Talk:Post-traumatic stress disorder/Archive 1

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refugees and rape/sexual assault/forced prostitution survivors

It makes me very sad that there isn't much discussed about refugees and rape/sexual assault/forced prostitution survivors. These are also very very important, and sadly very common members of the PTSD community. I do not have great official information on it, but I hope someone who does will add to the main article!!! - L (8Dec06) Lulashome 01:12, 9 December 2006 (UTC)

TIR and Scientology

"TIR is derived from Scientology " - is this actually true? A therapy for treating PTSD is derived from a cult? This claim seems dubious.

I would like to see some evidence for that claim or that sentence amended.

>> I determined this because the TIR page is part of the Scientology series. I understand that it should not be removed, but there's no reason at all to not allow the Scientology information when the link goes to "Frank A. Gerbode developed TIR by investigating Dianetics and working back to the origins of the Dianetics technique, then in use by the Church of Scientology. Until 1982 he had been a member of the Church of Scientology, at one time running the Palo Alto Mission of Scientology. After his departure, the Church of Scientology sued Dr. Gerbode; the suit culminated in a settlement in 1994." I am re-adding the material.128.194.40.189 02:43, 1 February 2007 (UTC)

organic cause and behavioral drugs

Moved here. First of all, it's not certain that some people aren't predisposed to PTSD for organic reasons, and there has been a lot of research on how stress causes organic changes in the brain. Second, it's not true that behavioral drugs are of little value in long-term psychiatric care.

I left the part about drugs being generally ineffective in the article.

as the disorder does not arise from any organic cause and behavioral drugs are of little value in long-term psychiatric care.

triggers in PTSD

Does anyone have any info on "triggers" in PTSD? The idea is that certain images, words, etc, may trigger PTSD victims into flashbacks, etc. I'd add something, but I've only heard about it from the satanic ritual abuse community, so I wonder on its wider prevalence... Martin 15:31 9 Jun 2003 (UTC)

"The idea is that certain images, words, etc, may trigger PTSD victims into flashbacks, etc." That's precisely it. Anything that reminds a victim of the trauma may lead to re-experiencing the trauma. It is this triggering that leads PTSD victims to avoid places/objects/people that remind them of the trauma. An example (from a documentary on PTSD I watched some time ago) would be a Vietnam war veteran having a flashback to a war experience triggered by the sound of a car door slamming closed (sounded somewhat like a gun shot). Or (making this one up) a rape victim flinching back from a harmless person who happens to share some facial features with her attacker. -- Kimiko 07:47 15 Jul 2003 (UTC)

EMDR and PTSD treatment

AFAIK, EMDR is not (at the very least not yet) the treatment of choice for PTSD. Exposure and response prevention are still the most used treatment for PTSD, like they are for most anxiety disorders. Could whoever put that assertion there provide some data to back it up? -- Kimiko 07:47 15 Jul 2003 (UTC)

An anon user replaced:

Two of the most successful techniques for the treatment of trauma are EMDR and TIR:

EMDR(Eye Movement Desensitization and Reprogramming) is a technique developed by Dr Francine Shapiro in which the client uses the movement of his or her eyes to access the traumatic event and allow the integration of emotions and sensations that occurred during the traumatic event. Continued research has validated the success of this technique and it is becoming the treatment of choice for PTSD.

with:

Two of the most controversial techniques for the treatment of trauma are EMDR and TIR:

EMDR (Eye Movement Desensitization and Reprogramming) is a technique developed by Dr Francine Shapiro (Her doctorate was earned at the now defunct and never accredited Professional School of Psychological Studies. Her undergraduate degree is in English literature.) in which the client uses the movement of his or her eyes to access the traumatic event and allow the integration of emotions and sensations that occurred during the traumatic event. EMDR is controversial and not accepted practice by the American Psychological Association.

Some of this user's other edits have been slightly suspicious. Could someone who knows about this subject please check if this is accurate. - Efghij 03:11, 8 Aug 2003 (UTC)

EMDR (and probably TIR as well, although I hadn't heard of that before) is somewhat controversial still. It has been shown to have some effect, although it is still unclear how it works. The eye movements don't seem to be necessary, and the rest of it is simply imagined exposure, which is used in the treatment of most anxiety disorders.

So, there is some truth in the above text. However, calling EMDR on of 'the most controversial' techniques seems a bit too much. The remark about dr. Shapiro's credentials is irrelevant to this article, ad hominem regarding EMDR, and copied verbatim from the linked skepdic site.

I'll edit it a bit to tone it down. -- Kimiko 06:08, 8 Aug 2003 (UTC)

---

Hello!! EMDR Is a very good treatment for PTSD, it seems to be one of the fastest and most effecient their is, ofcourse being treated by a good therapist... The eye movement isnt necessary there is also a technique where the therapist is touching the clients hands or legs. The important thing is to repeatedly touch the left and right side, its the same with the eye movement. A traumatic memory is just memorized in the right side of the brain,(a normal is memorized both in left and right side) and its surrounded with triggers that can cause a anxiety, flashbacks, panicattacks. So this techniqe simply puts the memory where it suppose to be. It does have a good survivalfunction, you react fast and like an animal, but its not good in the longterm.But still It do fill a function. I speak of experience, I have suffered from severe PTSD for 18 years, including nightmares. After 5 EMDR sessions last year 95 % of my nightmares disappeared, and alot of other sympthoms improved aswell,so I can RECOMMEND it!!!! cause I have tried it all.... H

I have added a reference to Spike Milligan in the reading section. Prune 22:43, 30 Nov 2003 (UTC)

Short comments that don't require extra explanation like this one (^) can be put in the Summary: field below the edit box. --Kimiko 09:53, 1 Dec 2003 (UTC)

great resource site

Hi, I added an external link to an article at eMedicine Health on Post-traumatic Stress Disorder for anyone interested in reading more about it. This is a great resource site for various conditions and diseases. All of the content is written and edited by real physicians.

question re: traumatic events and PTSD

Hi, I was just wondering... would the traumatic event have to involve actual or threatened death to yourself to possibley develop PTSD? Or could you also develop PTSD from a traumatic event in which your family (but not you) dies or are tortured or whatever?

PTSD is fundamentally a state where the body's "flight or fight" response doesn't return to its baseline, while the mind simultaneously experiences an obsessive psycho-social thought focus associated with that initial "flight or fight" reaction. So, the short answer is, "Yes", to both. --DashaKat 20:24, 21 June 2007 (UTC)

Veterans and Politics

There is an interesting parallel between this section and the history of the term posttraumatic stress disorder. "traumatic war neurosis" had been removed from the DSM during the Vietnam War, which then prevented claims for this problem. Through the efforts of Chaim F. Shatan and others, "posttraumatic stress disorder" was added to subsequent DSM's. Remember that the classification of disease is both political and scientific!Pustelnik 14:43, 20 October 2007 (UTC)

critique of current article

Here are my thoughts on reading the article.

• The name is not the accepted spelling used in DSM-IV, which is posttraumatic stress disorder.
• PTSD is not the same as shell shock, battle fatigue or operational exhaustion. Combat stress reaction (CSR) is the generally accepted military psychiatry term for this nowadays. The DSM-IV nearest equivalent of this is acute stress disorder but they are not the same thing although there is overlap.
• The stress does not have to be life threatening but can involve serious injury.
• The symptom list is more complex and also includes things like avoidance and hyperarousal (although this latter may be covered by "extreme distress").
• Brief reactive psychosis is not really related to PTSD but the sentence is correct otherwise but is more misleading than informative.
• There is no mention of delayed onset PTSD.
• Again "shell shock" is raised. The modern approach to (CSR) in the military is the PIES approach of proxity, immediacy, expectancy and simplicity. In the US other acronyms such as BICEPS are used but have basically the same approach. CSR is most definitely not treated as if it will lead to a more serious condition but the opposite is the case. Expectancy implies that everyone expects the soldier with CSR will get better soon. A few don't and they may go on to be diagnosed with ASR (and later possibly PTSD) or a brief reactive psychosis or even schizophrenia.
• Comorbidity is high in PTSD with alcohol abuse and depression being the most common comorbid disorders.
• The standard treatment for PTSD is a combination of antidepressants and cognitive behavioural therapy. EMDR was initially proposed as a cure but has now slipped back into being yet another useful treatment. I confess that I have not heard of TIR but then scores of new therapies have been suggested over the years as being effective in the treatment of PTSD.
• More recently there has been promising work aimed at treating the nightmares by helping PTSD sufferers change the "script" so that there is a resolution to the nightmare. Studies have shown that this not only results in fewer nightmares but also a general reduction in symptoms.

OK folks. I propose a separate article on CSR and a clearer article on PTSD with DSM-IV criteria and the above included. Comments please --CloudSurfer 10:54, 25 Sep 2004 (UTC)

Below is the original opening before I changed it.

Post-traumatic stress disorder (PTSD), formerly and colloquially called shell shock (this is a World War Oneterm), battle fatigue (World War II), and operational exhaustion (Korean War) during war, is a term for the psychological consequences of exposure to stressful, life-threatening and traumatic experiences. Symptoms include nightmares and flashbacks, sleep abnormalities, extreme distress resulting from personal "triggers", and emotional detachmentwith the possibility of simultaneous suffering of other psychiatric disorders. Experiences likely to induce the condition includerape, combat exposure, and childhood physical abuse. Unlike brief reactive psychosis, PTSD is a chronic condition.

PTSD is distinguished from normal grief and adjustment with traumatic events in that the normal emotional effects of traumatic events will tend to subside after several months or years, while in PTSD the emotional effects are ongoing. Most people who experience traumatic events will not have PTSD.

