Talk:Post-traumatic stress disorder/Archive 7

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Have restored the article to previous

There are a number of issues with these edits [1]

1. The previous headings were more clear [clearer].
2. [The section] "Military setting" deals with both shell shock and the vietnam war.
3. A discussion of history of terminology is needed and this is best dealt with in a [separate] ? section.
4. Not sure how [the following text] this pertains to PTSD "Erichsen observed that those most likely to be injured in a railway crash were those sitting with their backs to the acceleration. This is the same injury mechanism found in whiplash." Whiplash is not PTSD. Doc James (talk · contribs · email) (if I write on your page reply on mine) 16:47, 11 December 2013 (UTC)

The way it works, is a large amount of material gets split up under different headings. Therefore one heading 'military settings' should be split up to refer to ww1 and vietnam. This is quite standard. There is also (as far as I can see) nothing wrong with the title shell shock - fairly descriptive as I'm sure you'd agree. About Erichsen, railway spine is generally regarded as an early PTSD diagnosis, that's why it's there. Finally, it needs a separate section? How about the history section, which you have deleted. The nub of the matter is this: I have added well-referenced informative material that explains to the reader the history of PTSD, and you, for no good reason, are removing this and reverting to a version that is disjointed, unclear and missing several important facts. Why?Noodleki (talk) 19:13, 11 December 2013 (UTC)

Lets give others a chance to comment. Doc James (talk · contribs · email) (if I write on your page reply on mine) 19:23, 11 December 2013 (UTC)

Out of interest, if I was to, yet again, accommodate your unclear demands, would you revert it as well? With another list of problems?Noodleki (talk) 12:35, 13 December 2013 (UTC)

Noodleki, your text has been rejected; please engage higher quality journal sources when writing on medical content. Also, please avoid creating excessive sections for minor amounts of content. And see WP:UNDUE. SandyGeorgia (Talk) 16:02, 13 December 2013 (UTC)

If I understand you correctly, you think the section is too long (incidentally, not the reasons given above). So if I shorten it, that then wouldn't be a problem. The medical diagnosis of shell shock was the first major recognition of PTSD, and I'm sure you would agree that the article should cover this important historical aspect.Noodleki (talk) 17:57, 14 December 2013 (UTC)

No, I didn't say the section was too long. I said, "please engage higher quality sources" and "avoid creating excessive sections for minor amounts of content". SandyGeorgia (Talk) 21:08, 14 December 2013 (UTC)

I agree that we will have growing problems with giving a balanced picture of the complex history of the problems and diagnostic approaches across time for PTSD, if it grows by the addition of selected episodes. I agree that the article needs a lot of work in this area, but these additions are contributing to the problem.Hildabast (talk) 21:28, 14 December 2013 (UTC)

Higher quality sources? Your bar must be pretty high if it doesn't accept books written by scholars, academics and authors, like Nancy Coover Andreasen, Simon Wessely and so on. They are leading experts in the field, unless it's all a giant hoax. "excessive sections for minor amounts of content" - a huge section for a small amount of content? Even I can't commit this logical impossibility and I have been known to bend the laws of physics. The only interpretation I can think of, which doesn't involve believing ten impossible things before breakfast is that it's an Undue amount of material. This is why I previously suggested to reduce the size, to which you corrected me by repeating the same thing, and leaving me none the wiser. To Hilda Bast, - is a balanced article one in which no mention is made of railway spine and shell shock, thereby leaving the reader, who wishes to be enlightened, utterly in the dark? Groping for information? The 'selected episodes' didn't fall from the sky either, they are the major developments in the area. From an early, tentative awareness of pyschological issues affecting rail crash survivors, to the much more rigorous research and investigation into shell shock during WW1 and finally the modern understanding reached as a result of the Vietnam war.Noodleki (talk) 22:19, 14 December 2013 (UTC)

It's not so that no mention is made of these things: there are articles on issues such as railway spine and shell shock, and they are linked to. While I'm not saying there's not room for improvement, the sections you are talking about do not put things in much greater perspective than the current content, and place undue emphasis on particular selected sections rather than providing a balanced view of the development. There's not a single modern understanding that has been reached: it is a contested field.Hildabast (talk) 03:13, 15 December 2013 (UTC)

Okey dokey. As this is all rather unclear to me, let's objectify this, maybe with percentages. How much coverage to railway spine, shell shock, vietnam would be 'balanced'? At the moment, its 0% 0%, 85%. The rest is on the great Bard - who was a professional psychologist in his spare time.Noodleki (talk) 11:31, 15 December 2013 (UTC)

It is more that the military history of PTSD belongs in a section called that. I disagree with s [ p ] litting it up. Doc James (talk · contribs · email) (if I write on your page reply on mine) 02:04, 16 December 2013 (UTC)

What about those percentages?Noodleki (talk) 11:53, 16 December 2013 (UTC)

Misrepresentation/Misunderstanding of Information in Citation

The section on Prevention notes "The World Health Organization recommends against the use of benzodiazepines and antidepressants in those having experienced trauma," citing a report by the WHO.

What the source actually says is: "DO NOT prescribe benzodiazepines or antidepressants to manage symptoms of acute stress." (emphasis added)

In general, the report consists of flow charts showing recommended treatment options in a variety of situations. In some circumstances (such as the one that is apparently the source for the text in this Wiki), drugs are recommended against; in others they are recommended: "In adults, consider antidepressants, when CBT-T, EMDR or stress management prove ineffective or are unavailable"

This article is about PTSD, which pertains to the second quotation presented here, which recommends the use of antidepressants in at least some circumstances.

By contrast, the phrase "those having experienced trauma" presently in this Wiki gives the impression that the drugs in questions should never be used in treating PTSD (or, indeed in anyone who has ever suffered trauma ever in their life, if read literally). In the actual source, the guidelines are recommending against pharmacotherapy for Acute Stress Disorder, not PTSD. The line is therefore off-topic, as there is a separate article about Acute Stress Disorder.

Whoever added this line to this article seems either not to have understood the contents of the source, or is intentionally trying to mislead for one reason or another.

I could see the line as present forming the germ for something along the lines of "The WHO strongly recommends against the use of benzodiazepines and antidepressants during acute stress, but it does recommend that drug therapy may be appropriate in some adult patients who have since developed PTSD." As is, the line should probably just be deleted. 114.185.19.236 (talk) 15:50, 10 March 2014 (UTC)

PTSD is no longer an Anxiety Disorder in DSM-5

PTSD was moved from Anxiety Disorders in the DSM-IV to Trauma and Stressor Related Disorders in DSM-5. (http://www.dsm5.org/Documents/PTSD%20Fact%20Sheet.pdf) or (http://www.ptsd.va.gov/PTSD/professional/PTSD-overview/diagnostic_criteria_dsm-5.asp ). The opening sentence on the Wiki page defines PTSD as an anxiety disorder, then references the DSM-5. PTSD does not exist in the Anxiety Disorders chapter in the DSM-5. This reference is incorrect. PTSD is now a Trauma and Stressor Related Disorder. Doozer0311 (talk) 07:30, 26 March 2014 (UTC)

Yes have removed from the lead. Doc James (talk · contribs · email) (if I write on your page reply on mine) 10:12, 26 March 2014 (UTC)

Argue: that it's not a disorder but a symptom

PTSS seems to be referred to PTSD and I don't think this is correct. Discuss :) — Preceding unsigned comment added by 78.148.194.74 (talk) 03:09, 29 March 2014‎

Post traumatic stress injury

There is a movement to rename PTSD to posttraumatic stress injury. The name change would reduce stigma and acknowledge changed thinking about the nature of PTSD. See http://www.posttraumaticstressinjury.org/ and http://www.washingtonpost.com/world/national-security/new-name-for-ptsd-could-mean-less-stigma/2012/05/05/gIQAlV8M4T_story.html.

I wouldn't suggest that the article be renamed, but shouldn't there be a section that acknowledges a debate in the nomenclature and the underlying reasons animating that debate?

209.66.116.157 (talk) 16:28, 23 May 2014 (UTC)

I agree that it is a legitimate topic to include, although I suggest weaving it into the article, rather than creating a separate section. See WP:CRITS. - Mark D Worthen PsyD 23:28, 14 July 2014 (UTC)

Info about use of mobile apps and internet sites for treatment

I added a small sub-section beneath "management" about the emerging usefulness of smartphone apps and mobile web apps in treating PTSD symptoms. I used the following sources:
Brief, D., Rubin, A., Keane, T., Helmuth, E., Hermos, J., Lachowitz, M., Rybin, D., & Rosenbloom, D. (2013). Web intervention for oef/oif veterans with problem drinking and PTSD symptoms: A randomized clinical trial. Journal of Consulting and Clinical Psychology, 81(5), 890-900.
Kuhn, E., Greene, C., Hoffman, J., Nguyen, T., Wald, L., Schmidt, J., Ramsey, K., & Ruzek, J. (2014). Preliminary evaluation of ptsd coach, a smartphone app for post-traumatic stress symptoms. Military Medicine, 179(1), 12-18.

Fmvra1s (talk) 00:15, 29 April 2014 (UTC)

I liked your addition as this is an important new adjunct to treatment (or a treatment in itself). What you wrote needed to be tightened up, e.g., more succinct, remove editorial comment, but I am not sure why it was removed. You might want to converse with the editor who removed it and see what would be needed to add it back, albeit in a refined format. - Mark D Worthen PsyD 23:39, 14 July 2014 (UTC)

Fear, horror, and powerlessness are no longer described in the DSM, but are in the opening sentence of the article. Should this be removed?

Feelings associated with the trauma were part of DSM-IV criteria (Criterion A2), but are excluded from the DSM-5. Perhaps this should be redacted? — Preceding unsigned comment added by 67.71.178.179 (talk) 22:16, 16 July 2014 (UTC)

Please change "most people don't" to "some people will"

PTSD can be linked to intense feelings of shame and the belief that "something is wrong with me". I request that the "most people don't develop PTSD" wording, which seems to me easy to interpret as implying a social norm that people with PTSD are violating, shaming, be changed to "some people will". PTSD is not a voluntary choice they made and are continuing to make. — Preceding unsigned comment added by 66.249.84.113 (talk) 17:26, 19 August 2014 (UTC)

Non-English addition okay?

I could not find an answer to this question searching through Help. A recent edit (diff) added something in another language, although I can't find exactly where the addition is in the article--it's in a Category list. Is this okay? I am asking primarily for my own edification and so that I do not revert an edit that is actually acceptable. Thanks - Mark D Worthen PsyD 23:22, 14 July 2014 (UTC)

This is an intralanguage link. It is usually dealt with by Wikidata. Doc James (talk · contribs · email) (if I write on your page reply on mine) 07:00, 15 July 2014 (UTC)

Thank you! - Mark D Worthen PsyD 14:39, 20 August 2014 (UTC)

Start with Definition

I think the article should start by clearly defining what PTSD is, before starting discussing when it may occur as the article currently does. Cristiklein (talk) 09:06, 28 September 2014 (UTC)

New Section

https://wiki.riteme.site/wiki/User:MaScott14/sandbox

This is what I have been working on my sandbox. — Preceding unsigned comment added by MaScott14 (talk • contribs) 02:18, 19 October 2014 (UTC)

Assessment and Diagnosis Sandbox Edits for Posttraumatic Stress Disorder

Hello all, I have made changes in my Sandbox about this topic focusing on evidence-based assessment and diagnosis. It would be great if people would look at it and leave comments on my talk page before I post it on the article.

The sandbox link can be found here (https://wiki.riteme.site/wiki/User:Lizrjohnson/sandbox).

