PTSD."

Firstly, the citation for possible CPTSD diagnosis in the ICD 11 is http://apps.who.int/classifications/icd11/browse/l-m/en#/http%3a%2f%2fid.who.int%2ficd%2fentity%2f585833559.

In relation to the statement (the former includes "disorder of extreme stress, not otherwise specified"), is this correct? That to me references the DSM, which does not include DESNOS, or I'm blind, as I have the DSM V in front of me and that is not listed in the alphabetical disorder listings. This document also cites "the latter has this similar code "personality change due to classifications found elsewhere" (31.1)" which does not exist in the ICD 10 CM. The 31.1 range references Bipolar disorders. There is no such listing as personality change due to classifications found elsewhere.

Hope that helps whoever edits this document.

Developmental Trauma Disorder addition to lead sentence

CPTSD isn't a term that is used that generally in the literature regarding trauma. Much more commonly used terms are Complex Trauma and Developmental Trauma Disorder, see, for example

http://www.traumacenter.org/products/pdf_files/Preprint_Dev_Trauma_Disorder.pdf

So, I think adding the aka is helpful for reader to find the relationships among these various terms. OK? AxisOfCharm (talk) 15:55, 19 May 2011 (UTC)

See almost identical issue here.Fainites ^barleyscribs 16:18, 19 May 2011 (UTC)

Under the Treatment for children section there is a link to "developmental trauma disorder (DTD)" but that loops back to the same page, which may be unexpected for the casual reader. It should really lead to a section that discusses the similarity of these terms, as discussed here. Branciforte3241 (talk) 22:24, 16 January 2019 (UTC)

see also section

I alphabetized the list, got rid of some that seemed out of place, and added a couple. Still needs to be shortened more but I think it's better at least. Forgotten Faces (talk) 01:03, 22 January 2012 (UTC)

Name

Admittedly I just archived the page and I could be missing it, but why is this one CP-TSD when regular PTSD is without the dash? Should the page be renamed? WLU (t) (c) Wikipedia's rules:^simple/_complex 13:42, 24 January 2012 (UTC)

Argh, this has been bothering me too. On the PTSD talk page they have argued it to death. I say we change it to CPTSD, no dash. Forgotten Faces (talk) 16:12, 24 January 2012 (UTC)

Was consensus reached on PTSD? Can you link to a talk page section? We can't just move it now, we need the page history retained, which means we need an admin and consensus. WLU (t) (c) Wikipedia's rules:^simple/_complex 16:43, 24 January 2012 (UTC)

Here is the most recent archived discussion. Forgotten Faces (talk) 18:08, 24 January 2012 (UTC)

Want more practice? I'd say throw it to WP:PM to standardize with PTSD. See if anyone screams. 'tis better to beg forgiveness than ask permissino (or, WP:BRD, take your pick). WLU (t) (c) Wikipedia's rules:^simple/_complex 19:08, 24 January 2012 (UTC)

I was going to BRD but it wouldn't let me, so I threw up the proposed move template. Thanks, you are helping me a ton. Forgotten Faces (talk) 19:58, 24 January 2012 (UTC)

Requested move

The following discussion is an archived discussion of a requested move. Please do not modify it. Subsequent comments should be made in a new section on the talk page. No further edits should be made to this section.

The result of the move request was: no consensus for move. Favonian (talk) 23:39, 8 February 2012 (UTC)

---

Complex post-traumatic stress disorder → Complex posttraumatic stress disorder – There has been extensive past debate on the proper naming in the posttraumatic stress disorder talk archive. Consensus is posttraumatic without the dash. relistingAndrewa (talk) 18:42, 1 February 2012 (UTC) Forgotten Faces (talk) 19:56, 24 January 2012 (UTC)