In earlier times and even today, "shell shock" among veterans has been regarded as simple cowardice, an unwillingness to put one's welfare at risk when danger is at hand. The modern psychological evaluation disagrees strongly. Shell shock is a mental condition in which the individual involved is perilously close to a break from reality, usually by succumbing to any of severalneuroses or psychoses.

PTSD was first recognized in combat veterans following many historical conflicts; the term "shell shock" dates to World War I. At first, the medical community believed that shell shock resulted directly from the stress caused by the noise of repeated shell explosions. The modern understanding of the condition dates to shortly after the Vietnam War. PTSD may be experienced following any traumatic experience or series of experiences that do not allow the victim to readily recuperate from the detrimental effects of stress. It is believed that of those exposed to traumatic conditions, around 9% will experience some symptoms. In peacetime, 30% of those that suffer will go on to develop a chronic condition; in wartime, the levels of disorder are believed to be somewhat higher.

Above this is the original opening.

--CloudSurfer 12:57, 26 Sep 2004 (UTC)

I'd like to have more in the article on the script-changing-approach of nightmares that you mention. I think it can improve the condition.--Fenice 14:54, 26 Sep 2004 (UTC) I just found it - it is already in the text.--Fenice 15:14, 26 Sep 2004 (UTC)

PTSD a "a disorder of grief"?

the following "synonym":

'PTSD is also known as NBD (No Backbone Disorder)"
This smacks of falsehood to me - even if this is a term for PTSD sufferers, isn't it somewhat derogatory and judgemental?

this sentence:
PTSD is distinguished from normal grief and adjustment with traumatic events in that the normal emotional effects of traumatic events will tend to subside after several months or years, while in PTSD the emotional effects are ongoing.
It makes it look like PTSD is just prolonged grief and an adjustment problem; I think it plays down the desease.--Fenice 14:54, 26 Sep 2004 (UTC)

Yes, I agree. PTSD is an anxiety disorder not a disorder of grief. It can have comorbid depression and some of the features of PTSD are similar to grief but that is not the core issue. Please see my changes. --CloudSurfer 02:06, 27 Sep 2004 (UTC)

Diary link removed

I have just removed this link:

• Post Traumatic Stress Disorder A daily journal by a woman suffering from PTSD

While personal stories are sometimes helpful their role in an encyclopedia is limited. It would appear that this woman is suffering from more than a simple case of PTSD. Thus I felt it was a potentially confusing link. Please have a look at it and see if you agree or disagree. --CloudSurfer 08:45, 30 Sep 2004 (UTC)

Symptoms or Effects

I was wondering if somone could post some symptoms or effects to PSTD for a short story i'm writing. THNX --Jakob03 08:40, 23 March 2005

Dude, read the article. --Brasswatchman 00:13, August 14, 2005 (UTC)

PTSD prophylaxis (especially in the military)?

Has anyone developed a preventative therapy for post-traumatic stress disorder - essentially, some sort of form of psychological education that might help individuals cope with PSTD, or make them less likely to contract it? For example, is there any content about PSTD during basic training in the United States military? Thank you. --Brasswatchman 00:13, August 14, 2005 (UTC)

Brasswatchman, Military organizations have surely been working on types of "preventative" approaches to PTSD for some time, and in a major way military training is already designed to minimize normal reactions to traumatizing events. I'm not sure, although, preventative training would be very appealing to know about... in that the general trend of military training is to dehumanize people, numb emotional reactions, and simplify thought processes. In the end I'm probably just as curious as you are, it would be good to expose whatever training solders are having to go through. I'm sure a lot of experimentation is going on in the U.S.'s current war in Iraq. Maxmiles 02:14, 19 September 2006 (UTC)

I don't have any statistics or hard information, but from my personal experience with military systems, their approach to PTSD seems to waver between wholesale denial and a "suck it up" attitude. I would be surprised to find out that the U.S. or any other military were preparing their soldiers for the psychological impact of battle situations (other than by desensitizing, as Maxmiles mentions above). - LeaHazel 10:21, 20 September 2006 (UTC)

Fiction and movie sections - why here?

What are the fiction and movie sections doing in this topic? I thought a list of technical references would be sufficient already. --MegaHasher 23:31, 6 February 2006 (UTC)

I didn't put them there (tho I may add some), but I'd say two reasons.

1. Many articles have similar sections, sometimes called trivia: eg a town or historical event well-described in a movie.
2. Many of the writings and films which involve the condition are deliberate attempts to describe and illustrate it to the lay-person, often written by or in consultation with sufferers.

But there is a glitch that most of these egs are about combat stress, which has its own article at Combat stress reaction. So perhaps this lot should be moved there. JackyR 21:15, 23 March 2006 (UTC)

I have a policy of forking off trivia from technical pages once a critical mass is achieved. If there are other established pages, move the material there with appropriate and prominent links. David91 02:42, 24 March 2006 (UTC)

I agree. Unless it really adds to the understanding of the subject, it's prey to removal when it starts to take over the page.--DanielCD 02:43, 24 March 2006 (UTC)

I'll get round to combing the egs and moving the combat stuff to Combat stress reaction, unless it's better to stick to David's policy (by "forking" here, you mean having a dedicated article like PTSD in film and fiction?).JackyR 18:39, 24 March 2006 (UTC)

If there is a dominant meaning for the term, that gets to be the "main page" as, say, PTSD. All other uses get their own dedicated pages as PTSD (film), PTSD (fiction), etc. where the subcategory goes into the brackets. Depending on how many pages are generated: for small number just link at top of page or as "see also", but for larger number create a dab page.David91 03:16, 25 March 2006 (UTC)

Law

Stop, stop! Enough! :-) Just wanted an idea of whether the legal stuff was internationally true or being written from a single-country viewpoint... In fact, I'm inclined to loose the "/diminished responsibility in English law", as "diminished responsibility" includes a lk there and the broader statement is better (if still true?). Many thanks for answering lots more than the Q! Cheers, JackyR 21:15, 23 March 2006 (UTC)

Sorry, I was simply repairing links having forked three law pages. I will remove the excessive material.David91 02:44, 24 March 2006 (UTC)

"Saving Private Ryan" & PTSD?

In the bottom of the page it says that Captain Miller in Saving Private Ryan exhibits signs of PTSD such as his hand shaking. I was curious about this because no where in the rest of the article does it mention tremors or any kind of shaking as a symptom.69.124.124.70 19:34, 6 April 2006 (UTC) -bob

Well, it's associated with stress and hyperarousal, both of which are associated with PTSD. --DanielCD 19:40, 6 April 2006 (UTC)

"Saving Private Ryan" & PTSD? - more...

I removed this for now:

:Later in the film, Tom Hanks' character is killed when he is shell-shocked and walks out into the open during a period of heavy combat. He is shot in the chest by a German soldier credited by the film as 'Steamboat Willie'. Ironically, this German was a survivor of Miller's disastrous assault on the machine gun nest described above. Willie was allowed to go free and soon rejoined the German troops in the area. This decision was one also made by Miller, despite the objections of most of his squad. Miller's final and suicidal act is a fairly common occurrence with sufferers of PTSD, who tend to have a death wish and unnecessarily expose themselves to danger. At the end of the film the camera focuses on Miller's hand, which is (of course) no longer shaking.

He did not walk willingly out into the open, he wandered out there blindly. I don't see any argument that he intended to get himself killed. --DanielCD 19:40, 6 April 2006 (UTC)

citations need to be cleaned up

the citations in the beggining of the article need to be changed into footnotes.

PTSD & Movies, etc. put on separate page

The article is becoming quite cluttered and difficult to read. I propose that the article be limited to material about the psychiatric condition, PTSD: what it is, diagnosis, treatment and that fictional representations be placed in another article linked to this one. Please let me know your thoughts. If there is general consensus for this...or at least no vocal general opposition, I will do this some time in the next week or so when I get some time. RalphLender^talk 15:33, 21 August 2006 (UTC)

Agreed. From what I see, the WP standard would indicate List of people with post-traumatic stress disorder and/or List of fictional characters with post-traumatic stress disorder. I think it would be useful to separate the two from the get-go, since public figures and fictional portrayals are very different issues. However, if there are not enough references to support two list pages, the former title can/should be used, as it's more general. - LeaHazel 17:31, 21 August 2006 (UTC)

Agree, also. (I edited your note, RalphLender, to correct sp porpose to propose...if not ok, I appologize). I will be glad to help with the edit. I also agree with LeaHazel's suggestion to create 'two' pages with the titles as suggested. DPeterson^talk 21:43, 21 August 2006 (UTC)

I've created the two pages but left the content on this page so that people can see how it looks and links. If there is concensus, maybe someone could then delete the content on this page that is now on those two new pages. DPeterson^talk 21:59, 21 August 2006 (UTC)

Spelling isn't a strength of mine. I've gone a head and deleted the materials in the article since it is all on the two pages DPeterson made. RalphLender^talk 16:22, 23 August 2006 (UTC)

Moving that material to separate pages makes this article much more clear. Dr. Arthur Becker-Weidman_talk 22:28, 24 August 2006 (UTC)

Bad trips?

Bad drug trips are identified as things likely to cause PTSD. Are you sure this is right? As I understood it, the event must involve death or serious injury or threat thereof. I'm sure a person going through a bad trip might believe they were going to die, so that might qualify. But does anyone know if this is included in the DSM-IV criteria? Or verify with some other source? Thanks, delldot | talk 00:53, 5 September 2006 (UTC)

It can't possibly be confined only to near-death experiences, because rape and sexual assault are among the most common/most recognizable causes of PTSD. - LeaHazel 20:43, 5 September 2006 (UTC)

Article flagged for cleanup

It is good to see that there is discussion behind the page, but it is just a mess of uncited facts. The opening sentence does not describe the disorder, but rather one person's uncited belief about the most common treatment.

