Posttraumatic Stress Disorder Diagnosis and Assessment (2006) / Chapter Skim
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Appendix B: Establishing Posttraumatic Stress Disorder as a Psychiatric Disorder
Appendix B: Establishing Posttraumatic Stress Disorder as a Psychiatric Disorder
Pages 47-58
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From page 47... ...
Its introduction was based on clinicians' informal experience with groups of Vietnam veterans and Holocaust victims rather than on formal studies (Brewin 2003; Shepherd 2001)
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48 PTSD: DIAGNOSIS AND ASSESSMENT the field of psychiatry to split with its nonscientific past and, through more systematic data-based studies, achieve an equal footing with the rest of medicine (Luhrmann 2000)
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CORE CLINICAL FEATURES Defining a disorder begins by describing individual cases and then proceeds to the gathering of more data. In the 1970s, clinicians treating Vietnam veterans described two core symptom clusters: reexperiencing a trauma through flashbacks and other symptoms, and reacting to the reminders of the trauma with avoidance (avoiding thoughts, feelings, or conversations about the traumatic event or situations that remind one of it)
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Those studies of veterans from different countries and numerous other populations and traumatic events support the concept of PTSD as a distinct disorder. DIFFERENTIATING POSTTRAUMATIC STRESS DISORDER FROM OTHER DISORDERS A valid disorder is one that is distinct from others with similar symptoms, rather than merely another manifestation of them.
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PTSD ASSESSMENT INSTRUMENTS 51 does not preclude the validation of PTSD as a distinct disorder, but it makes the process of demonstrating its distinctiveness more difficult. A study (Keane et al.
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In other words, no laboratory test is currently useful for diagnosing PTSD. DEMONSTRATING TEMPORAL STABILITY OF POSTTRAUMATIC STRESS DISORDER Temporal stability is related to whether a disorder retains its distinct profile or evolves into another, established disorder.
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DETERMINING WHETHER POSTTRAUMATIC STRESS DISORDER AGGREGATES IN FAMILIES The fifth phase in validating a disorder is to determine whether it aggregates in families (Robins and Guze 1970)
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54 PTSD: DIAGNOSIS AND ASSESSMENT Twin studies help to sort out the relative contributions of shared genes versus shared environment. In one study of more than 4,000 twins during the Vietnam era (True et al.
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2003. Posttraumatic Stress Disorder: Malady or Myth?
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1989. Familial psychiatric illness in chronic posttraumatic stress disorder.
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2003. Predictors of posttraumatic stress disorder and symptoms in adults: A meta analysis.
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2004. Persistence and change of PTSD symptomatology -- a longitudinal co-twin control analysis of the Vietnam Era Twin Registry.
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