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Stress Disorder More Common in Women

SMMT,
   thanks, good response, causes some reflection.

If this is the criteria:
"1. The person has been exposed to a traumatic event in which both of the following were present:
             1. The person experienced, witnessed, or was confronted with an event or events that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others.
             2. The person’s response involved intense fear, helplessness, or horror"

Given the criteria above then which item are we discussing that would facilitate a PTSD diagonosis in a spouse? My understanding is that one had to be thier. As you have said SMMT the criteria that would best fit is "serious injury, or threat to self or others" dont you need to be at the incident to fall within this area?
 
3rd Horseman said:
No SME here on this issue. Just asking the question and giving my position. Guess I'm the crazy one. I will climb down off my high horse now and realize you must be right and I must be wrong. On that news then I will ensure my spouse gets to the claim centre and gets the help she so well deserves. Obviously their is nothing to question here, you and spud are the authorities on contagious PTSD, thankyou for answering my inquiry.

Never claimed to be an authority there partner, just someone with some empathy for all sides of this type of story. Sorry your attitude is based on stone age philosophy. (That's sarcasm).

I am sorry to hear you have PTSD. That's not sarcasm, I mean that.

potato
 
Spud,

  Sorry for the sarcasm when I included you. Thanks for your concern.

Still trying to define the issue on spouse its not about lack of empathy its about confusing reality. We keep trotting out the criteria and the definition is clouded and the current interpretation appears to be a moving target. I guess it boils down to can you get PTSD after the fact as a separated bystander from the incident due to concern for another. If that is the accepted criteria then it would not be a stretch for a soldier to get PTSD who is very close to his section mates to have not deployed but seen his friend return injured from a war. If that is the case we are opening up a flood gate be it good or bad I don't know.
 
What if the incident is the first time seeing your disfigured, nearly dead husband? Never expecting to see him this way? Feeling the guilt, the helplessness, the uncertainty...

its right here in the criteria you state:

was confronted with an event or events that involved actual or threatened death or serious injury
and
  2. The person’s response involved intense fear, helplessness, or horror"

Certianly plausible, giving a liberal interpretation of the definition.
 
St. Micheal's Medical Team said:
What if the incident is the first time seeing your disfigured, nearly dead husband? Never expecting to see him this way? Feeling the guilt, the helplessness, the uncertainty...

its right here in the criteria you state:
and
Certianly plausible, giving a liberal interpretation of the definition.

I know if I saw my wife come home half blown to smithereens, I would have a very hard time coping. Whether she was down street, or 10,000 miles away when it happened. But that's just me.


potato
 
St. Micheal's Medical Team said:
Certainly plausible, giving a liberal interpretation of the definition.

When you put it in the context of Liberal interpretation I can see how it would be plausible. Be that as it may is a liberal interpretation responsible.
 
Certainly. Esp if it is by a civilian practitioner whose sole purpose is getting their patient into the right specialist for treatment as soon as possible. Remember the military (esp the CF) does not have the majority on PTSD...just the most media sensationalized.
 
The focus of the DSM-IV definition of Post Traumatic Stress Disorder is a single life-threatening event or threat to integrity. However, the symptoms of traumatic stress also arise from an accumulation of small incidents rather than one major incident.

* repeated exposure to horrific scenes at accidents or fires, such as those endured by members of the
emergency services (eg bodies mutilated in car crashes, or horribly burnt or disfigured by fire, or
dismembered or disembowelled in aeroplane disasters, etc)
* repeated involvement in dealing with serious crime, eg where violence has been used and
especially where children are hurt
* breaking news of bereavement caused by accident or violence, especially if children are involved
* repeated violations such as in verbal abuse, physical abuse, emotional abuse and sexual abuse
* regular intrusion and violation, both physical and psychological, as in bullying, stalking,
harassment, domestic violence, etc

One can certainly get PTSD from the significant other.
 
Of course, none of this answers the question of why the spouses are being diagnosed with PTSD more frequently than in the past.

Might I suggest an answer so simple that I can't believe no one brought it up yet?  Could it be education?  Serving member comes home from deployment (healthy, injured, etc) and notices spouse acting differently.  I'm not talking about getting annoyed by the serving member wreaking havoc on the routine that the spouse has had for the past 6 months or so.  I'm talking about the soldier noticing the very symptoms they've been told to keep an eye out for in themselves and co-workers during their redeployment debriefs.  Being aware that there might be a deeper problem, they take steps for their spouse to see someone.