The article needs first a description of the disorder by a TRULY knowledgable person (no intuition psychiatry). Then some description of the history of the disorder and it's discovery.

Information about causes (eg war, loss of loved one, illness etc...)

Then a list of symptoms (cited, of course) - summary of dagnostic criteria.

Followed by treatment options.

Controversy for you argumentative types.

Debate over the effectiveness of the treatment technique itself belongs in treatment's own article, unless it is specific to the treatment's applicability to PTSD.

Anyway, this article is messy in so many ways that it needs attention, and people need to know that it is no example of a good wikipedia article.

Thanks!

Please be sure to sign your comments. The opening sentence is congruent with and a decent summary of the DSM-IV description of PTSD. It could be cleaned up and reorganized, I agree. However, the wholesale deletion of the article is not acceptable. Work to improve the material is much more productive. DPeterson^talk 11:28, 8 September 2006 (UTC)

My apologies about not signing. I didn't do any deletion - I came back today and it was a completely different article than what I saw yesterday. Most impressive :) Thanks for reverting it! 75.17.195.203 05:07, 9 September 2006 (UTC)

Merge with Combat stress reaction?

No. From what I've read and heard, some combat stress reactions are cumulative conditions, whereas PTSD may occur after one event... ? During WWII, US military officers were warned to watch for the "2,000-yard stare" whichall soldiers were expected to have after 200-250 days of intense combat (interestingly, Brit military soldiers were expected to reach the same point after 400-450 days because of the British use of front-lines rotation). --Renice 14:14, 27 October 2006 (UTC)

Some references: There is an article regarding Railway Spine now being the same condition as Fibromyalgia, both resulting from repetitive whiplash injuries from such jerky movements as railway cars, trampolines and sudden car stops. I will try to find it deep in my files and cite it. I think it was ALIVE magazine. Loss of muscle tone (note the blank stare refered to above- loss of tone happens to the eight muscles in the eyes too!) in PTSD may make a person more vulnerable to such injuries to the neck area- is this why it ends up being thought of as an "emotional" condition when the physical symptoms are real and an ongoing contributor to the condition. Has anyone else seen/heard about the documentary by Dini Petti on CBC about PTSD in Romanian orphans and children of drug addicts (essentially abandonment at early ages.)I saw it in 2001. The treatment proposed in this documentary was to return to the "triggers" and overlay them with a good memory rather than talk more about the traumatic event. I personally used this technique after a night attack on a dark road. I returned there with supportive friends, sang and prayed and find my physical reaction to thoughts of the incident are much reduced. Now when I "hear" the voice of my attacker I also hear the songs with my friends, see their faces, feel their hugs too, and their voices are stronger. In the documentary the children had been taken back to an apartment building and a park where horrific incidents had occurred. They went prepared to make new memories, had a picnic, went on the swings, sang songs and the (by then) teenagers stated they experienced some healing from the power of the memory triggers. user: Owlytoo, 27 October 2006

---

I don't think the articles should be merged either. They are related, however, they are not the same. Also, they are both quite long, and merging them would result in one article of extreme length (and any subtraction from either article would result in loss of quality). I am familiar with Post Traumatic Stress Disorder (PTSD), and Combat Stress Reaction seems like a type of PTSD. I recommend that some information about Combat Stress Reaction be added to the PTSD article along with a link to the full article about Combat Stress Reaction. It wouldn't result in a loss of quality and by giving a small amount of information, it would let readers decide for themselves if they want to read the full article or not. Also, for the readers who don't know that Combat Stress Reaction exists, it will inform them when they look for the article about the more well-known PTSD. --Ro

Diet paragraph; no citation

The following was added and a request for a citation was later put on

Another possible factor in PTSD is that a persistence of depressive symptoms may be caused by an underlying biochemical disorder, associated with insulin resistance (dysglycemia), that can be treated by a hypoglycemic diet

Unless someone can find a verifiable citation for this, I suggest it be deleted. DPeterson^talk 13:22, 7 November 2006 (UTC)

The following was removed

I removed the following material since no one provided citations. If there are citations, then this material should be added back into the Neurochem section from which it was removed.

Another possible factor in PTSD is that a persistence of depressive symptoms may be caused by an underlying biochemical disorder, associated with insulin resistance (dysglycemia), that can be treated by ahypoglycemic diet.

It is important to note that you may find seemingly contradictory information concerning physiological processes of PTSD as there is considerable controversy within the medical community regarding the biology of PTSD. For example, only a slight majority of studies have found a decrease in cortisol levels; many others have found no effect or even an increase.

DPeterson^talk 22:20, 18 December 2006 (UTC)

This citation: Lindley, S.E., Carlson, E.B., & Benoit, M. (2004). Basal dexamethasone suppressed salivary cortisol concentrations in a community sample of patients with PTSD. Biological Psychiatry, 55, 940-945. supports the sentence about contradictory findings in PTSD cortisol levels with specific citations of studies (and an additional original study). I think it is important to replace these sentences about controversy because there is a tendency for the media to love and hype biological variables, even though no biological variables have been shown to accurately identify those with PTSD. And I suggest omitting the qualifier "seemingly" as the empirical findings are definitely contradictory.Evebcarlson 18:27, 14 March 2007 (UTC)

• I agree and I put the text into the article.--DorisH 19:05, 14 March 2007 (UTC)

Symptoms and their possible explanations - citations needed

There should be a few citations here to support the statements made. In addition, there are two references "cited," but there is no way to verify those references. If they are to be used as a basis for the material in this section, then the full citations should be given and put into Wikipedia format, as the other references in this article have been put. DPeterson^talk 13:28, 21 December 2006 (UTC)

Removed Section on "odds"

I removed the following section

The current overarching hypothesis for this phenomenon is that PTSD develops as a result of a trauma survivor's home and social environment. It is thought that a supportive environment that validates a trauma victim's feelings of terror and disempowerment will dramatically reduce the victim's odds of developing PTSD, while a negating environment that denies the victim's feelings will greatly increase the odds of developing PTSD. This hypothesis is undergoing continual testing and evaluation.

and put it here because it really does need some citations and references. There should be some material on the general "odds" of developing PTSD and the effect of the factors mentioned in the section, with appropriate citations. DPeterson^talk 22:10, 12 January 2007 (UTC)

No problem, I may get to that later, or just let it rest. Because of some unreferenced statements that already existed in the opening section, it seemed like that is a "general intro" section whose ideas are explored in further, specifically referenced detail further in the article. The line left in - that DSM states that some trauma survivors get PTSD and others don't - didn't state the specific odds, but I can see how the article in general needs to be edited. 3Tigers 14:25 PST, 12 January 2007

Good points...Pls do add. The remaining section cites the DSM, which is a reliable and verifiable source. DPeterson^talk 01:12, 13 January 2007 (UTC)

Sexual assault is "life-threatening"?

A recent summary cites the DSM as stating that PTSD can only be triggered by a "life-threatening event." However, the article states that 80% of all people who went through sexual assault develop some level of PTSD, and sexual assault is not by definition a life-threatening event. How are these two reconciled? LeaHazel : talk :contribs 09:33, 18 January 2007 (UTC)

The DSM-IV criteria for 309.81, Posttraumatic Stress Disorder states,

A. The person experienced, witnessed, or was confronted with an event or events that involved acutal or threatened death or serious injury, or a threat to the physical integrity of self or others.

so the full criteria should make clear why sexual assult is included. Sexual assult may involve acutual or threatened death but it certainly involves serious injury or a threat to the physical integrity of self. DPeterson^talk 13:23, 18 January 2007 (UTC)

To state the obvious, the condition is called Post Traumatic Stress Disorder, not Post Near-Death Stress Disorder. FireWeed 20:28, 25 January 2007 (UTC)

But the definition requires "experiencing, witnessing, or being confronted with an event or evnts that involve actul or threatened death or serious injury..."DPeterson^talk 22:13, 25 January 2007 (UTC)

Experiences which may induce the condition - need for complete list?

I removed the text, below, from the main article. I'm pasting it below, in case there's strong disagreement, but I feel it diminishes the value of the article as a whole. Either this is a complete list, that people can check their experience against, or examples that should add to a lay-person's understanding. A complete list is impossible, as there are more potentially traumatic events than people willing to contribute to this article. As examples, this list is extremely vague and open-ended ( etc, attack by ... or other animal, job-related, witnessing almost any type of abuse against a person of any age ). Tsunami wouldn't have been added if not for the publicity of the Indian Ocean disaster; I have no doubt it caused PTSD among some survivors, but this is an article on PTSD, not the tsunami disaster, which is at best peripheral here. As an example, this does little to help someone living at the center of a continent understand the condition. Likewise tornados or shark attacks or severe electrical shock. If I had to guess, I'd say being involved in a serious auto wreck would be the leading cause in the industrialized world - this is found near the end of the list.

It's not just that this list is bad - I don't think one is needed. The article ( even the name of the condition ) makes it clear that being a victim or witness to a severely traumatic event may induce PTSD. That's plenty clear, without having to enumerate a list of what the media tells us ( terrorism, torture, war, tsunami ) is traumatic. FireWeed 20:55, 25 January 2007 (UTC)

Experiences which may induce the condition This article or section does not cite its references or sources. Please help improve this article by introducing appropriate citations. (help, get involved!) This article has been tagged since January 2007. childhood physical, emotional, or sexual abuse, including prolonged or extreme neglect; also, witnessing such abuse inflicted on another child or an adult violent physical assaults (at any age) adult experiences of sexual assault or rape surviving or witnessing a terrorist attack experiencing or witnessing physical or psychological torture civilian experiences of warfare or ethnic cleansing combatant experiences of warfare (also referred to as combat stress reaction) occupational experiences, such as through police work or fire fighting living through a natural catastrophe, such as a tornado, tsunami, or severe earthquake witnessing the sudden death of a loved one having or witnessing a serious automobile accident experiencing a vicious attack by a dog, shark, mountain lion, or other animal having a close brush with death as a result of electric shock, near-drowning, falling from great height, life-threatening medical complications, etc.