I appreciate it! YenLingChen (talk) 20:50, 3 November 2014 (UTC)

YenLingChen, Articles are discussed on article talk, not user talk. At any rate, I have posted to your course page about the numerous problems with the proposed sandbox edits, which should not be moved to mainspace as they will be reverted. Please ask your instructor to become familiar with the guidelines and online student training specific to medical content. SandyGeorgia (Talk) 23:50, 3 November 2014 (UTC)

see Talk:Autism_spectrum#Assessment_and_Diagnosis_Sandbox_Edits_for_Autism_Spectrum_Disorder Jytdog (talk) 00:17, 4 November 2014 (UTC)

and see User_talk:YenLingChen Jytdog (talk) 00:21, 4 November 2014 (UTC)

Semi-protected edit request on 11 November 2014

The table titled "Age-standardized Disability-adjusted life year (DALY) rates for PTSD, per 100,000 inhabitants, in 25 most populous countries, ranked by overall rate (2004)" has a typo in the Region associated with United States, Mexico, and Brazil. Mexico and Brazil have a region of "America". The United States has a region of "Americas" (plural). The regions should match for these 3 countries. Here is the code for the updated table (adding an 's' to America for both rows of Mexico and Brazil):

Age-standardized Disability-adjusted life year (DALY) rates for PTSD, per 100,000 inhabitants, in 25 most populous countries, ranked by overall rate (2004)

Region	Country	PTSD DALY rate, overall	PTSD DALY rate, females	PTSD DALY rate, males
Asia / Pacific	Thailand	59	86	30
Asia / Pacific	Indonesia	58	86	30
Asia / Pacific	Philippines	58	86	30
Americas	USA	58	86	30
Asia / Pacific	Bangladesh	57	85	29
Africa	Egypt	56	83	30
Asia / Pacific	India	56	85	29
Asia / Pacific	Iran	56	83	30
Asia / Pacific	Pakistan	56	85	29
Asia / Pacific	Japan	55	80	31
Asia / Pacific	Myanmar	55	81	30
Europe	Turkey	55	81	30
Asia / Pacific	Vietnam	55	80	30
Europe	France	54	80	28
Europe	Germany	54	80	28
Europe	Italy	54	80	28
Asia / Pacific	Russian Federation	54	78	30
Europe	United Kingdom	54	80	28
Africa	Nigeria	53	76	29
Africa	Dem. Republ. of Congo	52	76	28
Africa	Ethiopia	52	76	28
Africa	South Africa	52	76	28
Asia / Pacific	China	51	76	28
Americas	Mexico	46	60	30
Americas	Brazil	45	60	30

Culturesofwellness (talk) 01:07, 11 November 2014 (UTC)

Done. Good catch. --Ronz (talk) 18:01, 11 November 2014 (UTC)

Proposal for new information under the heading research

Below I have posted a couple of sentences, a proposal for an edit, that I thought would go well under the heading of Research. Its research done by the NIMH and did not appear under the current heading of research. this is where current research for PTSD is headed, in trying to find ways to possibly manipulate these signaling chemicals in order to help PTSD patients deal or overcome with PTSD. — Preceding unsigned comment added by Angelc542010 (talk • contribs) 20:05, December 3, 2014

Research

According to the National Institute of Mental Health, one of the largest scientific organizations and leader in research, some studies have shown that gastrin-releasing peptide (GRP) controls or regulates fear responses In studies done with mice, the NIMH reports that mice that lacked sufficient gastric-releasing peptide may have led to the creation of more powerful and permanent memories of fear. Angelc542010 (talk) 20:07, 3 December 2014 (UTC)

Interesting research. Your proposed edit looks good, I don't think anyone would object if you went ahead and added this to the article. Sarahj2107 (talk) 20:23, 3 December 2014 (UTC)

thank you. Is everything cited correctly, grammatically correct? I want to make sure its 100% before posting it. Thanks againAngelc542010 (talk) 04:31, 4 December 2014 (UTC)

I agree, looks good.--^Melody _Lavender 05:29, 4 December 2014 (UTC)

While this is true " one of the largest scientific organizations and leader in research," it is not needed here Doc James (talk · contribs · email) 15:06, 4 December 2014 (UTC)

Ok thank you for your input hows this:

Research

According to the National Institute of Mental Health, some studies have shown that gastrin-releasing peptide (GRP) controls or regulates fear responses In studies done with mice, the NIMH reports that mice that lacked sufficient gastric-releasing peptide may have led to the creation of more powerful and permanent memories of fear.

Why even mention NIMH? We should always use high quality sources thus that it is from a reputable body should be a given. Does anyone disagree?

"Some studies have found that gastrin-releasing peptide (GRP) play a role in controling or regulates fear responses. For example mice that lacked sufficient gastric-releasing peptide may create more powerful and permanent memories of fear."

Doc James (talk · contribs · email) 18:16, 4 December 2014 (UTC)

Ok that works for me. In what part of that sections should I post it? 98.190.168.58 (talk) 19:04, 5 December 2014 (UTC)

Proposed Changes to the Domestic Violence Entry

Hello, I would like to propose some changes to the organization and content of the Domestic Violence entry. The first paragraph of the entry would be more appropriate under the description of causes. In addition I would like to make Risk Factors a subsection directly after Causes because of the nature of the development of PTSD. Domestic violence is not direct causes for PTSD but they do put an individual at risk for its development. Any thoughts? JambaJuicy (talk) 18:12, 7 December 2014 (UTC)

Foster Care, A Risk Factor Not a Cause

Hi, I'd like to propose moving the Foster Care subsection to under Risk Factors instead of Causes, where it currently lies. Foster Care is not a direct cause of PTSD, events that occur within the system of foster care have been correlated to the incidence of PTSD, making it a risk factor not a direct cause. Dogsatthefarmersmarket (talk) 19:01, 4 December 2014 (UTC)

Done Doc James (talk · contribs · email) 19:52, 4 December 2014 (UTC)

While foster care is a subsection of risk factors now, risk factors is still a subsection of causes. Risk factors should probably get it's own section before causes.--^Melody _Lavender 19:33, 7 December 2014 (UTC)

Risk factors are potential "causes" in the lay sense of the term therefore I see nothing wrong with having risk factors under causes. This is generally were we put risk factors Doc James (talk · contribs · email) 19:53, 7 December 2014 (UTC)

Requirements of sources for considering social context of PTSD

Greetings! My student, User:MaScott14, has worked on a section that we consider parallel to the veterans section found in this spot for a project in this course. Her edits have four goals: to note the context of child soldiers in Uganda and elsewhere in Africa, to document how natural disasters impact PTSD in children, to remove the systemic bias in framing veterans as "U.S./not U.S.", and to include the differences in experiences of PTSD between children and adults. The draft is under revision in her sandbox.

The student posted her changes too quickly, as they had significant paraphrasing issues. We're working on these. I'm writing to get feedback about the possibility of appropriate use of non-tertiary medical sources. The veterans section currently does not meet the WP:MEDRS standards. To me, it shouldn't have to, as it is discussing sociological impacts. We believe that the information she seeks to include on youth merits the same standards as the veteran section. Thanks, and cheers. I would appreciate feedback from User:jytdog. Prof.Vandegrift (talk) 02:18, 25 November 2014 (UTC)

I also reviewed the "foster care" section. The sources are also quality secondary sources, like those proposed by my student. Furthermore, the section suggests by the heading that foster care is a cause of PTSD, when the literature discussed within seems instead to indicate that children in foster care have experienced prior traumatic events. Prof.Vandegrift (talk) 02:29, 25 November 2014 (UTC)

the issues were not just paraphrasing. Please look at the article. really -- go scan it. Now imagine someone just like you, next semester, who has another student, just like MaScott. Who also just dumps a student project wholesale, as a lump, into this article. Now imagine that for the next semester, and the next semester, etc. etc. Do you see a problem?

my point being, that what we try to do, is edit articles. Not craft content and dump it in. I fully understand that you may not be grading students for integrating content into Wikipedia articles. You should perhaps consider adding that criteria. This is by far one of our biggest problems with student edits. They do not care about the article into which they are dumping content; they care about their grade.

Please see WP:MEDMOS for some guidance as to how health-related articles are structured.

if content make claims about health (mental or physical), then MEDRS applies. If the content is just historical ("X happened") then MEDRS does not apply.

thank you for asking for my feedback. Jytdog (talk) 06:04, 25 November 2014 (UTC)

I disagree with the characterization of the student's edits as "dumping." The assertion that the student did not care about the article and only cares about the grade are inappropriate attributions. She identified a gap in the article based on a review of sociological scholarship. I do not see a problem with incorporating new sections when they fill gaps. The benefits of an interdisciplinary set of editors is to strengthen understanding of a topic.

I believe some outside perspective would be helpful, and I request more care in language use and attribution of motive on talk pages. {{Help me-helped}} with creating more thoughtful language in dialogue about content and about criteria - do all PTSD article editors really want no new sections or non-psychology scholarship about PTSD? I am concerned about how student voices are dismissed through this talk page. Prof.Vandegrift (talk) 16:17, 10 December 2014 (UTC)

no one is dismissing anybody. what is happening, is that students often don't know about, and don't particularly care about, WP's WP:Policies and guidelines for article content, and resist listening when we describe them. And this "dumping" really is a common thing that students do. I acknowledge that "dumping" is blunt language and not too nice, but that is what happened. And of course new sections are welcome - if they make sense with regard to WP:WEIGHT (not sure you are aware that piece of the WP:NPOV policy or not, but it has to do with how much space we give to various aspects of a topic. Having a huge section on side effects in an article about a drug, for example -- like three times as much space than any other aspect, is an example of WP:UNDUE weight that can make an edit fail NPOV. And again, this has to with the student actually looking at the whole article and thinking about it. Not just writing content for an assignment and sticking it into the article. The article and its needs come first. Jytdog (talk) 16:53, 10 December 2014 (UTC)

Jytdog, no more personal attacks, please. Again, as I've said before, I think it's quite problematic how some medical project editors are dealing with newbies. Don't WP:BITE. With the statements above you're not creating an enviroment that will lead to the recruitment of new editors. I'm very happy about the competent contributions of theses students. Disagreements about newly added content happen all the time on Wikipedia, due to the nature of the project. This is not a problem that occurs mostly or only with students. On the contrary, they invest time and they know the subject. The knowledge that Wikipedia uses secondary sources seems to have spread. So I see no problem and your dismissive language is out of line, Jytdog.--^Melody _Lavender 09:49, 11 December 2014 (UTC)

Edits I am interested in

Hello, I am editing Wikipedia pages for a Global youth Studies course, here are some of my ideas:

The topic that I have focused in on is post-traumatic stress disorder in children and adolescents, a topic where there is no information on the Wikipedia page. Talking about it in class, I wanted to be careful about making it not into a psychology-based contribution, but one that has a sociology spin on it. Therefore, I have to be careful to make sure that I have to find articles that do not talk about the science behind PTSD, but the sociology that is associated with it. At first I wasn’t sure that there was even sources about PTSD that didn’t talk about the neurological ideas associated with it, but after a quick search I was relieved that there was a lot on my topic.

The first thing I did was look on the library website and searched my topic in their search bar, and I was very encouraged. There were articles titled “Children and adolescents treated for post-traumatic stress disorder at the Free State Psychiatric Complex” and “Developmentally adapted cognitive processing therapy for adolescents and young adults with PTSD symptoms after physical and sexual abuse: study protocol for a randomized controlled trial” and “Longitudinal Relationships between Posttraumatic Stress Symptoms and Sleep Problems in Adolescent Survivors following the Wenchuan Earthquake in China”. All of these came from academic journals that are available in the library so that was encouraging.

I then turned to the internet for further research, and was also pleasantly surprised on the amount of research that has already been done on this topic. Just a simple google search of “post traumatic stress disorder in children and adolescents” and tons of articles are given. I know that I should be careful with deciding what source is reliable and credible, especially because I will be using these topics on the Wikipedia page.

I am new to wikipedia so feel free to contact me.