Simple as that.  On top of that, several MFRCs brief families on what the symptoms of PTSD and/or depressive illnesses are to be looked for.  So they are also more aware.

So, sound good?  Thoughts?
 
Strike said:
Of course, none of this answers the question of why the spouses are being diagnosed with PTSD more frequently than in the past.

Might I suggest an answer so simple that I can't believe no one brought it up yet?  Could it be education?  Serving member comes home from deployment (healthy, injured, etc) and notices spouse acting differently.  I'm not talking about getting annoyed by the serving member wreaking havoc on the routine that the spouse has had for the past 6 months or so.  I'm talking about the soldier noticing the very symptoms they've been told to keep an eye out for in themselves and co-workers during their redeployment debriefs.  Being aware that there might be a deeper problem, they take steps for their spouse to see someone.

Simple as that.  On top of that, several MFRCs brief families on what the symptoms of PTSD and/or depressive illnesses are to be looked for.  So they are also more aware.

So, sound good?  Thoughts?

Sounds good Strike. The exact same reasons more soldiers are now being properly diagnosed and treated. Education.
 
Such a simple answer.  Of course, it took a woman to find it. ;D
 
Strike,

  You posed a good theory. I would suggest that it is only a portion of the reason though. I would suspect that the change in treatment in the late 90s by therapists to add spouses to the therapy sessions brought spouses into direct contact with medical staff who then diagnosed the PTSD in the spouse. Reasons for this diagnosis is the issue of the original question I posed.
 
Strike said:
Of course, none of this answers the question of why the spouses are being diagnosed with PTSD more frequently than in the past.

Might I suggest an answer so simple that I can't believe no one brought it up yet?  Could it be education?  Serving member comes home from deployment (healthy, injured, etc) and notices spouse acting differently.  I'm not talking about getting annoyed by the serving member wreaking havoc on the routine that the spouse has had for the past 6 months or so.  I'm talking about the soldier noticing the very symptoms they've been told to keep an eye out for in themselves and co-workers during their redeployment debriefs.  Being aware that there might be a deeper problem, they take steps for their spouse to see someone.

Simple as that.  On top of that, several MFRCs brief families on what the symptoms of PTSD and/or depressive illnesses are to be looked for.  So they are also more aware.

So, sound good?  Thoughts?

Sounds great.  I think it's great that you bring the MFRC connection into the mix. 
Health professionals who work with the families of deployed members have long recognized the effect that deployments/injuries can have on the families back home. Programs and counselling services are made available because the seriousness of the impact on spouses has been recognized.  I also haven't heard one person in this thread dispute the fact that the spouses of injured CF personnel experience emotional trauma and stress- and I don't think you'll ever hear a logical person even remotely associated with the military ever say such a thing.
I once worked with a very caring psychologist who was very quick to stress that you must always treat the symptoms - not the label.  Every psychologist or psychiatrist could, through individual bias or interpretation- assign a different diagnosis to the exact same patient. Psychiatry is an inexact science.
Some might call it PTSD, or some might call it panic attacks, some might call it severe situational stress.  The point being, every one of us can likely come up with a definition from a fairly credible source that will fit our own personal idea of what PTSD is, or make an argument for it.
If the treatment of the symptoms are the same, does it matter? 
This is not meant to be a flippant remark.  It is a serious question.  Is it more validating to have such a diagnosis assigned-rather than have it simply labelled as very well deserved situational stress?
I'm on the fence on the whole issue of spouses claiming PTSD, simply because there are so many variables involved.  I will emphatically state that I know spouses can have severe reactions and emotional fall-out from facing the injuries sustained by wounded soldiers.  I was a military spouse- I know that just worrying about my husband on deployment was stressful enough- never mind if he had been hurt.  Am I ready to call it PTSD though- not yet. To me-it kind of takes away from the seriousness of what the actual initial victim experienced.  My opinion only-still ruminating on it.
I understand that an actual DSM-III diagnosis will make a difference when it comes to disability claims through SISIP and VAC-for the CF member.
There have been implications in this thread that spouses can benefit financially from a diagnosis of PTSD that stems from the trauma of seeing a loved one wounded in action or while serving.  Any basis to these implications? I'm aware that a fixed additional amount is applied to disability awards in recognition of the impact that a member's injury has on the family-but that is through the member's disability award.  To imply that a wife or husband of a wounded soldier will benefit financially from a diagnosis of PTSD seemed out there to me.
 