I think the listing is fine and belongs in the article....much of it is from the DSM-IV and it will help the novice reader get a sense of the experiences that cause this very serious disorder. DPeterson^talk 22:16, 25 January 2007 (UTC)

Ah, but Wikipedia is not the DSM. A partial list of events that might be able to cause PTSD in most people only hurts this article. If you read the comments above, explaining why the text was removed, they don't provide any more clarity for most readers than is already in the article. In fact, the list muddies the waters - I survived x, but it's not on the list, so I can't have PTSD; this is what's implied. The list distracts from more useful content in the article. Many of the examples cannot be put into context by the average reader. ( When was the last time "ethnic cleansing" happened in Cleveland? ) This list distracts from a deeper understanding of post traumatic stress disorder, fails to bring anything to light that isn't already here, and wastes space in the article. Perhaps I'm missing something ... but if so, there has to be a better reason than "it's also in the DSM." FireWeed 03:21, 26 January 2007 (UTC)

The listing is a fairly complete listing and helps the novice reader get a sense of the experiences that cause this disorder. As such, the listing is consistent with Wikipedia editing policies. As another has said, pls don't delete this listing, but instead, see what consensus develops here. If you want, you can consider having a poll as that is one acceptable method of dispute resolution. DPeterson^talk 13:21, 26 January 2007 (UTC)

While the list has been somewhat contentious for as long as it's been part of the article, I do think giving some sort of idea of what sort of "trauma" can trigger PTSD is necessary. A prose paragraph with several representative examples might be better, but it might also create the impression that there's a limited number of trauma experiences involved (as was once with the preception of "shell shock"). Perhaps it would be better to find citations for cases in which PTSD had been diagnosed in patients due to some of the more "unusual" traumas such as animal attacks, household accidents, work-related trauma and/or childbirth complications.

Once again, I think it's important that the lead section of the article convey the wide range of traumatic experiences that can lead to PTSD. LeaHazel : talk : contribs 13:33, 26 January 2007 (UTC)

(Thanks to DPeterson & LeaHazel for your sensible comments.)

What a delightful approach you have, FireWeed — truly a model of collegiality.

And there I was expecting you to honor my simple request not to revert the section I restored without agreement here on the talk page. Silly me.

Well, I suppose I could refer you to the "Do's & Don'ts" section over at WP:Revert, but I believe I've actually got something even better:

• "Well, I'm loathe to delete another user's hard work here, even if I do believe it's misguided."
• "I think that whenever content is removed from an article this is a bad thing, unless it's something patently untrue like 'Saddam was a good guy.'"

Ring any bells?? (I hope so)

Those are noble sentiments — and I'd like to think you were sincere when you wrote them on your talk page. I hope you haven't had a complete change of heart in the last 2-3 weeks!

That section is in the article because it serves a real purpose. Just because certain things are "obvious" to you, doesn't mean they're obvious to everybody. The primary experience that is linked to PTSD in the mass media is, of course, combat. For the average person, that's probably the extent of their knowledge. And that includes plenty of first-year psych students, as well. Don't assume the subject is covered adequately in the average Intro to Psychology textbook.

I assure you, for many students (and other readers) those concrete examples are very helpful — they provide a real connection to the subject, instead of leaving it largely abstract. And taken as a whole, it gives readers a sense of the scope of possible sources of PTSD, whether in their neighborhood or on the planet as a whole. (Perhaps you've forgotten that WP is used by readers all over the globe, not just in Seattle or Dubuque.)

If you think the list falls short in one way or another, then lend a hand and improve it.  You think "serious auto wrecks" belongs higher up on the list? Nothing's preventing you from moving it. (But please don't put it ahead of child abuse —which is almost certainly the leading cause of PTSD.)

As for the other concern you raise ("it's not on the list, so I can't have PTSD") — I honestly think that's pretty far-fetched, nonetheless, it would be simple enough to deal with that in a brief intro emphasizing that the list is meant to be illustrative and not exhaustive. It's hardly a reason to remove the list.

Anybody can delete stuff. Try being constructive. Cgingold 14:44, 26 January 2007 (UTC)

I've edited this twice, and people have disagreed with me in both occasions, so I'll respect that.

But please assume good faith; I've explained in great detail why I've removed the section, and I've raised some very good points. You specificially disagreed with one of them, which implies you agree with the others. It is constructive to remove text that harms an article. And as we're talking about post traumatic stress disorder, it would be far more constructive to use this page to discuss the merit of the PTSD article and what belongs there, than to debate Wikipedian theory on other users' talk pages; why change the subject? Personal attacks aside ( What a delightful approach you have, FireWeed — truly a model of collegiality ), nobody has presented any reason the article text belongs, except "it's in the DSM, too."

Cars are found across the globe. A Mongolian guide can rebuild a Russian engine in the middle of the Ghobi desert with a nail file. As China's and India's economy grows, personal ownership of cars is quickly rising there. Car's aren't "just in Seattle or Dubuque." And no one can say with a straight face that physical, emotional, sexual, or other abuse, as a child, adult, or at any age, either experienced or witnessed is helpful. The list reads like the fine print in a contract, designed to trick the signer.

These personal attacks ( as opposed to addressing the reasons I laid out ) are why I'm contributing less to Wikipedia as time goes on. Editors have a tendancy to revert changes for personal reasons and vendattas rather than on the merit of the changes. FireWeed 19:32, 26 January 2007 (UTC)

nobody has presented any reason the article text belongs, except "it's in the DSM, too."

Actually, I made my argument about why I think the list is necessary. You can read it above, in response to your original comment. LeaHazel : talk : contribs 21:58, 27 January 2007 (UTC)

Being in the DSM makes the material reliable and meets the wiki standard for being verifiable. But if you feel strongly, feel free to hold a poll or use some other wiki appropriate dispute resolution procedure. MarkWood 23:23, 27 January 2007 (UTC)

I have to agree with the three others that the listing should stay because it is relevant and consistent with Wiki policy...if you feel strongly about removing it, quote wiki policy to support its removal and follow wiki dispute resolution procedures. MarkWood 23:04, 26 January 2007 (UTC)

I have PTSD triggered by an acute fear reaction to a perceived medical problem. It turned out to be a false alarm, but I went through a period of about a week thinking I quite possibly had ALS (Lou Gherig's disease). It sounds absurd now, but for a few nights I was literally shaking with fear. After the traumatic week I found out I was fine, but the experience of being in a state of hyperarousal for so many days left permanent deficits. They have faded with time, but I still have mild brisk reflexes, burning eyes and occasional difficulty focusing (my eyes don't want to remain on one object), small jerks in my feet and toes (myoclonus), and a mild essential tremor that is worse whenever I'm excited or exercising. The symptoms are very mild and no one notices any of this (not even my wife) but me. But they are permanent, and a result of changed brian chemistry after my hypochondriac episode. You never know what can trigger PTSD! 169.253.4.21 15:26, 19 October 2007 (UTC)David S

Clean up needed!

Please clean up. For example "bob the builder" is in the opening sentence and "Dora the Explorer" appears further down. Yet in the editing page it does not appear. What gives??? Nuos 19:42, 29 January 2007 (UTC)

This was probably a case of vandalism that was reverted. LeaHazel :talk : contribs 15:04, 30 January 2007 (UTC)

Yes, I remember seeing those phrases recently, and they were indeed reverted (possibly by me, not sure).Cgingold 15:22, 30 January 2007 (UTC)

removed ref to Scientology

I removed the following:

Scientology, a religion known for having it's own approach to psychological issues, uses a technique known as Traumatic Incident Reduction for the treatment of PTSD.

because is it not a NPOV and is unsourced. If there are references to support this statement, then it should be added back.DPeterson^talk 23:00, 31 January 2007 (UTC)

I deleted the unsourced/unreferenced statement

Traumatic Incident Reduction is another, more controversial, targeted method of treatment, that was developed by a former scientologist based upon Dianetics, the TIR page contains more information.