MaScott14 (talk) 14:55, 2 October 2014 (UTC)

Sounds interesting! I think that a great place for you to contribute would be the "Society and culture" section of the article. Right now it only has two sections, and they're both about veterans. Depending on what kinds of review articles you can find, you might be able to add "United States--Civilians" and "Other countries--civilians" subsections there. Kerry Ressler, Bekh Bradley, and Tanja Jovanovic are doing some interesting work with traumatized civilians in Atlanta, which could be helpful for the US Civilians part. Rob Hurt (talk) 15:37, 2 October 2014 (UTC)[

Thanks, Rob Hurt, this is helpful feedback! MaScott14, hopefully you can check out these sources. I appreciate Rob's willingness to provide guidance to student editors working to improve Wikipedia content. Prof.Vandegrift (talk) 15:52, 4 October 2014 (UTC)

User:Jytdog, User:Doc James - I wanted you to see our beginning work to try to engage editors to do good edits on the article. I reviewed your discussion elsewhere on WP, and I'm sorry you are having such a negative experience with classroom projects, and that our efforts to include the impacts of PTSD on children in war zones and natural disasters have caused you so much consternation. We will not be continuing with our efforts to work on this page, and we will steer far clear of medical articles in the future. Please AGF when possible.Prof.Vandegrift (talk) 22:40, 11 December 2014 (UTC)

Prof.Vandegrift; your edits did not cause any consternation. Good luck to you. Jytdog (talk) 22:49, 11 December 2014 (UTC)

Primary Sources

Hello, I was just reviewing the "Domestic Violence" sub section on the PTSD page. I want to know why you reverted the work that I contributed. I understand that we should not use primary sources but those sources were not primary as they were literature reviews and meta-analysis. I am new to wikipedia and would like a clarification on this. JambaJuicy (talk) 23:59, 9 December 2014 (UTC)

User:JambaJuicy which dif specifically are you referring to? Is it this one [2] Doc James (talk · contribs · email) 01:04, 10 December 2014 (UTC)

she had left me a note on my Talk page asking why I reverted her, and I asked her to put it here. she did. we edit conflicted with my answer below.Jytdog (talk) 01:06, 10 December 2014 (UTC)

hi Jambajuicy thanks for asking. there are just a ton of issues and they would have taken forever to deal with. i will open separate sections for you below. Jytdog (talk) 01:06, 10 December 2014 (UTC)

first chunk this is from risk factors: trauma: domestic violence

(Note.. I am adding sentence numbers here.) (1) Research concerning the role of domestic violence in the development of PTSD is primarily focused on the relationship between mother and child, which omits any impact that the father-child relationship may have on a child’s development. (2) By centering research on the mother-child relationship, the development of PTSD in a child has been framed as solely dependent on maternal interactions. (3) Researchers that focus on domestic violence have historically sampled from low-income households and shelters due to the high visibility of women and children seeking refuge from violent situations. (4) Living in shelters can lead to additional stress and may have further impact on the mental health of the mother and child.

ok, sentences 1 and 2 are not supported by the Holt reference; I didn't find those ideas anywhere in the ref. please point them out. Also, they don't say anything about actual risk factors for PTSD. Also, please include PMID refs. we really rely on those, to help us see quickly what kind of source it is. I added it to the Holt ref so you can see what i mean. click on the PMID link in it, and you will see where it goes. and you don't need an "access date" for a journal article - they don't change. you need them for something like a database or a blog.

sentences 3 and 4 have nothing to do with the topic of this article or sectionJytdog (talk) 01:06, 10 December 2014 (UTC)

Jytdog First off thank you for responding to me. I was unaware of those specific citing rules I was not previously informed. The section in which I read the information for sentences 1 and 2 is on page five of the pdf document. I disagree with your judgment for sentences 3 and 4. The purpose of the "Domestic Violence" subsection is to elaborate on how being exposed to domestic violence puts someone at risk for the development of PTSD. It is important to note other social factors that might contribute to that development. Pretending that PTSD is developed through only one risk factor misleads the reader. Noting that researchers primarily study women and children from shelters, enlightens the reader on the additional economic, physical and mental stress that can ultimately lead someone to develop PTSD after they are abused. Due to these reasons I will be undoing your original edit. JambaJuicy (talk) 02:28, 10 December 2014 (UTC)

thank you for talking as well.

My request about citing PMID isn't a rule, its a norm. Different! I don't know if you were sent to this page Wikipedia:Citing_sources/Example_style- put the PMID thing is mentioned there. NBD, but this is one of the reasons why we prefer students to post drafts on Talk or in a sandbox and have somebody who knows how we operate give feedback, before it gets put into the article. i am happy to tweak refs - it is the content that is problematic.

I reckoned that page 5 is where you got sentences 1 and 2 from. They are not good paraphrases. The source doesn't say "omit" (as in "leave out altogether"; it says there has been minimal investigation - we do know some things and their impacts. The second is not there at all, especially the "solely". But again and more importantly, there is nothing there saying what is a risk factor for PTSD nor for whom.

with regard to your comments about sentences 3 & 4 -- no one is "pretending" anything. i have no idea what you are talking about. More importantly, there is nothing there saying what is a risk factor for PTSD nor for whom. it is absolutely clear that women in abusive relationships (especially if they are also in shelters) have a mindblowing amount of trouble; you could write several books on their troubles. What we need here, in this spot in the article, is direct information about risk factors for PTSD, not handwavy stuff about how much the lives of these women and their kids suck.

so none of this paragraph is OK. Jytdog (talk) 02:45, 10 December 2014 (UTC)

Sorry for my rash actions in reverting back the article. I was made aware by another user about the norms in editing and discussing. I am returning to this conversation because even though this was a project assignment I really care about this subject matter. Now moving forward; if you wish to cite the PMID for the sources please do so. In terms of the pre-exsisting primary sources it has come to my attention that I should have removed those in my edits. I did not think the existence of some primary sources were a hassle, but the user has told me if you see a mess clean it up. I used the word omit because a study that only focuses on the mother-child relationships does in fact omit (leaves out) the father's influence. Since early research is based on these findings mothers have been seen as the primary influence in the development of the child. If word choice/paraphrasing is the issue here then please don't just say that it was not in the source. For sentences 3 and 4 would you have preferred me to say, "Those who research the relationship between domestic violence and PTSD have historically sampled from low-income households and shelters due to the high visibility of women and children seeking refuge from violent situations. (4) By focusing on this specific population, researchers have compounded the possible trauma of living in shelters with the trauma of being exposed to domestic violence. " Though you think this information is 'handwavy', I believe that is important to add more information about how using a specific environment can influence research and later effect how the embodiment of traumas is displayed. JambaJuicy (talk) 03:37, 10 December 2014 (UTC)

JambaJuicy, I didn't say "if you see a mess, clean it up". I said WP:OTHERSTUFFEXISTS, and when we see a mess, we try not to make it worse :) [3] It's my bedtime now, so I hope you and Jytdog can sort this. (I cannot locate the "Children living with domestic violence" article in PubMed, so I don't know if it is a primary or secondary source. It is also from 2003, which is QUITE dated. And, that it's not PUBMED-indexed is not a good sign.) Holt (PMID 18752848) is a review, but it's six years old. At the top of this talk page is a box labeled Ideal sources with links to recent review sources which would be acceptable for this article. If you can find and review those, you'll have a better idea of how to continue working on this article. Did your professor explain that Wikipedia medical content is usually sourced to recent secondary reviews, and the difference between a primary and secondary source? SandyGeorgia (Talk) 03:51, 10 December 2014 (UTC)

The original edits (4 sentences cited above) were perfectly fine. I agree with JambaJuicy that the circumstances of the research (why is it limited to the impact of maternal relationships?) are important to give the statement context. Leaving that out is misleading. The Journal of Family Studies (Children living with domestic violence, second ref used) is a sociological peer reviewed journal and 2003 is not too dated to quote it here. The abstract is here. Whether to put "omit", "omit any", "mostly omit" or whatever - those are no issues that give you a reason to revert the whole work. Maybe a six year old ref can be improved, maybe not. The edits are for now, until someone finds newer sources, a definite improvement to the article. --^Melody _Lavender 08:54, 11 December 2014 (UTC)

Also, the full text of Holt et al is online here: The impact of exposure to domestic violence on children and young people: A review of the literature. A full text online is a huge asset for a reference in a free encyclopedia like Wikipedia, so I would leave that source in for quite some time, even if newer ones become available.--^Melody _Lavender 09:21, 11 December 2014 (UTC)

Melody, this was put into a section on risk factors for PTSD. Nothing in sentences 1-4 is about risk factors for PTSD - not even in Holt. Putting it here is WP:OR. Sentences 1-2 maybe could go into this section Domestic_violence#On_children but even so they are an exaggeration; the text actually describes some of what research has found. Sentence 3 could perhaps go into a section in Domestic violence critiquing research, if there was consensus there to open that. And again sentence 4 is not about PTSD and its presence here is OR. Jamba appears to be making a claim that these are risk factors for PTSD, butthe source doesn't say that.Jytdog (talk) 14:05, 11 December 2014 (UTC)

The risk factor is domestic violence. The section needs expansion. Most of the research is on women abusing their children. So far you agree that that's valid content. Sentence 1 by itself is obviously biased because it makes it look like women are the ones committing all the domestic violence against kids. We need to find a way to tell the reader that the statement is biased. We can't just say that, we need a source. The editor found one. Problem solved. I think I've witnessed situations like that many times before on high-profile articles where you can't add a syllable without a source. The solution JambaJuicy found is perfect. Same situation with the next statements: obviously collecting data in a shelter is biased and the sample is tainted, we need to tell the reader that or else the text will be biased. That is the reason for the addition of sentence No.4: further critiquing the research because living in a shelter might pose people at risk of mental illness, which is in and of itself a risk factor for the development of PTSD: if you have depression or anxiety disorder, you're more likely to develop PTSD after major psychological trauma. And I have just seen that this fact isn't in our text yet. But that's the reason why sentence 4 is there, imo.--^Melody _Lavender 17:14, 11 December 2014 (UTC)

"Most of the research is on women abusing their children." this is not at all what the Holt reference says on page 5 of the pdf. You don't seem to have read it.Jytdog (talk) 17:18, 11 December 2014 (UTC)

"living in a shelter might pose people at risk of mental illness, which is in and of itself a risk factor for the development of PTSD: if you have depression or anxiety disorder, you're more likely to develop PTSD after major psychological trauma" The step from the part of this sentence before the semicolon to the part after is OR/SYN. In the part of this before the semi-colon, said this broadly, the connection between the part before the comma and the part after the comma, is also OR/SYN and is not supported by the Holt reference either. This is not in the Holt ref or any other ref provided. That is my point. In the part after the semi-colon, the step from the first part to the second part 'is supported by Holt. Jytdog (talk) 17:18, 11 December 2014 (UTC)

It's in the paragraph before last paragraph on page 801. The second part is in the second ref, not in the Holt text. WP:OR means putting together unrelated stuff to make a completely new statement. Talking about shelters and then explaining relevant aspects of shelters is not OR. All those scientists who wrote these papers know that shelters are likely scary and depressing. And almost every sane individual under the sun can guess that that's true. This is not rocket science. It's a Wikipedia specialty that we need a source for the fact that the sun is visible in the sky with the bare eye on a clear day. And we found a source. I'd go beyond saying this is admissible content, I think it is necessary content. It's well sourced and well accepted science on the topic at hand.--^Melody _Lavender 17:34, 11 December 2014 (UTC)

I don't know which part of what I wrote about you are discussing, but at this point you are going to have to quote the parts of the sources where something specific is supported, because as I wrote, I don't find it. And the issue with discussing shelters nor discussing research into child-father relationship in domestic abuse in this section is that nothing in Holt connects those things with PTSD. Making those connection is WP:SYN. You are not dealing with that. If this section were structured so that any negative experience is a risk factor for PTSD, or anything related to trauma (e.g. father-child relationships in situations of domestic abuse), this section would become gigantic and without a focus. The section is about trauma as a risk factor for PTSD. Jytdog (talk) 17:56, 11 December 2014 (UTC)

At this point I can only recommend you put on your reading glasses, because I've given you the page number above. I'm talking about the text we're discussing, the 4 sentences. If you have doubts that domestic violence is a risk factor - that portion is still in the text in main space. The section should discuss some basics of domestic violence. That's what the 4 sentences do. I do understand however that you are unwilling to accept consensus and that I can't convince you. The 4 sentences are pretty basic stuff. Nothing in this small text is off-beat extraordinary content that arguably even needs a footnote.--^Melody _Lavender 18:25, 11 December 2014 (UTC)

and i read the page and i don't find it. that's why i asked you to bring quotes. and you still haven't addressed the lack of relation to PTSD. Jytdog (talk) 22:12, 11 December 2014 (UTC)

next chunk - now we are in the History section

The definition of rape trauma syndrome includes a number of symptoms that were not present in the DSM-I, and that were not widely accepted as symptoms of PTSD including many symptoms often associated with depression.