• Oppose per WP:HYPHEN/WP:RETAIN. Both post-traumatic and posttraumatic are acceptable: DSM-IV-TR (Chapter 7) has it unhyphenated ("309.81 Posttraumatic stress disorder") while ICD-10 (Chapter V) has it hyphenated ("F43.1 Post-traumatic stress disorder"). English style guides are similarly split: for example, Chicago Manual of Style prescribes posttraumatic while Guide to Canadian English Usage requires a hyphen when a prefix results in the doubling of a consonant. Some standardized rigour (talk) 07:25, 30 January 2012 (UTC)

I just want it to be consistent with the PTSD page, either way. Forgotten Faces (talk) 11:26, 30 January 2012 (UTC)

I don't see a problem with Posttraumatic stress disorder and Complex post-traumatic stress disorder coexisting under Wikipedia's Manual of Style: WP:HYPHEN explicitly does not endorse either the hyphenated or unhyphenated forms of prefixed words where usage varies. While neither posttraumatic nor post-traumatic is inherently "American" or "British", dictionary preferences reveal that this choice does, to an extent, reflect the general tendency for Americans to drop a hyphen where Britons would retain it:

• American Heritage (US): posttraumatic
• Cambridge (UK): post-traumatic
• Canadian Oxford (Canada): post-traumatic
• Chambers (UK): post-traumatic
• Collins (UK): post-traumatic
• Macquarie (Australia): post-traumatic
• Merriam-Webster (US): post-traumatic
• New Oxford American (US): post-traumatic
• Oxford (UK): post-traumatic
• Random House (US): posttraumatic

However, within each article, usage should be consistent. Some standardized rigour (talk) 07:25, 31 January 2012 (UTC)

• Oppose. Disagree that there is consensus on posttraumatic without the dash, can the nominator give some more specific wikilinks/quotations to/from the archive quoted? I waded through a lot there and found very little in the way of consensus. Andrewa (talk) 18:38, 1 February 2012 (UTC)

The above discussion is preserved as an archive of a requested move. Please do not modify it. Subsequent comments should be made in a new section on this talk page. No further edits should be made to this section.

Forms of trauma: cumulative trauma

I do agree that forms of trauma associated with C-PTSD include physical abuse, emotional abuse, so why not to refer to Khan, M. (1964). Ego distorsion, cumulative trauma and the role of reconstruction in the analytic situation. In International Journal of Psychoanalysis, 45, pp. 272-279. — Preceding unsigned comment added by 151.71.110.39 (talk) 17:41, 27 December 2012 (UTC)

what does the article say? Why add it? Williamsville (talk) 13:59, 18 December 2014 (UTC)

Discussion of treatment needs update

I'm a C-PTSD patient not a practitioner, this comment might affect more than one paragraph but so be it. On a number of external weblogs there's been quite a bit of discussion lately that many of us with C-PTSD also have alexithymia (severe difficulty feeling emotions or understanding them in others, also low creativity). Patients with this condition may find that it makes it next to impossible to successfully pursue most therapies, certainly EMDR in my experience is one, probably CBT as well, I never attempted DBT but I kind of doubt it works either, basically any method where getting a valid answer to the question "how does this make you feel?" will have problems. Now there has been much work recently particularly by Sebern Fisher (she has an informative book out about it, the forward was written by none other than Dr. Bessel van der Kolk) about applying infra-low neurofeedback techniques to the treatment of developmental trauma. I'm in the early stages of such a program so I'm not able to comment yet on its effectiveness but I think the issue of alexithymia itself ought to be mentioned, and perhaps that there are those seeing some relief from neurofeedback techniques especially when other options are not working, I don't wish to be dismissed as "an advocate" because I'm just trying to get well myself but I thought there might be others who could benefit from this information. Jlawton11 (talk) 21:38, 11 October 2016 (UTC)

You'd need a source to back you, not just personal experience...--KimYunmi (talk) 17:44, 15 October 2016 (UTC)