It is not sufficient to cite another wiki article...Pls read the wiki policy, "Encyclopedic content must be verfiable" Pls cite a reference for this statement. RalphLender^talk 15:26, 1 February 2007 (UTC)

Citations needed

There are a number of lines and statements that need a verifiable reference. Unless a valid citation can be provided, those lines should be deleted at some point.DPeterson^talk 23:12, 4 February 2007 (UTC)

SOLUTIONS: Instead of hacking away and flagging sections and deleting like a mad-man, why not help look up references? You have never heard of google? Good lord. This is not rocket science. Stop complaining and start helping. This article is a nightmare, an embarassment.--Filll 00:08, 5 February 2007 (UTC)

WP:CIVIL, people. It is important that information in articles be cited, especially in medical/scientific articles, and finding citations through google is not always easy. I should know, I spend a lot of time looking for citations.LeaHazel : talk : contribs 10:26, 5 February 2007 (UTC)

Of course it is important for articles to be cited. But there was some fairly unproductive flagging going on. This is basically hostile when someone is trying to fix this mess of an article a little. For such an important topic, I am shocked at its condition. And it is NOT that it is hard to find copious material about PTSD. It is a problem of having to pick and choose among a profusion of material, not a problem of having too little.--Filll 13:11, 5 February 2007 (UTC)

Much improved with the citations, 'thanks Fill'. It is the obligation of the person adding material and lines to haveverifiable references to support statements that may require support or that could appear to be POV. There remain a few more statements that require citations and that should be removed at some point if no one can suppor those statements. My first comment in this section was a call for that to occur and Fill did a nice job here. I agree with LeaHazel, please, lets all remail WP:CIVIL and improve the article. DPeterson^talk 13:48, 5 February 2007 (UTC)

No offense folks, but just "policing" articles that are in such bad shape is sort of counter-productive. Some of the material here is not even presented in English sentences! For heavily attacked and controversial articles like evolution orcreation-evolution controversy, then policing is necessary and any uncited statements will get removed. This article does not fall in that category, as far as I know or can tell. PTSD is VERY standard psychiatry and accepted. I am stunned that aeffort is being expended in "policing" here instead of actual work. Something does not smell right about this to me.--Filll15:01, 5 February 2007 (UTC)

Please adhere to Wiki policies such as WP:CIVILITY, WP:Assume good faith, and WP:No personal attacks.DPeterson^talk 17:30, 5 February 2007 (UTC)

Childbirth as potential cause of PTSD

Why the information that the childbirth may also induce the condition to PTSD is removed? Actually, in modern world not a war or concentration camps are the main cause of PTSD and we should fit the description to the conditions we live in. Actually, the percentage of PTSD cases after the labor, especially after the difficult labor is high, but still the knowledge about it is low among the staff and the symptoms are frequently either confused with postpartum depression or just ignored. Additionally, the (sometimes tragic like child murder) consequences of the uncured PTSD on the relation between mother and child are already known but the only way to help it is to recognize quickly PTSD of mother and cure it asap. What we can do is to spread the information.

At the moment the childbirth is kept removed from "Experiences which may induce the condition" list and replaced by vague "medical complications", however when you open the page of "Medical complications" you will find NOTHING about childbirth, pregnancy, newborns ect. Therefore I insist to include explicitly that childbirth is also an important experience which may induce the condition to PTSD, much frequent than tortures or earthquakes, and we cannot neglect it. For the source I add the link to the professional article in Psychiatry journal, it is not in English but the References are in English, easy to find: Post-traumatic stress disorder as a consequence of a particularly traumatic childbirth Merewyn 01:02, 10 February 2007 (UTC)

Rather than list one thousand specific events, it is better to list general principles and then list speicfic verifiablerefences. References in foreign languages are not verifiableDPeterson^talk 02:27, 10 February 2007 (UTC)

Please check the last page of Post-traumatic stress disorder as a consequence of a particularly traumatic childbirth for the verifiable references before rejecting it as a whole. IT IS in English. Merewyn 03:00, 10 February 2007 (UTC)

Have you actually read any of those references? While my Polish is very rusty, the references themselves are fairly easy to find with JSTOR access and none of that is uncontroversial. There are a lot of disagreements over whether PTSD is caused by childbirth, or by hospital care, or by post-partum disassociation, or a lot of other things. If you wish to include this then make sure you read the references before you make claims for them, the PDF file does support this claim but some of the conclusions are reaching and psychologists are hardly in agreement on it. --Elaragirl^Talk|Count11:32, 10 February 2007 (UTC)

You cannot neglect that there are the articles and documented cases that directly connect PTSD with the childbirth and nothing else. I am not a psychiatrist so I only gave you this one link with English bibliography for some of specialists to develop it. Why I did it? My reasons I presented above. Merewyn 12:17, 10 February 2007 (UTC)

(dryly) You may not be a psychological specialist, but I am. Looking the actual references up on JSTOR and reading the articles is what I did. We'll see what other editors say and go with consensus (note I'm not reverting anything out, just commenting).--Elaragirl^Talk|Count12:23, 10 February 2007 (UTC)

So that we know what we are talking about, I'll post the sources from Merewyn's link here:

• Ayers S, Pickering A. Do women get posttraumatic stress disorder as a result of childbirth? A prospective study of incidence. Birth 2001; 28: 111-8.
• Bailham D, Joseph S. Post-traumatic stress following childbirth: a view of the emerging literature and directions for research and practice. Psychol Health Med 2003; 8: 159-68.
• Ballard CG, Stanley AK, Brockington JF. PTSD after childbirth. Br J Psychiatry 1995; 166: 525-8.
• Reynolds L. Post-traumatic stress disorder after childbirth: the phenomenon of traumatic birth. CMAJ 1997; 156: 831-5.

Elaragirl mentioned that it is controversial whether childbirth is an event that can cause PTSD. Can you mention the source for this statement? I don't think the scientific discussion is about whether certain experiences can cause the disorder (so as to produce a list of possible events), but about what characteristics the trauma usually has. It is a matter of perception by the patient, whether an event is traumatic or not. For instance a little child may be traumatized by a situation which an adult perceives to be harmless. So I agree with DPeterson, that we need to describe the general principles that make a trauma strong enough for the kind of effect PTSD constitutes. I believe the most important such principle would be extreme anxiety, and often sources say the patient needs to have been afraid to die in that situation. In addition to that I think we should provide the reader with good examples for such traumatic events, and I believe difficult childbirth is a good example that many people can relate to.--Grace E. Dougle 17:52, 10 February 2007 (UTC)

Mental Health Matters in Primary Care. Elaine Millar, Mark Walsh. ISBN 0748745289. Pg 55-60 talk about PTSD and childbirth, reporting only 6% of women in childbirth report these things, and that studies found that most of those were inaccurate. I could list others. I just don't particularly care for the tone of this statement:

“ Actually, the percentage of PTSD cases after the labor, especially after the difficult labor is high, but still the knowledge about it is low among the staff and the symptoms are frequently either confused with postpartum depression or just ignored. Additionally, the (sometimes tragic like child murder) consequences of the uncured PTSD on the relation between mother and child are already known but the only way to help it is to recognize quickly PTSD of mother and cure it asap. What we can do is to spread the information. ”

Which is quite simply WRONG, the studies showed that most "reported" cases did INDEED turn out to be postpartum. In any case, I like going with diagnostics as perscribed by the DSM-IV-TR and the ICD. Mentions is good. Campaigning for "awareness" implies a POV. --Elaragirl^Talk|Count23:29, 10 February 2007 (UTC)

Is the English Wikipedia designed only for USA and can use only Americans sources?!? There are other people in the world speaking English and having other results and experiences than American doctors. Let's take a look here:

"It’s hard to say how common birth-related PTSD is. Some cases may look like postpartum depression to family doctors. (Stacey is currently taking antidepressants, which she says have helped.) Two studies in which women were assessed during and after pregnancy found that three percent met all the criteria for PTSD; however, 20 to 30 percent met some criteria. So,clearly, mental distress after a difficult birth affects a lot of women." LinkToday's Parents Dec 2006—Preceding unsigned comment added by Merewyn(talk • contribs) (Sorry, I forgot to sign Merewyn 18:59, 11 February 2007 (UTC)).

I wonder how much of that is PPD or PPP in those "some" criteria. Anyway, DPeterson has a good point. If you want to have a longish list of triggering events that "may" cause or is believed to have a possibility of triggering PTSD, fine, go for it. If you want to include a paragraph about it, no. --Elaragirl^Talk|Count17:42, 11 February 2007 (UTC)

All she wanted was the mention of a single word (childbirth), not a paragraph.--Grace E. Dougle18:41, 11 February 2007 (UTC)

This is the diff (which I realize isn't all her) that I referred to.--Elaragirl^Talk|Count18:54, 11 February 2007 (UTC)

Rather than list 500 separate experiences that might cause PTSD, it is better to list general categories; as others have stated here.DPeterson^talk 01:54, 11 February 2007 (UTC)

This totally surprises me. Elaragirl says 6 percent report symptoms though most of them turn out not to be PTSD, Merewyn says 3 percent...wow. I think that is a lot. When I made the above statement, to include difficult childbirth, I was thinking the percentage was more like zero point something, at the most. I agree with Elaragirl that Merewyns statement is from a POV (to create awareness). It is our task as authors to make the article interesting and provide the reader with good examples, something that creates an image in the head of the reader or something that creates a relation to something he or she has experienced. If we just write 'medical complications', many will just read over that. If we put 'difficult childbirth for example' most readers will either have given birth or seen one and many have probably thought about a difficult one. The average reader knows that the mortality rate in childbirth is high, I think, and will be able to understand the word trauma better. Also, I would prefer a descriptive section of the general criteria a traumatic experience has (+examples), not a list.--Grace E. Dougle 12:35, 11 February 2007 (UTC)

A listing of general categories i.e. life-threatening accidents (vs. being hit by a truck, being in a car accident, being hit by a bus, hitting a tree at high speed, etc.) is best here. If, then, someone wants to write a descriptive paragraph with the several hundred specific types of life threatening events (child birth, emergency surgery, etc. etc) that person should do it here and then the various interested editors can comment, see below.DPeterson^talk 14:04, 11 February 2007 (UTC)

The list you are describing is already in the article, but it lacks a source.--Grace E. Dougle 17:40, 11 February 2007 (UTC)

I agree with Grace E. Dougle: symptoms of PTSD AND some good examples to allow the reader make the picture of the subject. "Medical complications" is not a picturing example at all, especially when we have difficult childbirth in mind.Merewyn 18:59, 11 February 2007 (UTC)

Too many examples: childbirth, being hit by a bus, being in a car accident on the highway, being hit by a drunk driver, emergency surgery, waking up during surgery, falling off a tall building, falling down an elevator shaft, being mugged.....etc will just clutter things up. The article, Psychological trauma is the place to describe, in detail and with approprite citations, such salient examples, as childbirth. DPeterson^talk 20:15, 11 February 2007 (UTC)

Funny, Psychological trauma article does not contain even a word "childbirth" nor any related to it. So, what example/citation are you talking about?..... Merewyn 21:42, 11 February 2007 (UTC)