I don't know why you chose a 13 year old primary source here... and the source says literally nothing about DSM-I nor does it mention "depression". hmm Jytdog (talk) 01:06, 10 December 2014 (UTC)

next chunk

(Note.. I am adding sentence numbers here.) (1) Including civilian trauma in the definition of PTSD is important in calling attention to the traumas anyone can experience, as well as getting those exposed to such traumas the help they need. (2) However, the inconsistencies in defining and acknowledging those suffering from PTSD have not only to do with associated causes, but also with acknowledgment of pre-disposing (risk) factors. (3)The idea that veterans, who were supposed to be the strong face of a nation, were also susceptible to psychiatric disorders was inconsistent with the public’s conceptions. (4) “If [a patient] had another psychiatric disorder, such as depression, the stress reaction would be treated as secondary to that and would not be given an independent diagnosis. Implicitly, this approach suggested that gross stress reaction was a diagnosis that should not confer any stigma.” (5) This was partially responsible for the high percentage of PTSD diagnoses in military personnel in comparison to their civilian counterparts. (6) The stigma associated with depression and other anxiety disorders prevented those suffering from a combination of anxiety and PTSD from receiving the proper diagnosis and consequentially the proper care. (7) The DSM-III includes pre-existing depressive conditions as risk factors for developing PTSD. (8) This is especially important for victims of sexual violence who often present with depression following the trauma.

sentences 1 to 2 are WP:SOAPBOX and off target for a history section.

sentences 3-6 go back over content that was already discussed in the pre-existing text. why repeat this matter? what important new insight are you providing readers? i see nothing. it is wierd that the IHHRT ref comes with a "page needed" tag from January and it made me wonder where you copied this from, since I doubt you would add a page needed tag to a fresh ref. Where is it from? i just figured out that you don't know how to repeat a ref using "ref name". would have helped you fix that had you posted a draft.

sentence 7 and 8, why are you talking about DSM-III - like it was the first time. DSM-III was discussed in the pre-existing text. why are you not editing? why just dumping text into a mature article? this seems to connect up somehow with the prexisting text, but why was it important for women that depression was added as a risk factor to DDM-III. Jytdog (talk) 01:06, 10 December 2014 (UTC)

Great addition. Definite improvement to the article. Nothing wrong with it. The aspects discussed are very relevant to the article because combat veterans are a group that is often affected by PTSD. I'd support putting the content back in.--^Melody _Lavender 09:14, 11 December 2014 (UTC)

please see the edit that was made in its context. jumble. again with unclear relevance. please deal with the actual article and the edits proposed to it. thanks Jytdog (talk) 04:51, 12 December 2014 (UTC)

Mindfulness interventions for PTSD

(note - cut and pasted from my Talk page) Jytdog (talk) 19:27, 28 December 2014 (UTC)

Hi Jytdog, I noticed that you have deleted three of the references I had supporting mindfulness interventions for PTSD. However, I think it is best to keep the following one reference relating to cortisol, especially considering that cortisol is an important indication (biomarker) of hypothalamic pituitary axis function. This brand new study (published in 2014 Dec) measured salivary diurnal cortisol as an objective measure of hypothalamic pituitary axis function following mindfulness intervention for Veterans With PTSD. [Reference: Bergen-Cico D, Possemato K, Pigeon W (2014). Reductions in Cortisol Associated With Primary Care Brief Mindfulness Program for Veterans With PTSD. Medical Care, 52 Suppl 5 (S25-31)]

So, can I please add it back?

Thank you. Nandinik (talk) 22:12, 27 December 2014 (UTC)

that's a primary source, and one measuring a biomarker rather than an actual clinical outcome. Please read WP:MEDRS, especially the section called "Respect secondary sources". I am not too comfortable with the review you cited; it isn't specific to PTSD..... Jytdog (talk) 00:58, 28 December 2014 (UTC)

Although it is a primary source, this paper nicely reviews the literature in terms of presenting published studies that demonstrate significant improvements in PTSD symptoms among veterans who engage in mindfulness meditation. It also presents information on how decreases psychological distress symptoms are accompanied by reductions in diurnal cortisol levels, etc. The paper also has clinical implications considering that the measurement of salivary diurnal cortisol may be a useful way to identify biological marker for identification of improvements in PTSD related physiological dysregulation for veterans participating in mindfulness programs.

By the way, I found several “primary sources” cited in several places within the article – a quick search found the following: van Zuiden et al., 2009, Resnick et al., 1999, Pitman et al., 2002, Ahmadzadeh et al., 2002,Cohen et al., 2008.

So, I think this paper (Bergen-Cico, et al., 2014) should be included in the article, especially since it specifically addresses mindfulness interventions for PTSD. 96.52.36.115 (talk) 17:12, 28 December 2014 (UTC)

We should be having this discussion on the article Talk page. OK with you if I cut this from here and paste it there? thx. Jytdog (talk) 17:35, 28 December 2014 (UTC)

Please let me know where the talk page is located? Please let me know the link. I thought this was the talk-page? 96.52.36.115 (talk) 18:38, 28 December 2014 (UTC)

I provided links to this page on both the IP editor's Talk page and Nandinik's Talk page. Thanks for pointing out those other primary sources. I removed them and replaced them with reviews. Jytdog (talk) 19:43, 28 December 2014 (UTC)

So, as I have mentioned above, I think this paper should be included in the article since it specifically addresses mindfulness interventions for PTSD: Reference: Bergen-Cico D, Possemato K, Pigeon W (2014). Reductions in Cortisol Associated With Primary Care Brief Mindfulness Program for Veterans With PTSD. Medical Care, 52 Suppl 5 (S25-31) 96.52.36.115 (talk) 20:33, 28 December 2014 (UTC)

as i mentioned above, per WP:MEDRS we should only use review articles, not primary sources. Do you know how to find review articles? Jytdog (talk) 21:02, 28 December 2014 (UTC)

I do not think anyone would have written a review article on this new area of research – one might come up in a couple of years or so, I suppose. In the WP:MEDRS page, avoiding primary sources is only a guideline, not a strict rule. Therefore, I feel until a review article comes up, it would be good to cite this article, as it would even encourage someone to write a review article (and/or even to conduct more studies in this area). As I have mentioned above, it is a very relevant article to be cited (considering that this article also reviews the existing literature relating to PTSD and mindfulness). By the way, I am sure there would be additional primary source articles within this Wikipedia article - I only listed a few that I happened to find quickly to give as examples. 96.52.36.115 (talk) 22:59, 28 December 2014 (UTC)

do you know how to find review articles? and WP:OTHERSTUFFEXISTS is never a good justification. Jytdog (talk) 23:21, 28 December 2014 (UTC)

I generally search MEDLINE (and other academic databases) for articles. Anyway, I found two review articles on PTSD/mindfulness that can replace the existing Hofmann, et al article. Since there is no ‘edit’ button for the Wikipedia article, I am unable to incorporate them – if you wish you can do it. The following are the two articles:

Cindy Crawford, Dawn B. Wallerstedt, Raheleh Khorsan. A Systematic Review of Biopsychosocial Training Programs for the Self-Management of Emotional Stress: Potential Applications for the Military. Evidence-Based Complementary and Alternative Medicine(2013), Article ID 747694, 23 pages. http://dx.doi.org/10.1155/2013/747694

Lobsang Rapgay, Jae L. Ross, Owen Petersen. A Proposed Protocol Integrating Classical Mindfulness with Prolonged Exposure Therapy to Treat Posttraumatic Stress Disorder. December 2014, Volume 5, Issue 6, pp 742-755

Nandinik (talk) 23:21, 29 December 2014 (UTC)

Society and Culture

I made some edits (diff) to the Society and Culture section for various reasons, e.g., promotional, not relevant, belonged in another section, etc. The information for the UK seems appropriate for the section, but I ended up with nothing for the United States.

For medical diagnoses, the Society and Culture section can be a challenge. It's easy for it to end up being a hodge-podge of various snippets of information that are often not relevant to the intent of the section. What is the intent of the section? According to WP:MEDMOS (Wikipedia Manual of Style for Medicine-related articles), the Society and Culture section "...might include stigma, economics, religious aspects, awareness, legal issues, notable cases."

I suggest discussing proposed or new edits to the Society and Culture section here on the Talk page, so we make sure we're all on the same page. ;-)

Thanks - Mark D Worthen PsyD 15:24, 21 January 2015 (UTC)

Semi-protected edit request on 11 February 2015

A medical device that uses H-coil for deep transcranial magnetic stimulation (Deep TMS) as a noninvasive treatment. Brainsway obtained European Union CE mark approval to treat posttraumatic stress disorder (2011).[10] https://wiki.riteme.site/wiki/Brainsway Germanbrother (talk) 08:35, 11 February 2015 (UTC)

Not done: it's not clear what changes you want to be made. Please mention the specific changes in a "change X to Y" format. — {{U|Technical 13}} (e • t • c) 11:37, 11 February 2015 (UTC)

Moved to talk for sourcing

None of this is well sourced (if sourced at all). Moved to talk for sourcing and discussion. SandyGeorgia (Talk) 16:39, 12 February 2015 (UTC)

Medications

Some medications have shown benefit in preventing PTSD or reducing its incidence, when given in close proximity to a traumatic event. These medications include:

Alpha-adrenergic agonists: Anecdotal report of success in using clonidine ("Catapres") to reduce traumatic stress symptoms suggests that it may have benefit in preventing PTSD.

Beta blockers: Propranolol ("Inderal"), similar to clonidine, may be useful if there are significant symptoms of "over-arousal". These may inhibit the formation of traumatic memories by blocking adrenaline's effects on the amygdala.

Glucocorticoids: There is some evidence suggesting that administering glucocorticoids immediately after a traumatic experience may help prevent PTSD. Several studies have shown that individuals who receive high doses of hydrocortisone for treatment of septic shock, or following surgery, have a lower incidence and fewer symptoms of PTSD.

Psychobiological treatments have also found success, especially with cortisol. Psychobiological treatments target biological changes that occur after a traumatic event. They also attempt to chemically alter learning or memory formation. Cortisol treatments after a traumatic event have found success in mitigating later diagnosis of PTSD. As discussed earlier, cortisol is often lower in individuals at risk of PTSD after a traumatic event than their counterparts. By increasing cortisol levels to normal levels this has been shown to reduce arousal post event as well prevent GR upregulation.

References

DSM

We cannot duplicate DSM in aricles: the APA guards its copyright. Moved to talk for rewrite. SandyGeorgia (Talk) 16:39, 12 February 2015 (UTC)

DSM-IV-TR

The diagnostic criteria for PTSD, stipulated in the Diagnostic and Statistical Manual of Mental Disorders IV (Text Revision) (DSM-IV-TR), may be summarized as:

A: Exposure to a traumatic event. This must have involved both (a) loss of "physical integrity", or risk of serious injury or death, to self or others, and (b) a response to the event that involved intense fear, horror, or helplessness (or in children, the response must involve disorganized or agitated behavior). (The DSM-IV-TR criterion differs substantially from the previous DSM-III-R stressor criterion, which specified the traumatic event should be of a type that would cause "significant symptoms of distress in almost anyone," and that the event was "outside the range of usual human experience.")

B: Persistent re-experiencing. One or more of these must be present in the victim: flashback memories, recurring distressing dreams, subjective re-experiencing of the traumatic event(s), or intense negative psychological or physiological response to any objective or subjective reminder of the traumatic event(s).

C: Persistent avoidance and emotional numbing. This involves a sufficient level of:

• avoidance of stimuli associated with the trauma, such as certain thoughts or feelings, or talking about the event(s)
• avoidance of behaviors, places, or people that might lead to distressing memories as well as the disturbing memories, dreams, flashbacks, and intense psychological or physiological distress
• inability to recall major parts of the trauma(s), or decreased involvement in significant life activities
• decreased capacity (down to complete inability) to feel certain feelings
• an expectation that one's future will be somehow constrained in ways not normal to other people.

D: Persistent symptoms of increased arousal not present before. These are all physiological response issues, such as difficulty falling or staying asleep, or problems with anger, concentration, or hypervigilance. Additional symptoms include irritability, angry outbursts, increased startle response, and concentration or sleep problems.