I'm not sure you got my point, this form of neurofeedback treatment works by a computer monitoring electrodes placed on your skull and making subtle changes in the computer display that the patient is observing, and this "incentivizes" the brain to make changes in the observed EEG patterns thereby accomplishing "training" to overcome the fear response and reorganize itself along more natural response patterns (what actually happens is pretty technical but I believe this description is adequate for current purposes). At no time in the therapy is the patient "asked about his feelings" therefore the alexithymia doesn't serve to invalidate the mechanism of therapy. Now I'm personally starting to see some overall benefit from the therapy but my whole point is about recognizing that there exists a way to do therapy which circumvents the mechanism by which the alexithymia invalidates most of them. I don't believe by this formulation of the problem I'm imposing any "value judgments" but I'll try to take another crack at it if you still don't agree.Jlawton11 (talk) 11:54, 8 November 2016 (UTC)

Study distinguishes Borderline, PTSD and c-PTSD

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4165723/

That one. I thought I would put it up for consideration and inclusion. The study found that they could distinguish between comorbidity and individual cases of having just c-ptsd. Published 2014. Because that section of the article is sparse.

Also, it might be worth mentioning that the World Health Organization included c-PTSD as a separate diagnosis from both PTSD and borderline in the lead and in the article in their ICD: Reference: http://www.ptsd.va.gov/professional/newsletters/research-quarterly/V25N2.pdf --KimYunmi (talk) 17:44, 15 October 2016 (UTC)

Causes of C-PTSD

The introduction describing the causes of C-PTSD currently includes victims of parents or guardians with Narcissistic Personality Disorder but there is no mention of relationships with people (especially with a parent or guardian) who have Anti-Social Personality Disorder (ASPD). Perhaps that could be included and/or people with Cluster B personality disorders in general. Cyrus Freedman (talk) 21:30, 25 October 2016 (UTC)

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Maybe the children and adolescent symptoms section could be cleaned up?

In particular, there's the bit about PAS that cites Childress. Besides the bad formatting, I'm struggling to find how it's directly relevant to symptoms of C-PTSD in children and adolescents; to my eye, it looks as though it was meant to be edited into the article about Parental Alienation Syndrome and accidentally ended up here. But it's possible I'm missing something. If the information is deemed relevant, I'd like to fix the formatting, but first wanted to check if others thought it should even be there in the first place. 73.61.15.187 (talk) 01:41, 7 October 2017 (UTC)

BPD and C-PTSD

The entire section was removed and I don't think that is what is best. I propose we trim it down a bit and take out some of the long quote, or summarize it? TantraYum (talk) 19:50, 26 May 2018 (UTC)

I agree. It contains some useful information but is by now extremely unclear. Solus Nisi Ulrich (talk) 07:02, 26 August 2018 (UTC)

Agree. The shortened version makes the section unnecessary and the attached articles don't differentiate the diagnoses like the original section which is pertinent to the article. The original probably should cut down that one reference and retain at least some of the references made in that section, cutting the fat. I added a valid reference to that section originally that was summarily cut without discussion that could help cut it down a bit. If there is going to be a new article--that's different from cutting everyone's work on that section. --KimYunmi (talk) 02:15, 1 October 2018 (UTC)

@KimYunmi I mean considering the debate about what the differences are between the two & the fact that C-PTSD is often misdiagnosed as BPD. Wouldn't it then be ideal to just have a line saying it can be a differential for & confused with BPD and leaving it as that to prevent confusion? 86.14.56.116 (talk) 13:58, 5 September 2022 (UTC)

That was 2018. I fixed it since then since we had consensus and restored and cut down the previous version. Check the dates and edit history. KimYunmi (talk) 18:33, 5 September 2022 (UTC)

I think that this section can still be trimmed down a bit or cleaned up.--Bbettencourt (talk) 04:09, 18 September 2022 (UTC)

Acronym in lead

The lead says "not DNS based" but does not explain what DNS means in this context. I would be appropriate to expand the acronym or to “link” it, I believe. I can’t do this myself, since I am not familiar with the topic. Ariadacapo (talk) 11:43, 2 May 2019 (UTC)