I am saying that the details about childbirth belong in that article not this one. If there is no material there, then go ahead and add it to that article. That seems like the appropriate place since this article should only have a listing of broad categories not 500 specific examples. DPeterson^talk 22:33, 11 February 2007 (UTC)

Removed section - re: physical damage as a necessary cause

I removed the following section,

For an event to have a traumatizing effect it is not necessary that physical damage occurs. Regardless of the source of the trauma, the experience has three common traits: it was unexpected, the person was unprepared and there was nothing the person could do to prevent it from happening. It is not the event that determines whether trauma occurs, but the subjective experience of that person. It is not predictable if a person reacts to one of the following events by developing PTSD or not.

because it is not about PTSD and confuses the issues. PTSD is not necessarily caused by an unexpected event (Katrina), it may be something the person could prevent, and the person may be prepared...DPeterson^talk 13:23, 13 February 2007 (UTC)

I concur, the section does not belong in an article about the DSM-IV diagnosis, PTSD. RalphLender^talk 16:02, 13 February 2007 (UTC)

This article is not only on the DSM-IV-diagnosis, but also on the ICD-diagnosis. Other than that, as the author of this piece you just cut out, I think you absolutely need to replace it with something, or else the section makes no sense. See my comments above and below.--Grace E. Dougle 16:28, 13 February 2007 (UTC)

The section does not belong in an article about psychiatric diagnose (ICD or DSM).RalphLender^talk 18:25, 13 February 2007 (UTC)

The same applies to your treasued list. It does not belong in an article on the psychiatric diagnosis. If you won't allow a comment on the list, or write one, this list is simply misleading. These events do not always lead to PTSD.--Grace E. Dougle 18:43, 13 February 2007 (UTC)

Please refrain from personal attacks and maintain assume good faith. If you disagree with the edits, why don't you suggest an Rfc or poll as that is the proper wikipedia procedure for resolving disputes, not revert wars or deletions. RalphLender^talk 19:19, 13 February 2007 (UTC)

I did not 'personally attack' you and I have no idea why you made that up. Should I consider that a personal attack on your part?--Grace E. Dougle 19:46, 13 February 2007 (UTC)

Removed section - examples of events causing PTSD

I removed the following section:

Experiences which may induce the condition:

• childhood physical, emotional, or sexual abuse, including prolonged or extreme neglect; also, witnessing such abuse inflicted on another child or an adult
• experiencing an event perceived as life-threatening, such as an

1. automobile or other serious accident,
2. a vicious attack by an animal,
3. medical complications,
4. violent physical assaults or surviving or witnessing a terrorist attack,

• adult experiences of sexual assault or rape
• experiencing or witnessing physical or psychological torture
• civilian experiences of warfare or ethnic cleansing
• combatant experiences of warfare (also referred to as combat stress reaction)
• occupational experiences, such as through police work or fire fighting
• living through a natural catastrophe, such as a tornado, tsunami, or severeearthquake

because it is not about PTSD and confuses the issues. PTSD is not necessarily caused by these events, as I previously said in the talk section about childbirth. It's confusing to the reader. These experiences only cause PTSD under certain circumstances. Listing or describing events that might cause PTSD makes no sense, because it could basically be anything that scares an individual. If we cannot come up with a decent discription of general principles, we might as well leave out the list of accidents and the like.--Grace E. Dougle 16:18, 13 February 2007 (UTC)

I edited this back because a few examples would be helpful to the novice reader.RalphLender^talk 18:26, 13 February 2007 (UTC)

Please avoid misleading edit-summaries. These are not a few examples, but a steadily growing list. It does not deserve its own section, and it is misleading without any comment added to it. You could write a comment to put it in perspective, or make constructive comments here. How about if we create a separate article: List of events that possibly lead to PTSD...--Grace E. Dougle 18:36, 13 February 2007 (UTC)

The few examples listed are general categories for the novice reader. As such, it deserves it's own section. However, if you strongly disagree, the proper procedure for resolving content disputes is with an Rfc or poll. Creating a separate article tht lists events that could, possibly, lead to PTSD would be fine too. If you'd go a head and do that, I'm sure other editors would contribute. RalphLender^talk 19:22, 13 February 2007 (UTC)

No, Ralph. The proper procedure is to discuss it on the talk page.--Grace E. Dougle 19:55, 13 February 2007 (UTC)

Calm down. Discussing changes here is fine and if there is an unresolved dispute, then an Rfc or poll could be in order. I think the list is a valuable additon to the article. DPeterson^talk 22:27, 13 February 2007 (UTC)

Well thank you for your new contribution to this discussion. Always good to hear profound arguments, DLenderson.--Grace E. Dougle 22:40, 13 February 2007 (UTC)

The list is an excellent addition and should remain. Grace E, your sarcasm really is in bad form and not consistent with wiki practices and policies. Constructive dialogue is the best way to resolve disputes. JonesRD_talk 23:42, 13 February 2007 (UTC)

removed: Cancer section

I suggest removing the cancer section as well, because the article is too long. I copied this section into psychological trauma, where I believe it belongs.--Grace E. Dougle 16:23, 13 February 2007 (UTC)

spelling mistakes

Are there spelling mistakes etc in the first paragraph e.g. Traumitic. The end of the paragraph seems all over the place and hard to follow. 140.203.12.242 18:41, 15 February 2007 (UTC)

Prevalence - citation needed

The second sentence under Prevalence suggests that “...between 5% and 80% will develop PTSD.” I'm very skeptical of this statistic: the range is too large to have been statistically significant, and it lacks a citation (unlike the following paragraph). Skepticism aside, the range is still too large to be remotely informative or useful. If the writer of this can be tracked down, we'll need a citation for this; otherwise, the sentence needs to be rewritten.--AaronRosenberg 17:46, 15 March 2007 (UTC)

I agree that this needs to be rewritten and properly sourced, but it is correct: There are numerous statistics, the percentage varies according to the circumstances f. i. 50 % for rape, 80 % for children when a parent is the perpetrator. It is closer to ten percent when the individual is an adult and the trauma is a natural unforeseeable desaster.--DorisH13:53, 16 March 2007 (UTC)

That sounds right, but do you have references to support the statement. As it stands now, the line has no citation and really should be referenced DPeterson^talk 13:59, 16 March 2007 (UTC)

The statistics should be broken down so as to be less vague and more useful. LeaHazel :talk : contribs 14:58, 17 March 2007 (UTC)

I agree with LeaHazel the statistics should be broken down with referencs so that the material can be accurately evaluated.JonesRD_talk 15:48, 17 March 2007 (UTC)

Amnesia a possible symptom of PTSD?

I've heard that some who suffer from PTSD develop some kind of amnesia to "block out" memories of whatever traumatic expeience they had. Amnesia is also in the related articles sections, but it is not mentioned in this article. —The precedingunsigned comment was added by Marshmello (talk • contribs) 14:28, 3 May 2007 (UTC).

It's not amnesia per se. It's repression and/or dissociation. DashaKat 15:15, 3 May 2007 (UTC)

Removed recently added historical material

A large amount of material was added without any citations or sources. I reverted to a prev version...but if sources can be provided, or other editors disagree, the material can be added back in. DPeterson^talk 03:28, 9 May 2007 (UTC)

deleted abusive talk page section

I don't know if this is allowed, but the section was abusive and foul so I deleted it. JonesRD_talk 15:23, 9 May 2007 (UTC)

Sally Satel - inappropriate mention of political orientation; citation needed

The section that mentions the work of Dr. Sally Satel refers to her as a conservative as is the think tank to which she is associated. The relevance of that seems to exist in order to steer conclusions. For clarity could all other political connections be made known, or conversely could it be assumed that everyone is operating in good faith. Also, while Dr. Satel is mentioned no link to her work seems to be provided. Curious. Bobholmgren 20:39, 28 May 2007 (UTC)05/28/2007

Bob Holmgren

section removed: Dyadic Developmental Psychotherapy (DDP)

I have removed Dyadic Developmental Psychotherapy from this page. This little known therapy has been extensively advertised on Wiki as evidence based, sometimes the only evidence based treatment for a variety of disorders affecting attachment. (Theraplay, also little known and not evidence based has also been advertised in this way.) A range of attachment articles including attachment therapy are currently before ArbCom. In the course of ArbCom it has transpired that of the 6 users promoting DDP and Theraplay and controlling these pages, User:DPeterson, User:RalphLender, User:JonesRD,User:SamDavidson, User:JohnsonRon, and User:MarkWood, the latter four are definitely socks and have been blocked, and the other two have been blocked for one year. The attachment related pages are in the course of being rewritten.Fainites ^barley 20:49, 1 August 2007 (UTC)

Update - all 5 are now indefinitely blocked as sockpuppets of DPeterson, and DPeterson has been banned for 1 year by ArbCom.[1] Fainites^barley 19:41, 5 September 2007 (UTC)

Additional information

The information recently added includes links to credible and verifiable sources.24.168.224.213 18:54, 2 August 2007 (UTC)

"PTSD and society section" - move to separate article?

I would propose moving the PTSD and society section to an altogether different article, most porbably assoiciated with the Sociology project. For?/Against? --DashaKat 21:09, 2 August 2007 (UTC)

Has this already been done? I can't see a section in the article.--CloudSurfer 03:09, 17 August 2007 (UTC)

Treatment with propranolol - section revised

An anonymous user has deleted the following saying it is vanity and irrelevant.

James McGaugh is a pioneer in the neurobiology of learning and memory. He directs the Center for Neurobiology of Learning and Memory at the University of California at Irvine.

For several decades, he has performed numerous animal and human experiments to understand the processes involved in memory consolidation. He believes strongly in the work being done to help people suffering from PTSD.