E: Duration of symptoms for more than 1 month. If all other criteria are present, but 30 days have not elapsed, the individual is diagnosed with acute stress disorder.

F: Significant impairment. The symptoms reported must lead to "clinically significant distress or impairment" of major domains of life activity, such as social relations, occupational activities, or other "important areas of functioning".

References

Advert

This is a poorly sourced advert; I've moved it to talk for discussion and sourcing. SandyGeorgia (Talk) 16:39, 12 February 2015 (UTC)

The Sierra Club Military Families and Veterans Initiative organizes wilderness trips for veterans, and has received positive feedback about stress reduction. One viewpoint suggests that "the key seems to be helping vets experience intense challenges free from the psychological shackles of life-and-death danger." Ice climbing has been a successful activity, "because its perceived challenge is so high," and Grizzly Tracking in Montana for Veterans, Service Members, and Families is scheduled for summer 2012. More relaxing wilderness trips may also be of value, as settling into a rhythm moves an individual away from a state of hypervigilance into a more relaxed "flow experience". A Colorado therapist has suggested that "repetitive motor movements like cycling or skiing" and "rhythmic outdoor activities" reduce stress through a mechanism similar to EMDR therapy. An Outward Bound instructor comments that "the most healing occurs while [people are] drinking coffee and hanging out by the river" with fellow vets.

Some uncontrolled studies have found benefits for people with PTSD from exercise programs. A small trial studied adding a physical component to biofeedback-based CBT with traumatized refugees. The authors concluded that physical activity may lead to clinical improvement, but bigger trials are needed. More trials are underway.

References

Proposal for new information

I was hoping to post some more information about the terms hypervigilance, intrusions, and arousal on this page. They are briefly mentioned, but I feel that they should be explained further. Thanks, Echilcot12 (talk) 00:53, 12 February 2015 (UTC)

Hi, Echilcot12; new posts go at the bottom of the talk page, so I have moved your post (see talk page guidelines in a link at the top of this page). Some of those terms can most likely be addressed by using wikilinks: it is best not to repeat information on this page that could be found at:

• Hypervigilance
• Arousal

The word intrusion is used twice on this page, and I'm not sure what article to link it to. If you can provide your sources, that would be helpful.

Also, have you had a chance to review WP:MEDRS, WP:MEDMOS (particularly the way medical articles are organized), and this helpful information? If you list a PubMed identifier (PMID) for your sources, that is helpful.

Expanding the article based on MEDRS-compliant sources, following the suggested outline at MEDMOS, and making sure this article stays on topic (with other info placed in articles that can be linked to) is the way to go. Regards,SandyGeorgia (Talk) 01:04, 12 February 2015 (UTC)

Please use recent secondary sources as described in WP:MEDRS. Please follow WP:MEDMOS. Please pay mind to the overall article - don't give your new matter undue weight. Please read all three of those links, if you have not already. If you don't understand something in them please ask - writing good health related content in WP is not simple. Thanks!Jytdog (talk) 00:59, 12 February 2015 (UTC)

SandyGeorgia Thanks for the feedback on my proposal for new information. I have decided to change the topic that I'm working on to a stub that's been less worked on. Echilcot12 (talk) 20:14, 12 February 2015 (UTC)

Semi-protected edit request on 20 February 2015

The sentence under "Risk factors" subheading "Trauma" implies that only men are combat veterans. Please change "Rates of PTSD are higher in combat veterans than other men, with a rate estimated at up to 20% for veterans returning from Iraq and Afghanistan.[16]" to "Rates of PTSD are higher in combat veterans than non-veterans, with a rate estimated at up to 20% for veterans returning from Iraq and Afghanistan.[16]" Also, the source at [16] doesn't seem to have anything to do with finding rates in combat veterans when compared to any other population, and instead deals with which diagnostic method is best in a clinical setting. Perhaps it's mislabelled? 77.100.182.199 (talk) 15:14, 21 February 2015 (UTC)

Partially done. [4] SandyGeorgia (Talk) 15:20, 21 February 2015 (UTC)

Uncontroversial requested move? No

See also

• Talk:Post-traumatic stress disorder/Archive 3#NO HYPHENS in_.22Posttraumatic....22_PLEASE
• Talk:Post-traumatic stress disorder/Archive 6#NO HYPHENS in_.22Posttraumatic....22_PLEASE
• 18:45, August 22, 2007 VigilancePrime (talk | contribs) moved page Post-traumatic stress disorder to Posttraumatic stress disorder over redirect (Bringing this in line with the official DSM-IV titling.)

WikiWinters, Anthony Appleyard, as you can see from this edit, the change of the article name here was most certainly not uncontroversial.[5] This article was moved based on no feedback or discussion here on article talk, and based on the request of one editor. Please restore the correct title per DSM, then discuss. SandyGeorgia (Talk) 00:32, 22 February 2015 (UTC)

From the article text:

The condition was added to the DSM-III, which was being developed in the 1980s, as posttraumatic stress disorder. In the DSM-IV, the spelling "posttraumatic stress disorder" is used, while in the ICD-10, the spelling is "post-traumatic stress disorder".

References

Discussion about the name change might conclude that the ICD version should be used, but how is it that one editor decides that a move is "uncontroversial" without noticing article talk? SandyGeorgia (Talk) 00:47, 22 February 2015 (UTC)

• This is indisputably a medical article, so the relevant guideline for its title is Wikipedia:Manual of Style/Medicine-related articles #Article titles: "The article title should be the scientific or recognised medical name that is most commonly used in recent, high-quality, English-language medical sources".

ICD-9 uses "Posttraumatic stress disorder"

ICD-10 uses "Post-traumatic stress disorder"

DiseasesDB uses "Posttraumatic stress disorder"

The Diagnostic and Statistical Manual of Mental Disorders IV uses "Posttraumatic stress disorder"

There are examples of both variants, but that in itself should make it obvious that the move from Posttraumatic stress disorder to Post-traumatic stress disorder could not possibly be uncontroversial. Personally, I'd always go with the DSM for mental disorders, so my !vote would be for Posttraumatic stress disorder. --RexxS (talk) 01:08, 22 February 2015 (UTC)

Similarly (and as discussed multiple times at WT:MED), I also go with the DSM here, noting the absurdity of some ICD names, like ... Combined vocal and multiple motor tic disorder [de la Tourette]. This was clearly controversial; please take greater care to notice talk in the future. SandyGeorgia (Talk) 01:14, 22 February 2015 (UTC)

• That move request was entered in uncontroversial format by User:WikiWinters at 17:23, 21 February 2015 (UTC). I have reverted it. Anthony Appleyard (talk) 06:41, 22 February 2015 (UTC)

  I apologize for the inconvenience. I didn't take the time to review the page for notices such as that one before I had requested the move, so it is my fault. I'll certainly take greater care in the future. Thank you. --WikiWinters (talk) 13:12, 22 February 2015 (UTC)

Semi-protected edit request on 10 March 2015

Under domestic violence, there is a misspelling. The word pregnancy is incorrectly spelled "pregnacy". Thenickman100 (talk) 23:12, 10 March 2015 (UTC)

Done Cannolis (talk) 23:37, 10 March 2015 (UTC)

Semi-protected edit request on 11 March 2015

Citation might be needed: "Because cortisol is normally important in restoring homeostasis after the stress response, it is thought that trauma survivors with low cortisol experience a poorly contained—that is, longer and more distressing—response, setting the stage for PTSD." Thenickman100 (talk) 01:37, 11 March 2015 (UTC)

Not done: it's not clear what changes you want to be made. Please mention the specific changes in a "change X to Y" format. — {{U|Technical 13}} (e • t • c) 21:37, 11 March 2015 (UTC)

PTSD Treated With Cannabis...Except On WP!

Not one goddamned mention of the people who use this plant to alleviate their symptoms. Was this article started by Nancy Reagan? Who has massaged it to read as such? What is the alternative product(s) being sold??? HuntClubJoe (talk) 05:26, 21 March 2015 (UTC)

Please check your personal attacks and bad faith assumptions at the door. Since I researched extensively Wikipedia's article on Medical cannabis, I can report to you that it mentions all of the uses of cannabis that comply with Wikipedia's medical sourcing guidelines. Unless something has changed in the last few months, there are no reliable secondary reviews compliant with MEDRS that support the use of cannabis for PTSD. If you have one, please present it. If you don't, please refrain from battleground statements. SandyGeorgia (Talk) 12:53, 21 March 2015 (UTC)

The symptoms come very late in the article

The article talks about PTSD for too long before finally the symptoms are mentioned in section 6.2) Medication.

Shouldn't the symptoms be mentioned somewhere near the top, just like the other psychological diseases articles? Ai.unit (talk) 12:19, 2 April 2015 (UTC)

Yes this article needs a "signs and symptoms" section at the start. Doc James (talk · contribs · email) 12:57, 2 April 2015 (UTC)

Epizelus

The reference to Epizelus as an early example of PTSD is inappropriate: Epizelus suffered from hysterical blindness, which may or may not have been induced by psychological trauma, but certainly is not PTSD. If anything, it would be a symptom of acute stress disorder. Cmacauley (talk) 14:29, 8 April 2015 (UTC)

Addition to page

Hello, I am creating a new page for the peer support model of Trauma Risk Management (known also as TRiM) and have been advised to link to it from this existing PTSD page (but to start a discussion on the existing page, hence this message). I would like to link to the new TRiM page by adding the topic of Peer Support in the most appropriate place on this existing page, which would be under the Prevention section. Does anyone have any feedback before I do this? Many thanks Kirstinhay (talk) 15:08, 28 April 2015 (UTC)

Hi, Kirstinhay. From your contrib history, it appears that you may be talking about Draft:Trauma Risk Management; is that accurate? If so, I can't agree with the feedback you were given there, because a good deal of that content would be off-topic here and would, in fact, be better placed under a TRM specific article. If you were to place all of that info here, some of it would be overly detailed and off-topic for this article; I don't agree with the reasoning for declining your draft. Also, there is too much "how-to" info in your draft. Also, if you can look up PMID at PubMed and add them to your sources, others can more easily evaluate your sources per WP:MEDRS to determine if any of the content is appropriate here. SandyGeorgia (Talk) 15:18, 28 April 2015 (UTC)

Thanks so much for the feedback (Talk) Yes that is the page but I meant that I would link to the Draft:Trauma Risk Management page from this one with a short insert - a short paragraph about peer support and TRiM as one method of peer support - then linking to the full article (as you say and as I pointed out after the previous feedback it is definitely a subject in it's own right with lots of research and evidence) but I was trying to follow the advice given by the user who declined it. I will tidy up the draft content to take into account your comment about too much 'how too info' and add the referencing you mention. Do you know if I can simply resubmit the draft page that was initially declined? Apologies if I'm doing this incorrectly, as you can probably see I'm very new to this. thank you Kirstinhay (talk) 15:40, 28 April 2015 (UTC)

P.T.S.D. doesn't redirect here

Someone fix it.

Done Doc James (talk · contribs · email) 14:28, 30 April 2015 (UTC)

Semi-protected edit request on 14 May 2015

Post-traumatic stress disorder 142.27.171.3 (talk) 17:58, 14 May 2015 (UTC)

Not done: it's not clear what changes you want to be made. Please mention the specific changes in a "change X to Y" format. Altamel (talk) 18:40, 14 May 2015 (UTC)

Alternate spelling

I do not want to get into some battle, because a trend, medical change, or even editorial consensus, has decided on a particular spelling, but there is absolutely no reason why the alternate spelling of Post-traumatic (post-traumatic) is not in the lead. It was spelled this way and according to this very article and links the spelling is still used which is clear evidence of a variation of spelling. With all that stated would someone please add this to the lead (alternate spelling: post-traumatic) per Wikipedia policies and guidelines? Otr500 (talk) 10:34, 11 May 2015 (UTC)

Important note

It seems to me there is a whole lot of effort that has been put into making it look like the name of this article must remain as it is. This does not follow any policy that I know of and I want to "clear the air".:The hidden note directing editors: DO NOT CHANGE THE NAME OF THIS ARTICLE, and the edit warning, raises flags of concern.