Thanks for pointing this out. The sentence's topic „DNS“ is occuring in is nature versus nurture. Therefore I guess, desoxyribonucleic acid is meant and I altered the acronym accordingly. The person who added that paragraph might also speak German, where DNA is abbreviated as DNS. -- K (T | C) 15:13, 2 May 2019 (UTC)

Terrific :-) Thank you for the thorough and collegial answer, and the edit. Ariadacapo (talk) 19:03, 2 May 2019 (UTC)

Disambiguating CPTSD from other mental/behavioral disorders

CPTSD is related to a number of disorders, and the introduction to this article can do a better job explaining that.

• It encompasses DESNOS (Disorders of Extreme Stress Not Otherwise Specified)
• it encompasses EPCACE (Enduring Personality Changes After Catastrophic Events), which is also called Concentration Camp Syndrome
• It is another name for Dissociative Post Traumatic Stress Disorder. Dissociative Amnesia is a symptom of CPTSD. If PTSD and Dissociative Identity Disorder can be thought of as belonging to a continuum of disorders, with PTSD having an ANP and an EP, and DID having multiple ANPs and EPs. CPTSD is PTSD having two or more EPs.
• CPTSD can come from severe, personality altering extreme stress (e.g., being a prisoner of war, kidnapping), or lower level but more chronic stress (e.g., years of psychological abuse)
• CPTSD can develop from multiple independent traumatic responses interacting with each other, such as witnessing physical abuse as a child and then being in an abusive relationship as an adult.
• CPTSD is commonly called Childhood Post Traumatic Stress Disorder, because it also develop during childhood as a result of exposure to abuse, or from growing up in a Narcissistic household.

Joe Easterly (talk) 19:51, 19 April 2022 (UTC)

References

Introduction II

“…motivations behind such abuse vary, though mostly being predominantly malicious, it has also been shown that the motivations behind such abuse can occasionally be well-intentioned” I don’t think this sentence belongs in the introduction, though maybe in the main article. Motivation for abuses and crimes (or even understanding of perpetrators of the repercussions of their actions) is a complex topic in itself and this sentence is clumsy and not inherent to introducing a basic outline of the topic. 88.104.102.175 (talk) 14:09, 12 May 2022 (UTC)

Propose remove canadian boarding schools

Remove from a principle environment in which C-PTSD develops over "Undue weight" https://en.wikipedia.org/wiki/Wikipedia:Reliable_sources_and_undue_weight

Canadian residential school system is only one of a large number of similar government-sanctioned environments where survivors will risk developing C-PTSD — Preceding unsigned comment added by 81.147.85.176 (talk) 09:15, 12 June 2022 (UTC)

Propose adding Pandemic-Lockdowns

Largest C-PTSD event in modern History.

Discuss appropriateness of including Mandated Pandemic Lockdown induced C-PTSD in this page... — Preceding unsigned comment added by 67.42.69.55 (talk) 21:11, 16 June 2022 (UTC)

You'd need a reference, not merely an opinion. And for some people it might be CPTSD, and others PTSD and some others none at all. Not everyone reacts the same. KimYunmi (talk) 18:35, 5 September 2022 (UTC)

Two Types of C-PTSD:

Such as EPCACE & DESNOS: There is a slight difference in criteria between both. https://www.mind.org.uk/information-support/types-of-mental-health-problems/post-traumatic-stress-disorder-ptsd-and-complex-ptsd/complex-ptsd/ 86.14.56.116 (talk) 13:52, 5 September 2022 (UTC)

Proposal: For this C-PTSD Article to be merged into PTSD

Perhaps as a sub-section, or as a type of variant for it. 86.14.56.116 (talk) 13:54, 5 September 2022 (UTC)

Article still does not accurately reflect the controversy

This article needs to be focused on what the term "complex PTSD" refers to, which is a proposed condition and/or a theoretical construct. Most of the citations are from Judith Herman, whose claims about PTSD are highly controversial.