An event becomes a strong memory, a traumatic memory, when emotions are high, he explains. Those emotions trigger a release of stress hormones like adrenaline, which act on a region of the brain called the amygdala -- and the memory is stored or "consolidated," explains McGaugh.

Current studies have focused on propranolol, a beta blocker commonly prescribed for heart disease because it helps the heart relax, relieves high blood pressure, and prevents heart attacks. "Hundreds of thousands, millions of people take this drug now for heart disease," he tells WebMD. "We're not talking about some exotic substance."

Studies have shown that "if we give a drug that blocks the action of one stress hormone, adrenaline, the memory of trauma is blunted," he says.

The drug cannot make someone forget an event, McGaugh says. "The drug does not remove the memory -- it just makes the memory more normal. It prevents the excessively strong memory from developing, the memory that keeps you awake at night. The drug does something that our hormonal system does all the time -- regulating memory through the actions of hormones. We're removing the excess hormones."

Recently, the use of Virtual reality and Integrated reality experiences applied as a new type of exposure therapy methods to come types of PTSD (specifically military related patients) has been gaining recognition. Some of this work is done at the CAREN VR LAB at the SHEBA rehabilitation hospital in Israel. The ideas behind this methods is based on introducing PTSD causes in a gradual manner, inside a safe environment, the hope is that training in VR in this manner will reduce stress and transfer to daily reality. A similar system is recently installed at the BAMC (Brooke Army Medical Center ) In the USA.

All but the last paragraph seems to relate to a news article. I suspect the anon editor did not realise that the last paragraph was separate.

The section on propranolol is verbose and "newsy". I have reinstated the final "lost paragraph" and replaced the rest with:

Propranolol, a beta blocker which appears to inhibit the formation of traumatic memories by blocking adrenaline's effects on the amygdala, has been used in an attempt to reduce the impact of traumatic events.

I have used reference number 13 from this list.

1: Huffman JC, Stern TA. Neuropsychiatric consequences of cardiovascular medications. Dialogues Clin Neurosci. 2007;9(1):29-45. Review. PMID 17506224

2: Strawn JR, Geracioti TD Jr. Noradrenergic dysfunction and the psychopharmacology of posttraumatic stress disorder. Depress Anxiety. 2007 Mar 12; [Epub ahead of print] PMID 17354267

3: Adamec R, Muir C, Grimes M, Pearcey K. Involvement of noradrenergic and corticoid receptors in the consolidation of the lasting anxiogenic effects of predator stress. Behav Brain Res. 2007 May 16;179(2):192-207. Epub 2007 Feb 6. PMID 17335916

4: Kornischka J, Cordes J, Agelink MW. [40 years beta-adrenoceptor blockers in psychiatry] Fortschr Neurol Psychiatr. 2007 Apr;75(4):199-210. Epub 2007 Jan 2. Review. German. PMID 17200914

5: Garakani A, Mathew SJ, Charney DS. Neurobiology of anxiety disorders and implications for treatment. Mt Sinai J Med. 2006 Nov;73(7):941-9. Review. PMID 17195879

6: Debiec J, LeDoux JE. Noradrenergic signaling in the amygdala contributes to the reconsolidation of fear memory: treatment implications for PTSD. Ann N Y Acad Sci. 2006 Jul;1071:521-4. PMID 16891611

7: Orr SP, Milad MR, Metzger LJ, Lasko NB, Gilbertson MW, Pitman RK. Effects of beta blockade, PTSD diagnosis, and explicit threat on the extinction and retention of an aversively conditioned response. Biol Psychol. 2006 Oct;73(3):262-71. Epub 2006 Jul 7. PMID 16828533

8: Glannon W. Psychopharmacology and memory. J Med Ethics. 2006 Feb;32(2):74-8. Review. PMID 16446410

9: Giles J. Beta-blockers tackle memories of horror. Nature. 2005 Jul 28;436(7050):448-9. No abstract available. PMID 16049437

10: Debiec J, Ledoux JE. Disruption of reconsolidation but not consolidation of auditory fear conditioning by noradrenergic blockade in the amygdala. Neuroscience. 2004;129(2):267-72. PMID 15501585

11: Vaiva G, Ducrocq F, Jezequel K, Averland B, Lestavel P, Brunet A, Marmar CR. Immediate treatment with propranolol decreases posttraumatic stress disorder two months after trauma. Biol Psychiatry. 2003 Nov 1;54(9):947-9. Erratum in: Biol Psychiatry. 2003 Dec 15;54(12):1471. PMID 14573324

12: Taylor F, Cahill L. Propranolol for reemergent posttraumatic stress disorder following an event of retraumatization: a case study. J Trauma Stress. 2002 Oct;15(5):433-7. PMID 12392232

13: Pitman RK, Sanders KM, Zusman RM, Healy AR, Cheema F, Lasko NB, Cahill L, Orr SP. Pilot study of secondary prevention of posttraumatic stress disorder with propranolol. Biol Psychiatry. 2002 Jan 15;51(2):189-92. PMID 11822998

14: Reist C, Duffy JG, Fujimoto K, Cahill L. beta-Adrenergic blockade and emotional memory in PTSD. Int J Neuropsychopharmacol. 2001 Dec;4(4):377-83. PMID 11806863

15: Famularo R, Kinscherff R, Fenton T. Propranolol treatment for childhood posttraumatic stress disorder, acute type. A pilot study. Am J Dis Child. 1988 Nov;142(11):1244-7. PMID 3177336

Have fun with these. --CloudSurfer 10:33, 14 August 2007 (UTC)

Thanks to SandyGeorgia I have finally discovered [tool] for filling out cite references using the PMID number. If you tick the "ref" box you get a unique reference that can be referenced later in the article by just putting <ref name="name" /> in the text. If you want to know more about this, or just editing a medical article, have a look at Wikipedia:Manual of Style (medicine-related articles).--CloudSurfer 12:33, 14 August 2007 (UTC)

"Posttraumatic stress disorder" - Spelling/hyphenation issues

Referring to this, which was added as a footnote... An apter spelling would be "post traumatic-stress disorder." The usual spelling, "post-traumatic stress disorder," suggests that this is a "stress disorder" caused by a "trauma," whereas it is actually a "disorder" caused by a "traumatic stress." Regrettably, using twohyphens ("post-traumatic-stress disorder") would still leave the meaning equivocal.' This is alternatively Original research and a personal Point-of-view. Additionally, the official diagnostic criteria's spelling and punctuation is factually accurate and any deviation is by definition inaccurate. From a grammar standpoint, it is also correct. Post modifies Traumatic, and ajective modifying the noun, used as a type, Stress. It is not modifying Stress Disorder as a phrase, but the word Stress which is qualifying (i.e. giving the quality to) Disorder. Adjective-to-adjective modification uses the hyphen - Post-Traumatic - which as a single unit modifies the noun Stress. This is a Disorder caused by Stress, specifically stress that isPost-Traumatic, hence the particulars of the punctuation. VigilancePrime 21:39, 17 August 2007 (UTC)

I read the name "Post-Traumatic Stress Disorder" a little differently. I think the individual is suffering from adisorder that is secondary to (i.e., that is "post-") a "traumatic stress."

If I'm right in this interpretation, it's not the first time that a committee has come up with confusing terminology. But it'll probably get corrected in another edition of DSM.

Cheers! Nihil novi 22:10, 17 August 2007 (UTC)

The correct spelling in DSM-IV, which is the main standard used, is Posttraumatic Stress Disorder, without the hyphen.--CloudSurfer 18:36, 22 August 2007 (UTC)

If that's the case, then it should be the title of this article; I don't have the ability to reference directly unfortunately ATM. Cloud, was that the -TR that you pulled that out of? VigilancePrime 18:44, 22 August 2007 (UTC)

Referring to my copies, it was hyphenated in the DSM-III-R (and so presumably the DSM-III as well) and is no longer hypehnated in DSM-IV, original, and TR. --CloudSurfer 10:19, 24 August 2007 (UTC)

Given that this is the correct spelling and that there is already a page for this which redirects to the hyphenated version, would it not be a good idea to move the whole thing over to there and redirect the hyphenated spelling page to the correct spelling page? --CloudSurfer 18:41, 22 August 2007 (UTC)

Lead paragraph(s)

Nihil, thanks for cleaning up that lead... I knew when I added that part that it wasn't in the best format, but hoped someone smarter than I in that respect could fix it as the information was very important! I am wondering, though, if the total lead is too long now and should be moved. Keep the first two paragraphs (that give the name, reference the DSM, and give a quick-summary) and then move the rest of it to a new section above History. A Summary section, perhaps. I'm not sure what to CALL it, though, or I'd have "been bold" and done it (in true WikiDragon fashion!). Any thoughts on this? I think the current lead paragraphs are too long, but wanted a consensus first. VigilancePrime 20:27, 22 August 2007 (UTC)

I was thinking along similar lines. Concur about limiting the lead to the first two paragraphs (I'm glad you provided the information about variant spellings). The rest might, indeed, be placed above "History" and perhaps titled something like "Overview." Nihil novi 20:48, 22 August 2007 (UTC)

Ooh... Overview... I like it. :-) VigilancePrime 21:19, 22 August 2007 (UTC)

I'm reluctant to make a wholesale edit, but IMHO, the entire intro is irrelevent. If we want to make a grammactical distinction, then just enter a redirect, or merge the two articles. --DashaKat 11:51, 23 August 2007 (UTC)

Here's the removed text: In some references, "PTSD" is hyphenated ("post-traumatic stress disorder"). "Posttraumatic Stress Disorder," without the hyphen, is the official spelling in "DSM-IV" — the American Psychiatric Association'sDiagnostic and Statistical Manual of Mental Disorders, 4th edition. (DSM idiosyncratically capitalizes every word of a diagnostic entity.)