"Attention editors Posttraumatic stress disorder has no hyphen on Wikipedia. Please review the talk page archives before proposing to change it or requesting a move to an article name with a hyphen."

First; the definitive "Posttraumatic stress disorder has no hyphen on Wikipedia" is wrong on so many levels. The way this is written even an alternate spelling would be prohibited so this needs to be removed.

• For the record:

There are many policies and guidelines, with broad Wikipedia community-wide consensus, that gives evidence there is no policy to dictate that the common name, per references, and Wikipedia consensus, can be trumped by anything other than maybe the Wikipedia Foundation. If there is a directive from the Wikipedia Foundation that this name "must" remain as it is would someone please provide the source?

It is really subversive to splash "legal" looking tags and warnings that gives the appearance that something must be left alone, for whatever reason. Semi-protection has a purpose like protection against vandalism, but NOT to hamper Wikipedia.

The name of this article is simply not mandated solely by the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), nor any other "official" ("Wikipedia does not necessarily use the subject's "official" name as an article title") naming. For reference this can be viewed at Wikipedia:Article titles, especially Deciding on an article title. Title naming can also be subjected to the fact that consensus can change. It is not the job of Wikipedia or editors to change a name or spelling (or advance one particular name) of a word because the supposed experts decide they like another one better. These warnings can be seen as a sort of instruction creep or ownership. Clarification of any potential confusion can be found at Wikipedia:Ownership of articles.

This article also has problems. The name, if not what is found to be the more common by reliable sources, is possibly one. There also appears to be a problem with this article and related titles: Combat Fatigue redirects to Combat stress reaction (generally short-term) that states it should not be confused with post-traumatic stress disorder (generally long-term) but is related to shell shock that can lead to PTSD. The American Psychiatric Association states: "PTSD has been known by many names in the past, such as “shell shock” during the years of World War I and “combat fatigue” after World War II.". There is certainly confusion and either what would surely be considered authoritative is wrong or some content reflecting clarification is needed.

The British use "post traumatic stress disorder", the Canadian military use "Operational Stress Injury" (OSI) for combat related PTSD. The New England Journal of Medicine (Vol. 346, No. 2 · January 10, 2002) uses a hyphen, as well as the National Institute of Mental Health." and "Pubmed".

I have not taken a position concerning the title name at this time, as I have not reviewed the talk page archives and how consensus was achieved, but do think the way things are presented could be better worded.

Considering the above; I will be adding the alternate spelling (per "Alternate spelling" above); Post-traumatic stress disorder (possibly Post traumatic stress disorder), of course supported by Wikipedia policy that "Only the first occurrence of the title and significant alternative titles are placed in bold:", as well as some mention of the names as used by other countries. Otr500 (talk) 00:12, 10 June 2015 (UTC)

A minor spelling variations (ie the hyphen) is not the most important thing about this condition. Thus it can go in the body of the article. We already say "Acceptable variants of this term exist; see the Terminology section in this article."

As the article has been like this for some time and obviously your change is controversial you should get consensus first.Doc James (talk · contribs · email) 13:50, 14 June 2015 (UTC)

You see this as a "minor spelling variations" but with the extreme actions to protect the name, with ONLY that "The spelling/hyphenation of "posttraumatic" is correct per DSM-5", I see it as protectionism, that is not conducive to the enhancement of Wikipedia. I took the position of compromise and posted 4 days ago my intentions, with reasoning supported by Wikipedia broad consensus, and you now jump on the band wagon reverting stating it is "controversial". There is also policy that dictates content inclusion (and exclusion), to include removing relevant referenced content. A "Terminology" section does not exempt a proper lead section from content per policy nor does it allow for a name or spelling to be advanced by subversion by burying information.

You seem confident, maybe supported by local consensus, that you can bully the changed spelling, possibly being exempt from compromise and possibly policy. I will now start a RM to see if community consensus is in line with local consensus that an official name, or spelling, or variant, can be pushed over what I see as by far the more common name, spelling, or variant. In case you did not know, I am not restricted to "local" consensus, especially when a "controversy" involves clear attempts to circumvent community consensus and policies and guidelines. Thank you, Otr500 (talk) 14:33, 14 June 2015 (UTC)

Details of spelling are trivia and the way the article handles it now is appropriate. Wikipedia is prone to Enormous Battles over Tiny Things like this. What matters is how well we describe the condition itself. Folks are free to spend time on what they want but there are so many articles needing attention to their substance.... Jytdog (talk) 14:43, 14 June 2015 (UTC)

I do not care one bit which of the variations of spelling is used. What I do not care for is having these tiny variations of little / no importance filling up the lead. Doing so is undue weight. Doc James (talk · contribs · email) 15:27, 14 June 2015 (UTC)

To me it is trivia to exclude the common name. Look at the tags dated December 2014. Both editors that commented are worried about the proper adding of what has long been the spelling of the word, now changed, and referencing that it is clutter to properly mention it in the lead because it is covered elsewhere. This is "still" (and even more) reason to list at least use of the main" alternate names and spellings in the lead. This is supported by recent consensus. I am almost certain both editors already know this. The "so many articles needing attention to their substance" card was played. This is so funny that, if it were not horrendous, would make me laugh. The lead is the body of the article. I reviewed the article, made comments, was not happy with the exerted effort I saw at maintaining the spelling by the warnings, as well as I saw other areas (the names and spellings used in other countries etc...) that could be improved. My first edit was reverted. So much for "substance".

IF the details of the spelling are "trivia" then change the spelling to that which I have overwhelmingly found to be more common, and move the DSM-5 approved "official" spelling down in the body. I bet that finds resistance also. The name as it is spelled now is controversial to me, is not in accordance to an abundance (I have a long list) of references, but I was satisfied with having it covered in the lead. I have no ulterior motive with this article except improvements. I am a persistent little piss and patient. I was once informed "...but there isn't a snowball's chance in, well, the Gulf Coast that you will prevail...", and I did. You are defending exclusion of what I see as ridiculous not to be included, claiming it trivia. I have listed (but you already know) "some" of the reasoning, provided policies and references, and now I am having to explain what is really a given.

Before I go off on a crusade, that I feel is supported by community consensus, I figure (it rarely works) I would appeal to the better side of compromise. It really would be better to just add the alternate spelling, and spend time adding substance than to have a protracted community discussion over the "trivial" spelling. Otr500 (talk) 00:34, 15 June 2015 (UTC)

I do not care whether or not the version with or without the hyphen is in the lead. Having both minor variations of hyphenation is not needed IMO and is well covered currently. If you want to start a RfC to change which version is present go for it. I will not weight in wrt to which. Doc James (talk · contribs · email) 10:22, 15 June 2015 (UTC)

Article title

If there is continued subversionary actions to not only propagate changing the well established, as well as very likely by far more common name (spelling), of post-traumatic stress disorder I will seek a RM. I have not taken a position to seek any title changes but to revert (or change) well established community-wide consensus practice, that is supported by WP:policies and guidelines, of listing alternate names and spellings, in bold in the lead just because someone doesn't think it belongs in the lead, to me is paramount to vandalism. Otr500 (talk) 13:56, 14 June 2015 (UTC)

Why a new section? This was being discussed above. Doc James (talk · contribs · email) 15:28, 14 June 2015 (UTC)

Yes it is. I am not sure why there wasn't an edit conflict. Otr500 (talk) 02:04, 15 June 2015 (UTC)

Merger proposal

Someone (I didn't dig back to find who) has added merge tags to discuss merging Trauma trigger into Posttraumatic stress disorder. Let's discuss.

• Support - BUT, "Trigger warnings" should remain as an article of its own. "Trigger warnings" are a social phenomenon and their use is much broader than PTSD. (Or maybe more specifically, detached from PTSD.) Gronky (talk) 01:41, 3 September 2015 (UTC)

==

• Caveat One concern with this proposed merger is that traumatic aggravation and trauma triggers may occur with levels of trauma that do not result in a PTSD diagnosis. Its important to recognize that not all trauma results in a post traumatic stress disorder, but individuals may still experience triggers. I'm not a clinician, so I'm inclined to defer to others on this. 11:54, 10-14-15 — Preceding unsigned comment added by 207.255.24.193 (talk) 15:58, 14 October 2015 (UTC)

Potential Addition to Research Portion of Page

Research conducted by Gilebertson, Lasko, Metzger, Milad, Orr, and Pitman (2006) studied adversely conditioned stimuli responses in 18 males meeting DSM-IV criteria for Post Traumatic Stress Disorder (PTSD) and 10 males previously exposed to trauma who did not develop PTSD. The effects of [blockade] on retention of a [response] was examined via administration of [[6]] HCl. Retention of the conditioned response was tested after one week in a threat group and a non-threat group. The [stimulus] were colored circles and the [stimulus] was an electrical stimulus. One week following the response acquisition, the conditioned response was only evident in the threat condition. This suggests that the belief in the presence of a threat is necessary for activating previously conditioned responses.

Citation: Gilbertson, M. W., Lasko, N. B., Metzger, L. J., Milad, M. R., Orr, S. P., & Pitman, R. K. (2006). Effects of beta blockade, PTSD diagnosis, and explicit threat on the extinction and retention of an aversively conditioned response. Biological Psychology, 73(3), 262–271. doi:10.1016/j.biopsycho.2006.05.001

(Mjester22 (talk) 03:57, 12 October 2015 (UTC))

Need secondary source per WP:MEDRS. That is a primary source. Doc James (talk · contribs · email) 12:02, 13 October 2015 (UTC)

Potential additions to "Prevention" section of the page

A Cochrane review published in 2014 assessed how effective various pharmacological treatments were for preventing the onset of PTSD in individuals that had experienced a traumatic event but at the time did not meet diagnostic criteria for PTSD. The findings of this review may be beneficial to include in this page's "Prevention" section. Below is a suggestion for a possible addition:

A review done by the Cochrane Collaboration assessed how effective pharmacological interventions were for presenting the onset of PTSD in individuals that had experienced a traumatic event but did not meet diagnostic criteria for PTSD. The results of this study found some evidence for the efficacy of hydrocortisone to prevent the onset of PTSD in adults, however the results provided no evidence for the efficacy of propranolol, escitalopram, temazepam and gabapentin.

References

--Siobhanhsu (talk) 02:55, 13 October 2015 (UTC)

Added. Doc James (talk · contribs · email) 12:02, 13 October 2015 (UTC)

PTSD definition missing

I noticed this article has no definition of PTSD? Can we use the DSM criteria? A. The person has been exposed to a traumatic event in which both of the following have been 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. Note: In children, this may be expressed instead by disorganized or agitated behavior. If no others mind I will add this.Charlotte135 (talk) 15:32, 10 November 2015 (UTC)

I am not sure whether I need to have talked here on this page before making edits to the article as I did a few days ago, given the semi-protection. If not, could someone explain this to me? Also, as i said above the definition appears to be missing from this article, which would I assume add some benefit to the content.Charlotte135 (talk) 14:56, 11 November 2015 (UTC)

I will go ahead and add the DSM definition to the article as per my comments from several days ago.Charlotte135 (talk) 22:35, 11 November 2015 (UTC)

Another potential addition to the "Prevention" section

This article does not give much focus to PTSD in children and adolescents-I think this page could be strengthened by adding information that is applicable for children. There is a 2012 Cochrane review, "Psychological therapies for the treatment of post-traumatic stress disorder in children and adolescents," that addresses treatments which have particular effectiveness for children. This review found that cognitive behavioral therapy (CBT) has the best effectiveness for the treatment of PTSD in children and adolescents. According to the review, improvement was significantly better for up to a year following treatment, and PTSD symptom scores were significantly lower. Out of multiple different treatments options, including CBT, psychodynamic therapy, narrative therapy, supportive counseling, and eye movement desensitization therapy, CBT was the only therapy shown to be effective for treating PTSD in children and adolescents.