Yes, it was recently included in the ICD, so calling it a "proposed condition" in the article may not be necessary. But the article needs to acknowledge that the slim number of citations it was able to procure, including expert opinions as well as original research, do not necessarily represent the consensus.

The article takes for granted some dangerous assumptions about PTSD, namely that it is limited to very specific traumas (it's not), that it is a rigid construct that cannot evolve (it has, per the much better cited PTSD article), and that it is easily treated (treatment is for individual symptoms, not the overall condition). It bases these assumptions on individual opinions, not consensus, and does allow PTSD experts, who typically oppose the splitting of PTSD into two labels or grudgingly tolerate it, to be represented here.

To a lesser extent, it does this for BPD. Stigmas of and misconceptions about BPD played a huge role in the development of C-PTSD as a distinct clinical entity. These misconceptions of BPD are addressed on the article for that condition, but not here, which to me says that this article was created entirely by combing the internet for supporting evidence and ignoring how controversial this label still is.

I think that, rather than focusing on the controversy itself, the article should reframe the condition in terms of clinical practice. It is not okay to say "PTSD does or does not include such-and-such symptoms" without providing clear evidence, but it is okay to make claims about C-PTSD, like, "C-PTSD is increasingly used to diagnose cases where prolonged trauma has occurred, rather than using the older diagnosis of PTSD." This is a fact, per its inclusion in the ICD and increased rate of diagnosis, and bypasses the controversy in a way that will probably keep the page from being a "validation project" for one side of the argument, as it is now and largely has been.

This is not an attack on Herman or the practical utility of C-PTSD as a distinct clinical entity. It's a counterattack on a fringe movement that is obsessed with invalidating the PTSD community based on decades-old research. — Preceding unsigned comment added by 2603:7081:1603:A300:D02E:367C:7CE4:2B16 (talk) 14:40, 24 January 2023 (UTC)

My cynical take is that the cottage industry surrounding CPSTD is just another scam aimed at exploiting vulnerable marks. What with the supposed "therapies" and the TedX talks. Classic grifter BS.

95.193.130.244 (talk) 16:05, 21 January 2024 (UTC)

Thats very interesting and prevalence in opinion

Naming for wartime PSD, but I don't understand how the term "somatization" apears in it, I don't agree. And to edd to this, but a different topic, I don't understand why, scientifically, psychology has to be understood as mainly American, I don't believe psychology is what americans understand right now, also you in US has very little knowledge in medicine and this is obvious in your psychological articles. I don't even like the amercain stile of writing, I don't think most of it is correct, in fact I think it is mostly not right, but some terminology still is good, however the quality is getting too low, because of this "claim that psychology is an American discipline". It is not also true that American is contrary to Russian psychology, I've noticed how Medvedevian politicians, administration and "psychologists" rely to American psychology, they also tend to claim that "it cures them medically" this is not true, they seek the closest medician who also reads psychology to "paranormally" and with mental efford cure them, which is beyond....unpolite. Also they use American psychology for dictatorship Russian pupouses. And not only they, what about even Prince W. whos people would take American psychology to press on Russian communists with Russian psychology? And categorise communists as sick based on these ideas, but US is a federal republic? Yet, in psychology looks like it isn't. It is normal that everyone wants to read psychology and psychological advices, and what this one would find with these tendencies.