I agree with DashaKat on this one. I suppose the removed information could go somewhere, but definitely not in the introduction. Absentis 16:51, 23 August 2007 (UTC)

I can see this. The "reaction" part is important and I re-added it (and removed it from above as I felt that was reasonable to do, even though it was added by someone else on the talk page - please don't be offended if you feel it was a misstep). The rest I think is really more talk-page justification for WHEN (not if) someone comes along and starts renaming/moving/blanking/etc. this page in favor of the hyphenated page that currently and correctly redirects here. VigilancePrime18:28, 23 August 2007 (UTC)

I agree that the reaction part is important, but the introduction should stick to a summary of the disorder and the article. I think what you put back in belongs later in the article. (I'm not trying to cause a conflict here, just give "third-party" suggestions.) Absentis 18:53, 23 August 2007 (UTC)

Post traumatic stress "reaction"

Deleted text

PTSD is sometimes called post-traumatic stress reaction, to emphasize that it is a result of traumatic experience rather than a manifestation of a pre-existing psychological condition. The presence of a PTSD response is influenced by theintensity of the experience, its duration, and the individual person involved.

I have been in the business 25 years, and specialize in PTSD, C-PSTD, and PSTD/C-PSTD co-occuring with personality disorders. I have never heard of PTS "reaction". We need a citation for this before we can include it, otherwise it's misleading.--DashaKat 23:19, 23 August 2007 (UTC)

I do not like this term either, but check this out for a list of sites with that exact phrase, including Gaza Community Mental Health Programme (shows internationalization), of Applied Social Psychology, and National Institute of Health. At minimum, there needs to be some mention for people who search for this string. What I have seen in looking at this is that most hits on that exact phrase are referring to the reactions that symptomize or typify PTSD, making the reactions a symptom of the disorder. Perhaps a section on the PTSD article that lists symptoms can clarify that, and a redirect page would be good for the exact phrase (in multiple formats). Thoughts? VigilancePrime 05:23, 24 August 2007 (UTC)

Treatment section needs serious revision

The current text under this heading is disorganised and very patchy. A good resource for this area isAustralian Guidelines for the treatment of adults with ASD and PTSD. The full guidelines are available fordownload at no cost. The headings from this are:

PSYCHOLOGICAL INTERVENTIONS

Trauma-focussed CBT

Eye movement desensitization reprocessing (EMDR)

Brief psychodynamic psychotherapy

Stress management

Supportive counselling/therapy

Narrative exposure therapy (NET)

Hypnosis/hypnotherapy

Interapy

Imagery rehearsal

Group therapy

Debriefing

Psychological first aid

PHARMACOLOGICAL INTERVENTIONS PHYSICAL THERAPIES

Medical

Exercise

Alternative therapies

PSYCHOSOCIAL REHABILITATION

This seems like a good framework for the Wikipedia article as well and would cover all the major interventions/treatments. The main headings (the ones in all caps above) could be headings in the Treatment section. Later in the Guide evidence is reviewed and recommendations are then made.

Trauma-focussed CBT and EMDR are the psychological treatments of choice. However, the eye movements in EMDR have not been shown to be important in the treatment. Rather it is the trauma-focussed aspects. Following assessment, eight to twelve 90-minute sessions were usually sufficient. Severe problems with multiple traumas or with chronic severe disability require specific targetting which may require more sessions and increased time spent building trust. Group interventions may have a role.

Drug treatment should not be used as a first-line treatment. If it is indicated then an SSRI is the first choice. Second-choice treatments include the new antidepressants (notably mirtazapine)and the tricyclic antidepressants. Olanzapine may be indicated in some cases. (The Guide has a fairly complex set of indications for the use of these drugs.)

"There should be a focus on vocational, family and social rehabilitation interventions from the beginning of treatment."

Regular aerobic exercise may help. --CloudSurfer 11:19, 24 August 2007 (UTC)

combat operational stress (COS) - needs to be included in article

Just like Vietnam, avoidance of the issue. Found extensive material on Army and DOD site concerning COS, all of its symtems are PTSD.(69.144.67.124 23:09, 26 August 2007 (UTC))

abortion as possible cause of PTSD - needs to be included in article

Could we get a citation for abortion being a traumatic experience that might cause PTSD? I'm willing to believe it is, but it really does seem like a good idea to link to examples or evidence. —Preceding unsigned comment added by 70.231.226.75 (talk) 01:33, 4 September 2007 (UTC)

Better references needed; remove anecdote about "survivor guilt"

These need to be added: the nofootnote and pagenumbers headings "nofootnote|article"...

Also, the claim that a veteran described "survivor guilt" need to be quoted accurately or removed as "original research". The only reference is to an audio psychological digest in 2007, but the writer can't find the accurate date? It sounds like an anecdote, maybe even vaguely class-based (why would we assume this is a true story or necessary to this article -- because soldiers are so supposedly dumb they don't know the difference between "guilt" and "guilt"?), has no real reference. Really doesn't belong here. 98.196.202.92 18:09, 11 October 2007 (UTC)

Audio-Digest Psychiatry, a series of recordings of lectures by psychiatry professors, issued by a company affiliated with the California Medical Association. The lecture in question was published before 2007. Sorry can't help with exact date. And yes, there sometimes are malingerers among veterans — sorry to shock you. Nihil novi 05:22, 12 October 2007 (UTC)

I would also recommend that this anecdote be deleted. I can tell you from personal experience that medical lecturers often illustrate their lectures with stories and "urban legends" to drive a point home. This does not mean that the incident actually happened.Pustelnik 14:32, 20 October 2007 (UTC)

Just stumbled across the section at issue. There is a lot of "some people say..." without specifying which people, and an entirely US-centric POV even to the point of using those "Operation Potato Freedom"-type codenames which not even American media use anymore. The guilt anecdote is of dubious relevance, since it doesn't even make the point which it is trying to. It could just as well be that the guy did suffer from survivor's guilt but didn't know what it was called. It would be nice to cite some serious studies on the issue, rather than just juxtaposing various partisan views. <eleland/talkedits> 17:35, 31 October 2007 (UTC)

When adding refs, pleae add the whole ref - "Smith 1999" means very little - it's taking me a little time to actually cross-ref all of those into citable refs, thanks Bridesmill 17:04, 1 November 2007 (UTC)

PTSD conflated with Brain Damage

The following piece was inserted 11 Oct 07 by user:Palaskar

• Despite popular consensus, closed-head injuries and PTSD are organic brain disorders and should receive a diagnostic work-up through brain SPECT and PET scans. EEG and CT scans are usually of initial use. SPECT and PET scans are most useful for brain function, while MRI and are most useful for anatomical brain defects. Neuropsychological testing and not psychiatric testing is very helpful to measure memory, visual-spatial, language, emotional, and executive function impairments. (Peter S. Mueller, M.D., P.A., march 9, 2007, letter to Secretary Gates.)

Given that this essentially their only contrib to wiki, and given the far-out nature of this claim, I'd like to leave this here until someone provides something more concrete....Bridesmill 18:20, 1 November 2007 (UTC)

• OK, I think case closed - found a number of related letters at the vet in subject letters has[2]; it seems that user palkar is confusing & confabulating PTSD (which the vet in subject letters apparently has) and Post Traumatic Temporal Lobe Epilepsy (which he also has). Please read your refs carefully before drawing such conclusions...Bridesmill 18:28, 1 November 2007 (UTC)

Inappropriate use of APA style in article

I love the APA style, and I am one of the few people I know who not only love it (I'm usually surrounded by MLA-obsessed folks...yuck!) but I can write in APA format from memory usually (with occasional hints from the stylebook). Unfortunately, this is not an APA-style project, and we need to insure that the referencing system in this Wikipedia article is at least close to Wikipedia's style guide (WP:MOS, IIRC). I took out all the APA-ness of one section but it's late and I'm not going to work on the rest of the page tonight lest my brain turn off and I mess up some other section of the page (done that before). Anyway, just a note. I love the APA style, but Wikipedia is not the right place to be trying to use it. VigilancePrime 07:36, 3 December 2007 (UTC)

Okay, I went through and finished un-APA-ing the article. BUT, many of the "references" need to be properly referenced as many of them I simply put into the WikiFormat of endnotes rather than the full-bore citation (mostly when there was no citation information other than name and year), so the article there still needs a lot of work. Furthermore, I removed a ton of just plain extraneous stuff... like the large paragraph about a Holocaust memorial turning into a city embarrassment... what did that have to do with anything? I also pulled some unsourced statements (if it's a quote, it absolutely needs a citation) and did a bunch of tagging of other statements, mostly with {{fact}} tags and the occasional {{POV-statement}} or {{dubious}} tags. Still, the article overall, I believe you all will find, is far better and much more balanced, and in that belief I also removed one of the POV tags. Please, realize three things: 1. I am a WikiDragon who is Being Bold, 2. it is late and I may have made some mistakes, and 3. this all was done in very good faith. Cheers! VigilancePrime 09:16, 3 December 2007 (UTC)

PTSD symptoms list needed in article

Why are there no symptoms listed? —Preceding unsigned comment added by72.240.69.236 (talk) 23:10, 8 December 2007 (UTC)

This is the exact reason why I looked up this article, as I was hoping to quickly get a list of the symptoms without having to look it up in the DSM. It's hard to believe that such an obvious section has been left out. I'll have some time in a couple days, during which I'll write up a brief synopsis from the DSM, from which someone else can build upon.124.169.36.244 (talk) 03:40, 29 March 2008 (UTC)

edit: symptoms are listed below diagnosis. i am not sure that if you know what "diagnosis" is... it is hard to believe to see an ignorant wiki reader. (erol)\