References

-Aabraswell (talk) 22:45, 6 November 2015 (UTC)

Addition of a Risk Factors Section

Ciivilian women are more likely to develop PTSD than civilan men, but that both genders will have an increased risk for PTSD the younger they are at the time of trauma, the lower their socioeconomic status, and the higher intensity of the trauma experienced. For military individuals, the factors were slightly different; adverse childhood conditions, trauma severity, and a lack of social support all led to higher rates of PTSD. Other risk factors that were highlighted were poor education and minority status—both lead to increased risks of developing PTSD. (Brewin)

References

-- — Preceding unsigned comment added by Houstonsummers (talk • contribs) 17:55, 27 November 2015 (UTC)

This is a 16 year old source. no. Jytdog (talk) 05:18, 9 March 2016 (UTC)

Addition to Treatment Section

Chronic long-term PTSD can be significantly improved using Cognitive Processing Therapy (CPT), especially among individuals who have experienced violence and sexual trauma. Since Exposure Therapy would not be appropriate for situations of sexual trauma CPT should be used since this therapy has proven to be a balanced and effective form of psychological treatment for this type of trauma.

References

- — Preceding unsigned comment added by Houstonsummers (talk • contribs) 18:00, 27 November 2015 (UTC)

This is PMID 22182261, a primary source. No. Jytdog (talk) 05:19, 9 March 2016 (UTC)

Addition of Efficacy of Treatment Types

The efficacy of PTSD treatments-- psychological therapies were more effective than drug therapies, and both were more effective than controls. The best drug therapies included SSRIs and carbamazepine, both of which had large effect sizes. The psychotherapies that rated as most effective were CBT and EMDR—both of these treatments resulted in equally effective results. It was also noted that individuals that presented depression-like symptoms performed better using SSRIs - — Preceding unsigned comment added by Houstonsummers (talk • contribs) 18:09, 27 November 2015 (UTC)

Though it is commonly believed that a combination of psychological and drug therapies provide great results, a 2010 Cochrane review by Parslow et al. showed no significant differences in the combinations of treatments with selective serotonin reuptake inhibitors (SSRIs) and Prolonged Exposure Therapy (PE) or Cognitive Behavioral Therapy (CBT).

I agree that it should be included that combination therapy (psychological and pharmacotherapy) has NOT been found to be more effective than just psychological therapy alone. Lstrenk (talk) 15:14, 7 March 2016 (UTC)

The availability of school-based interventions is particularly important for children with PTSD. Children with PTSD are far more likely to pursue treatment at school (because of its proximity and ease) than at a free clinic.

References

-Lstrenk (talk) 15:13, 7 March 2016 (UTC)

Semi-protected edit request on 11 November 2015

Please change the formatting in the section 6.2 "Medication" as shown below. The categories have been elevated to headings and links preserved by duplicating the term in the first sentence of each section.

Medication

Medications including fluoxetine and paroxetine may improve symptoms a small amount. Most medications do not have enough evidence to support their use. With many medications, residual symptoms following treatment is the rule rather than the exception.

Selective Serotonin Reuptake Inhibitors (SSRIs)

Selective Serotonin Reuptake Inhibitors are considered to be a first-line drug treatment. SSRIs for which there are data to support use include: citalopram, escitalopram, fluoxetine, fluvoxamine, paroxetine.

Benzodiazepines

Benzodiazepines are not recommended by clinical guidelines for the treatment of PTSD due to a lack of evidence of benefit. Nevertheless, some use benzodiazepines with caution for short-term anxiety relief, hyperarousal, and sleep disturbance. However, some authors believe that the use of benzodiazepines is contraindicated for acute stress, as this group of drugs promotes dissociation and ulterior revivals. While benzodiazepines can alleviate acute anxiety, there is no consistent evidence that they can stop the development of PTSD, or are at all effective in the treatment of posttraumatic stress disorder. Additionally, benzodiazepines may reduce the effectiveness of psychotherapeutic interventions, and there is some evidence that benzodiazepines may actually contribute to the development and chronification of PTSD. Other drawbacks include the risk of developing a benzodiazepine dependence and withdrawal syndrome; additionally, individuals with PTSD are at an increased risk of abusing benzodiazepines.

Glucocorticoids

Glucocorticoids may be useful for short-term therapy to protect against neurodegeneration caused by the extended stress response that characterizes PTSD, but long-term use may actually promote neurodegeneration.

References

67.174.241.202 (talk) 09:11, 11 November 2015 (UTC)

Good suggestion. I added the subheadings as you recommended. Mark D Worthen PsyD 10:45, 26 November 2015 (UTC)

[[

File:Pictogram voting wait.svg|20px|link=]]

Already done By Markworthen. -- ferret (talk) 18:31, 1 December 2015 (UTC)

PTSD-specific Search Engine for Journal Articles and Books

The National Center for PTSD provides a free PTSD-specific search engine, which is very effective at finding journal articles, books, treatment guidelines, etc.

It is called PILOTS (Published International Literature On Traumatic Stress) and is available at:
http://search.proquest.com/pilots/?accountid=28179

The PILOTS User Guide and the PILOTS Thesaurus are available at:
http://www.ptsd.va.gov/professional/pilots-database/index.asp

When I want to review the literature on a PTSD topic, I search PILOTS, PubMed (MEDLINE), and PsycINFO. PILOTS frequently finds relevant journal articles that the other two do not.

Mark D Worthen PsyD 10:56, 26 November 2015 (UTC)

more suggestions

Risk Factors for Children and Adolescents--Potential Addition

There are medium to large effect sizes for factors relating to the subjective experience of the event and post-trauma factors; some of these factors include low social support, peri-trauma fear, perceived life threat, social withdrawal, comorbid psychological problem, poor family functioning, distraction, and thought suppression. These results indicate that subjective factors experienced by the child during or after trauma play a major role in determining whether the child develops PTSD after exposure to a traumatic event. Aabraswell (talk) 03:19, 28 November 2015 (UTC)

Addition to Management Section

According to a 2012 Cochrane Review, cognitive behavioral therapy (CBT) has the best evidence for effectiveness for the treatment of PTSD in children. According to the review, improvement was significantly better for up to a year following treatment, and PTSD symptom scores were significantly lower. Out of multiple different treatments options, including CBT, psychodynamic therapy, narrative therapy, supportive counseling, and eye movement desensitization therapy, CBT was the only therapy shown to be effective. Aabraswell (talk) 03:20, 28 November 2015 (UTC)

I understood this Cochrane review to report that all of the psychological therapies looked at (CBT, exposure-based, psychodynamic, narrative, supportive counselling, and eye movement desensitization and reprocessing) were effective at improving PTSD symptoms, but that CBT was the most effective. Lstrenk (talk) 15:11, 7 March 2016 (UTC)

Addition to Screening and Assessment Section

One of the most comprehensive tools for screening children for PTSD symptoms, is the Juvenile Victimization Questionnaire; this questionnaire has been validated for ethnically diverse samples of children ages 2 to 17. It is also important to note that the best screening strategies depend on children's ages. Children 7 years and older can self-report through such assessments as the UCLA PTSD Index for DSM-IV or the Child PTSD Symptom Scale, but for children younger than 7 assessments must be given to caregivers since the children are too young to give an accurate self-report of their symptoms. Such assessments include the Child Behavior Checklist and the Trauma Symptom Checklist for Children. Aabraswell (talk) 03:36, 28 November 2015 (UTC)

References

Aabraswell - I suggest you add what you have written above to the article. :O) - Mark D Worthen PsyD 23:06, 7 December 2015 (UTC)

Twitter "PTSD"

I came to look for references to online harassment, the con artistry and cry-bullying of people claiming they have this serious medical disorder. The best I could see in this article is a hand-wave reference to bullying.

The only related thing I immediately saw was PTSD Symptom Scale – Self-Report Version, which is a dangerous article supported by a garbage study. — Preceding unsigned comment added by 162.221.203.241 (talk) 19:46, 6 December 2015 (UTC)

Welcome to Wikipedia. :O) May I suggest that you contribute to the article? See Getting Started. - Mark D Worthen PsyD 23:12, 7 December 2015 (UTC)

Putting all this in the lead

I disagree with putting all this in the lead "(also known as post-traumatic stress disorder in many scholarly publications and the Collins English Dictionary, though the Diagnostic and Statistical Manual of Mental Disorders, the American Heritage Dictionary of the English Language and the Random House Kernerman Webster's College Dictionary do not hyphenate "post" and "traumatic")" and have thus moved it back to the body of the text.

References

-Doc James (talk · contribs · email) 12:37, 3 January 2016 (UTC)

Illustration

Does art therapy by a U.S. Marine have research value? And how is the art not more indicative of another condition, such as major depressive disorder? Unless showing an MRI of a brain with PTSD, please remove the illustration. - — Preceding unsigned comment added by 240f:17:9208:1:ad43:c1ef:3bc4:9008 (talk • contribs) 06:43, 3 January 2016 (UTC)

PTSD is not a mental illness!!!

The very first line should change mental illness to "brain injury". Period. End of subject.— Preceding unsigned comment added by Midwestern Mad Woman (talk • contribs) 19:20, 6 January 2016

You need a ref. Doc James (talk · contribs · email) 05:54, 7 January 2016 (UTC)

Semantics. Is brain cancer a "mental illness" or a "brain injury"? Wbm1058 (talk) 04:19, 16 January 2016 (UTC)

Also see philosophy of mind.

Ah, but brain cancer is a physiological disease that can cause mental illness via brain injury. PTSD does not require any form of brain injury, however some traumatic brain injuries can increase the risk of PTSD. That said, PTSD is essentially a maladaption by the brain/mind to a significant stress event.Wzrd1 (talk) 13:37, 13 February 2016 (UTC)

Grammar in first sentence

The sentence reads 'an' mental illness and not 'a' mental illness. — Preceding unsigned comment added by 5.151.199.128 (talk • contribs) 15:05, 15 January 2016 (UTC)

children

I think it would be helpful to add even more about the difference in DSM-5 criteria for children. According to the DSM-5, children over the age of six have the same diagnostic criteria as adults. For children six and under, the criteria are more age-appropriate. They can experience either avoidance or negative alterations in thinking; it does not have to be both. Additionally, these requirements highlight the fact that young children are less likely to use words to relive their experience, but instead express their memories through play.

References

Lstrenk (talk) 15:06, 7 March 2016 (UTC)

something very brief and specific. OK. Jytdog (talk) 05:20, 9 March 2016 (UTC)

Ethnic Differences in PTSD (possible addition)

I think it would be both interesting and beneficial to discuss ethnic differences regarding the lifetime prevalence of PTSD. A research studied showed that there are in fact, ethnic differences. For example, Compared to 7.8% of African Americans reporting lifetime PTSD, only 1.9% of Asian Americans reported lifetime PTSD. This was not due to a difference in reaction to traumatic events and further research is needed to explain this. The main findings showed that African Americans have higher prevalence rates than Asians and Latinos, and non-Latino whites have the lowest rates of probable lifetime PTSD.

For further reference: Alegría, M., Fortuna, L. R., Lin, J. Y., Norris, L. F., Gao, S., Takeuchi, D. T., … Valentine, A. (2013). Prevalence, Risk, and Correlates of Posttraumatic Stress Disorder across Ethnic and Racial Minority Groups in the U.S. Medical Care,51(12), 1114–1123. http://doi.org/10.1097/MLR.0000000000000007http://doi.org/10.1097/MLR.0000000000000007]

-— Preceding unsigned comment added by Danamansfield (talk • contribs) 01:06, 9 March 2016 (UTC)

this is PMID 24226308, a primary source. no. Jytdog (talk) 05:22, 9 March 2016 (UTC)

PTSD In Children (possible addition)

Though it was mentioned that adults are more likely to develop PTSD after a traumatic event than children, it is important to note that PTSD in children still occurs and there are some risk factors associated with this. PTSD is often seen as being something that occurs after a traumatic event, but there has been little discussion on what happens if this traumatic event was an accident, and in particular an accidental injury. Studies have shown that children who had a traumatic experience where they were accidentally injured are at higher risk of PTSD. Other risk factors include the psychological problems of the parents and it's impact on their children's symptoms after a traumatic event and children of parents who have PTSD are more likely to develop PTSD later on. I think we need to continue to have these discussions and may be beneficial to include on the wikipedia page.