I dont agree that American psychology is entirely pure and without political dictatorship methods, in fact it serves most of the time RUssian politics, it is so very obvious, that it looks offensive, even. Psychologynewartnotice2 (talk) 16:03, 23 February 2023 (UTC)

Syntax/happening and ICD-date issues

Hi @7e8y: I'm moving this discussion to this page as it's much easier than communicating through the short summaries.TempusTacet (talk) 19:22, 27 April 2023 (UTC)

Hi TempusTacet!! Thank you for your contributions, they improved the text meaningfulness and gave me some fun;-). 7e8y (talk) 12:29, 28 April 2023 (UTC)

Syntax/happening issue
You wrote: I do agree that the verb 'to develop' fits the contextual use but the Wikipedia’s first sentence becomes too close to the ICD-11's first sentence... Please, consider that the verb 'to happen' also fits this contextual use from [https://dictionary.cambridge.org/dictionary/english/happen]. It strikes me as unusual to state that "a disorder is happening in response to something". I don't think I've ever come across that in spoken or written language. Do you have examples where "happening" is used like that? (I'm not claiming it's wrong or isn't common, I'm more than happy to learn that it is!) Usually, as far as I'm aware, a disorder either "develops" or "occurs". While I'm not a fan of blindly copy-pasting definitions from the ICD or DSM to Wikipedia, in this case, I believe the fact that the ICD states that CPTSD is something that "develops" is a strong argument in favor of using that verb. It's also one of the rarer cases where the lay person's understanding and the scientific meaning are closely related. It's very common to say e.g. "I developed a headache due to stress" or "I developed a fear of something". TempusTacet (talk) 19:22, 27 April 2023 (UTC)

Thank you for pointing out a potential syntactic awkwardness of mine. You gave me the opportunity to improve. The Cambridge University Press 2023’s English dictionary’s definition of the verb to happen ‘theoretically’ fits this contextual use. Moreover, I performed a Google Scholar search with the search query “disorder happens”; I got 652 results. Unfortunately, most of the returned papers on the first two pages were not in very popular scientific journals, and this syntactic expression targets both psychological, biological and even medicine-unrelated phenomena... When I performed a Google Scholar search with the search queries "disorder develops" and "disorder occurs"; I got more results (i.e. respectively 4 370 and 20 100), more popular scientific journals, and more scientific papers about psychological/psychiatric disorders. In this context, using "disorder happens" is socially and scientifically acceptable, but using the verb "to develop" or "to occur is definitively better in practice; just like you said!! If we want to provide a semantically correct definition while syntactically differing from the ICD-11, we should use "disorder generally occurring"... What do you think? 7e8y (talk) 12:29, 28 April 2023 (UTC)

Thanks for introducing so much factual information. I'm fine with either "generally occurring" or "generally developing".--TempusTacet (talk) 09:00, 4 May 2023 (UTC)

Thanks again for this constructive exchange; I will apply "generally occurring". 7e8y (talk) 12:31, 4 May 2023 (UTC)

ICD-date issues
You also wrote: ii.wholesomeness – i.e. please pay attention in your edit summaries to ambiguities, e.g. I have never claimed that CPTSD was in the DSM. I have never stated that you claimed that CPTSD was in the DSM. I added this fact to the article that previously just claimed that CPTSD had not yet been added to the DSM-5. That second statement is, of course, also correct, but much narrower than "To date, CPTSD has never been recognized in the DSM". TempusTacet (talk) 19:22, 27 April 2023 (UTC)

I do agree with you. Also I was already sure that you are kind person!! My message was: pay attention with this kind of circumstantial writing (even though it was illustrative), because other people read. It sounds like 7e8y does not understand one point about the ICD, and 7e8y sounds also misunderstanding the same point about the DSM;-). In short, we should avoid circumstantial writing in the ‘edit summaries’ (only;-).

The problem occurred when you wrote that CPTSD (and other mental disorders) in the ICD-11 came into effect in 2022. This is scientifically not relevant because researchers and health-care providers have had an online access to the definition (and thus to the capability of moving the topic forward or of looking for suitable treatments through the literature) since 2018. It could be socially relevant if someone explained to the readers that both health-care providers and patients could expect benefiting from an acknowledgement (which includes health-reimbursement issues) of CPTSD by their health systems from 2022. However, I am afraid that health-care providers and patients would have to wait, and the date for this acknowledgement is countries/governments- and private-insurers-dependent... What do you think? 7e8y (talk) 12:29, 28 April 2023 (UTC)

Thanks for elaborating, this is a perspective I hadn't considered. I'll make sure to keep that in mind when phrasing summaries!