The Librarian said:
Another successful trainee I see.  ;D

A trained man is like a good utility knife. You may have to carry him around for years, but once in a while he does come in handy!!

potato
 
3rd Horseman said:
Strike,

  You posed a good theory. I would suggest that it is only a portion of the reason though. I would suspect that the change in treatment in the late 90s by therapists to add spouses to the therapy sessions brought spouses into direct contact with medical staff who then diagnosed the PTSD in the spouse. Reasons for this diagnosis is the issue of the original question I posed.

You just reinforced what I said -- education leads to more diagnosis.  Add the spouse into the therapy and they are more educated and more likely to get help if required.

Same answer, different words.
 
So, I thought about it, and I came up with some info...

First, an article that basically states the same as the article in the first post...except it gets more in depth into why women react differently to stress- the hows and whys.

http://www.healthyplace.com/Communities/Anxiety/women_ptsd.asp.

Second, an article from a med journal, 1991, stating quite clearly that it (PTSD) "is also seen in those who provide care to trauma victims, such as police officers, firefighters and hospital trauma unit personnel, as well as in the spouses and children of persons suffering from the disorder".

http://www.findarticles.com/p/articles/mi_m3225/is_n5_v44/ai_11666492

This second is quite outdated, but it shows that what we've been discussing is not a new phenomenon.  The original DSM-III has gone through many revisions-The DSM-III diagnostic criteria for PTSD were revised in DSM-III-R (1987), DSM-IV (1994), and DSM-IV-TR (2000).

I hope you find it relevant nonetheless.

The many revisions on PTSD criteria also shows that the diagnostic criteria are an ever changing thing-proving that all the education is making a difference, and that differences in presentation, cause, and severity of PTSD are being defined.

For those fence sitters like me, I think it's relevant to note that there are subtypes of PTSD.  There are three types of PTSD: acute, chronic, and delayed onset. In acute PTSD, symptoms last less than 3 months. In chronic PTSD, symptoms last 3 months or more. In delayed onset PTSD, symptoms first appear at least 6 months after the traumatic event.

I hesitated on this one simply because I didn't want the significance of the PTSD diagnosis to be diluted or diminished in any way.  It took a long time to get the disorder recognized and accepted - to think that others were jumping in to benefit from it made me pause.  A bit judgemental of me, I realized, so I thought I'd research it a bit.









 
There is also Complex PTSD. The term Complex PTSD (formerly referred to unofficially as Prolonged Duress Stress Disorder or PDSD.

It's widely accepted that PTSD can result from a single, major, life-threatening event, as defined in
DSM-IV. Now there is growing awareness that PTSD can also result from an accumulation of many
small, individually non-life-threatening incidents. To differentiate the cause, the term "Complex PTSD"
is used. The reason that Complex PTSD is not in DSM-IV is that the definition of PTSD in DSM-IV
was derived using only people who had suffered a single major life-threatening incident such as Vietnam
veterans and survivors of disasters.

It seems that Complex PTSD can potentially arise from any prolonged period of negative stress in which
certain factors are present, which may include any of captivity, lack of means of escape, entrapment,
repeated violation of boundaries, betrayal, rejection, bewilderment, confusion, and - crucially - lack of
control, loss of control and disempowerment. It is the overwhelming nature of the events and the
inability (helplessness, lack of knowledge, lack of support etc) of the person trying to deal with those
events that leads to the development of Complex PTSD. Situations which might give rise to Complex
PTSD include bullying, harassment, abuse, domestic violence, stalking, long-term caring for a disabled
relative, unresolved grief, exam stress over a period of years, mounting debt, contact experience, etc.
Those working in regular traumatic situations, eg the emergency services, are also prone to developing
Complex PTSD.

http://www.bullyonline.org/stress/ptsd.htm
 
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