I understand your concern regarding the mention of years. For the general public it's difficult to understand how diagnoses are developed and that there are several stages of becoming "official". I believe the current "Classifications" section does a good job given its brevity, leaving the reader with the impression that CPTSD has recently been recognized by the WHO and was previously already recognized by major organizations.

I'm not sure whether this Wikipedia article is the right place to discuss that it will still take years until all countries in the world have moved their healthcare systems to ICD-11, thus allowing people to be formally diagnosed with CPTSD instead of some related condition. If not done carefully this could easily lead to the misconception that CPTSD and appropriate treatment "does not exist" in these countries just because it is not possible to officially diagnose someone with CPTSD.--TempusTacet (talk) 09:00, 4 May 2023 (UTC)

Well, do not worry too much for the ‘edit summaries’; ambiguities always happen because of the brevity the limit of 500 Unicode codepoints imposes;-). Indeed, the current section on ‘classifications’ is sufficiently informative. Mentioning both the date of the scientific acknowledgement/availability and of the administrative acknowledgement/release by the WHO is a good idea. It gives some clues to the readers about the existence of an additional delay, before the countries/governments and private insurers acknowledge CPTSD too. Besides, the subsection on the ICD-11 version of the ICD already highlights this issue. The purpose of my text (above), was just to share with you the rationale about the importance of mentioning the date: 2018. 7e8y (talk) 12:31, 4 May 2023 (UTC)

Differentiation with Borderline personality disorder

The argument currently displayed:

However, CPTSD and BPD have been found by some researchers to be distinctive disorders with different features. Those with CPTSD do not fear abandonment or have unstable patterns of relations; rather, they withdraw.

Repeated use of withdrawal as a defense mechanism may in fact cause unstable patterns in relationships. And it certainly makes sense to use withdrawal as a defense when fearing abandonment. See avoidant or disorganized attachment styles. 142.117.46.145 (talk) 21:45, 16 January 2024 (UTC)

The article also takes for granted that fear of abandonment is the defining feature of BPD, when in fact it is not even required for diagnosis. Essentially it is a stereotype that just happens to have a lot of basis in reality, like someone with OCD washing their hands a lot. That study in particular, while technically a reliable source per Wikipedia, has done a lot of damage to people with BPD.

People are highly defensive of CPTSD and it is incredibly hard to make any constructive additions to this article without summoning activists. Reading this, you would think the discussion on what separates it from existing diagnoses is settled and North America is just too stupid to realize that. In reality, it's an ongoing discussion and progress is very slow in determining what is actually the best course of action for people with severe PTSD, childhood PTSD, or BPD that appears to be linked to childhood trauma. 2603:7081:1603:A300:88EC:74E:2AD5:A9A5 (talk) 15:29, 3 May 2024 (UTC)

Wiki Education assignment: BMSC 4309 Nutritional Biochemistry and Metabolism

This article was the subject of a Wiki Education Foundation-supported course assignment, between 17 January 2024 and 9 March 2024. Further details are available on the course page. Student editor(s): Bacteriaburst (article contribs).

— Assignment last updated by DoctorHeck (talk) 17:45, 20 February 2024 (UTC)

Emotional invalidation as a cause?

The article includes emotional abuse as a cause, but does not include chronic emotional invalidation. Are these two distinct, and if so, should the article name emotional invalidation as a cause? Sweet petunia (talk) 17:04, 8 November 2024 (UTC)

@Sweet petunia From my understanding of CPTSD and emotional abuse, emotional invalidation can be a form of emotional abuse. IntentionallyDense (talk) 21:27, 8 November 2024 (UTC)