An article for reference: Meijel, E. P. van, Gigengack, M. R., Verlinden, E., Opmeer, B. C., Heij, H. a, Goslings, J. C., Bloemers, F. W., et al. (2015). Predicting posttraumatic stress disorder in children and parents following accidental child injury: evaluation of the Screening Tool for Early Predictors of Posttraumatic Stress Disorder (STEPP). BMC Psychiatry, 15(1), 1-8. ??? Retrieved from http://www.biomedcentral.com/1471-244X/15/113

- — Preceding unsigned comment added by Danamansfield (talk • contribs) 04:42, 9 March 2016 (UTC)

this is PMID 25963994, a primary source. No. Jytdog (talk) 05:23, 9 March 2016 (UTC)

Difference between PTSD and complex PTSD (possible addition)

I think it would be interesting to add how the DSM-5's diagnostic criteria of PTSD and the ICD-11 (also known as the International Classification of Diseases, 11th version) differ in definition. The ICD-11 definition of complex PTSD has components of PTSD; however, it suggests that certain symptoms should be added in order to adequately distinguish the two. In order for an individual to be classified as having complex PTSD, the individual must have a 1) affective dysregulation, 2) negative self-concept and 3) interpersonal problems, in addition to the four domains of PTSD defined in the DSM-5: 1)re-experiencing, 2) avoidance, 3) negative alternations of mood, and 4) hyperarousal.

More information can be found in this article: Elklit, A., Hyland, P., & Shevlin, M. (2014). Evidence of symptom profiles consistent with posttraumatic stress disorder and complex posttraumatic stress disorder in different trauma samples. European journal of psychotraumatology, 5, 1-10. Retrieved from http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=4028608&tool=pmcentrez&rendertype=abstract

- — Preceding unsigned comment added by Danamansfield (talk • contribs) 04:56, 9 March 2016 (UTC)

this is PMID 24851144 , a primary source. No. Jytdog (talk) 05:23, 9 March 2016 (UTC)

The Effects of PTSD

    Like many mental illnesses, post traumatic stress disorder (PTSD) is different with everyone. This illness not only affects military veterans but anyone who has experienced a serious trauma. Some people may experience every symptom while others only encounter a select few. Some of these symptoms include: flashbacks, depression, anger, anxiety, inability to feel emotions, guilt, paranoia, eating disorders, nightmares, other sleep problems, self-harm, substance abuse, and even suicidal thought and actions . Events that are most likely to cause PTSD are assault, sexual trauma, sudden death of a loved one, severe illness or injury, an accident, natural disaster, and combat. Younger children, women, someone who recently lost a loved one or experienced a trauma as a child, and those with unsupportive families are more susceptible to being diagnosed with PTSD after experiencing these traumas ("PTSD: Statistics, Causes, Signs & Symptoms). With the wide range of traumas and the countless types of people, post traumatic stress disorder develops  differently with each individual, making it crucial for anyone with PTSD or who has a loved one suffereing from it, to find help immediately.

Resources: "PTSD: Statistics, Causes, Signs & Symptoms.” The Refuge. 2015. Web. 3 Mar. 2016.

    <http://www.therefuge-ahealingplace.com/ptsd-treatment/effects-symptoms-signs/>

McDoNaLd2121 22:24, 10 March 2016 (UTC) — Preceding unsigned comment added by McDoNaLd2121 (talk • contribs)

Notable PTSD incidents

I thought this incident was worth mentioning in the article as a social reaction to PSTD. It has been covered by numerous RS.

In 2016, a District Court Judge in Cumberland County North Carolina sentenced a veteran suffering from PTSD to 24 hours in jail for failing a court ordered urine test related to substance abuse treatment. The judge, Lou Olivera, joined the veteran for the night in jail to help him avoid a recurance of his PSTD symptoms.

References

--Nowa (talk) 15:29, 23 April 2016 (UTC)

What is the enduring interest of that? That is like a "human interest" story on the nightly news. Jytdog (talk) 15:32, 23 April 2016 (UTC)

True, but at least it's a start.--Nowa (talk) 10:59, 25 April 2016 (UTC)

Edits

This "Prevention may be possible when counselling is targeted at those with early symptoms but its not effective when carried out among all people following trauma."

Does not mean the same as "Prevention may be possible when psychotherapy targets those with early symptoms but its not effective for all people following trauma."

IMO counselling is a perfect appropriate and easier way to state psychotherapy. Psychotherapy is a type of counselling. This source says "The PACFA Research Committee recognises that there is overwhelming research evidence to indicates that, in general, counselling and psychotherapy is effective and that, furthermore, different methods and approaches show broadly equivalent effectiveness. The strength of evidence for effectiveness of any specific counselling and psychotherapy intervention or approach is a function of the number, independence and quality of available effectiveness studies, and the quality of these studies is a function of study design, measurements used and the ecological validity (i.e. its approximation to real life conditions) of the research." [7] Doc James (talk · contribs · email) 14:11, 18 April 2016 (UTC)

CADTH describes these measures as "Type of Counselling or Therapy Intervention and Comparator" [8] I would be equally happy with "therapy" rather than "counselling". Or we could use "talk therapy" at least in the lead. Doc James (talk · contribs · email) 10:31, 19 April 2016 (UTC)

I'm sorry, but your opinion is not factual. Counseling is a specific type of psychotherapy, and it is certainly not synonymous with psychotherapy. Yes, counseling is effective for many things. For PTSD, only a few specific types of psychotherapy modalities are evidence-based and specifically focus on trauma. I had listed all of those, but you deleted them and changed "psychotherapy" to "counselling." As I said elsewhere, this is not just a matter of semantics. If a patient with PTSD reads this page and starts seeking out "counselors" they may delay obtaining definitive treatment for PTSD and this delay could impair prognosis. I urge you to be more careful with your wording in the future when it is not your specialty. As a psychiatrist, this is mine, which is why -- unlike your thousands -- I only edit a handful of pages I have expertise in. This is not the first time you have changed one or two words and completely changed the meaning. — Preceding unsigned comment added by 2602:306:3589:DAB0:C18C:7D7D:3448:8720 (talk) 11:37, 30 April 2016 (UTC)

Would therapy make you happy? Not comment on the ref I provided? Doc James (talk · contribs · email) 15:06, 30 April 2016 (UTC)

Concerning sentence with no attribution

I was reading the history section, and found a sentence I thought sounded odd:

• The addition of the term to the DSM-III was greatly influenced by the experiences and conditions of US military veterans of the Vietnam War.[174] Due to its association with the war in Vietnam, PTSD has become synonymous with many historical war-time diagnoses such as railway spine, stress syndrome, nostalgia, soldier's heart, shell shock, battle fatigue, combat stress reaction, or traumatic war neurosis.[175][176] Some of these terms date back to the 19th century, which is indicative of the universal nature of the condition. In a similar vein, psychiatrist Jonathan Shay has proposed that Lady Percy's soliloquy in the William Shakespeare play Henry IV, Part 1 (act 2, scene 3, lines 40–62[177]), written around 1597, represents an unusually accurate description of the symptom constellation of PTSD.[178]

The first problem with that bolded sentence is that it is not attributed to any source. Second, without any source, it sounds like the Wikipedia editor's opinion on what sources and examples mean; while I cannot cite the specific rule, I do not believe Wikipedia editors are supposed to say that sources "suggest" or "indicate" anything other than what those sources/examples actually say. Third, these examples do not suggest "universality"; they are all English-language terms, originate in the Western world, and the only one outside of the 19th Century to the modern day is the Henry IV play (which is obviously Western). As it is, this statement sounds unencyclopedic. I would recommend either removing the statement, or find some respected source that suggests these terms and examples (or at least ones like them) demonstrate universality. — Preceding unsigned comment added by 206.193.226.178 (talk) 21:58, 2 May 2016 (UTC)

Edit request: Footnote 12

For some reason, the citation in Footnote 12, to The Body Keeps the Score, does not include the author: Bessel van der Kolk, MD. Please add. Also, it has a random "p." with no following page number; it is unnecessary, because the cite is to a specific chapter number. Please strike. — Preceding unsigned comment added by 24.61.41.34 (talk) 20:45, 11 June 2016 (UTC)

That ref was extra; i just removed it. Jytdog (talk) 23:25, 11 June 2016 (UTC)

Semi-protected edit request on 7 July 2016

TYPO: The Neuroanatomy section's last sentence refers to a 2026 study in the past tense. The source sited is from a 2016 study. I just want to correct the year to 2016.

GlitterBoots (talk) 20:42, 7 July 2016 (UTC)GlitterBoots

Done nyuszika7h (talk) 21:14, 7 July 2016 (UTC)

Semi-protected edit request on 8 July 2016

In the section Neuroendocrinology the following chunk of text occurs twice:

"The maintenance of fear has been shown to include the HPA axis, the locus coeruleus-noradrenergic systems, and the connections between the limbic system and frontal cortex. The HPA axis that coordinates the hormonal response to stress,[58] which activates the LC-noradrenergic system, is implicated in the over-consolidation of memories that occurs in the aftermath of trauma.[59] This over-consolidation increases the likelihood of one's developing PTSD. The amygdala is responsible for threat detection and the conditioned and unconditioned fear responses that are carried out as a response to a threat.[29]"

It looks like an edit was done for readability, but the original text was not removed.

Dicebar (talk) 09:18, 8 July 2016 (UTC)

 Done Thanks for pointing that out - Arjayay (talk) 09:29, 8 July 2016 (UTC)

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thumb — Preceding unsigned comment added by 90.219.119.246 (talk) 14:52, 18 November 2016 (UTC)

Semi-protected edit request on 29 November 2016

In the section describing the psychotherapy options, it currently states "CBT has been proven to be an effective treatment for PTSD and is currently considered the standard of care for PTSD by the United States Department of Defense.[117] "

However, the reference #117 does not contain any indication that it is currently the standard of care for the Department of Defense. Nowhere in the reference does it state it as such.

I would request the line to be modified as follows:

"CBT has been proven to be an effective treatment for PTSD.[117] " MrHobbits (talk) 03:20, 29 November 2016 (UTC)

Thanks for pointing out the issue. The content was correct and I provided two refs for it, and removed the other. Thanks again. Jytdog (talk) 03:46, 29 November 2016 (UTC)

how about linking the word "traumatic" in the first sentence of the lede

https://wiki.riteme.site/wiki/Psychological_trauma — Preceding unsigned comment added by 71.183.234.47 (talk) 03:33, 23 February 2017 (UTC)

Infobox image

This image isn't even remotely representative of anything. In my opinion, articles for diseases and disorders shouldn't even have images. Honestly, it's just distracting. What do you guys think? 2804:14C:65D6:6960:507C:3DCA:BD1:FFE (talk) 03:00, 8 February 2017 (UTC)

I agree with you. The image is distracting and does not add anything constructive.STRONGSTAR (talk) 21:41, 28 February 2017 (UTC)

Combat PTSD

Passing on from Ticket:2016081710014178 Mdann52 (talk) 23:33, 27 February 2017 (UTC)

I would like to suggest a section and subheading for this article titled "Combat PTSD" to strengthen what you have begun with the existing section titled "Military Experience." Combat PTSD is a more challenging condition to treat and that is why substantial resources have been put into research into combat PTSD, so that we will not have another generation of chronic PTSD sufferers like the U.S. had and continues to have as a result of the Vietnam war.

STRONG STAR was initially funded by the U.S. Department of Defense. The Consortium to Alleviate PTSD was funded jointly by the U.S. Departments of Defense and Veterans Affairs.

Principal investigators of these consortiums include the creators of two forms of therapy cited in the Wikipedia article on posttraumatic stress disorder. They are Edna Foa, PhD, of the University of Pennsylvania, who developed Prolonged Exposure therapy; and Patricia Resick, PhD, of the Duke University Medical Center, who developed Cognitive Processing TherapySTRONGSTAR (talk) 21:19, 28 February 2017 (UTC).

STRONG STAR is directed by Alan Peterson, PhD, ABPP, at The University of Texas Health Science Center at San Antonio.

The Consortium to Alleviate PTSD (CAP) is directed by Alan Peterson, PhD, ABPP, at The University of Texas Health Science Center at San Antonio and the South Texas Veterans Health Care System; and Co-Director Terence Keane, Ph.D., of the VA Boston Healthcare System, the National Center for PTSD and Boston University

Both consortiums are led by The University of Texas Health Science Center at San Antonio.

At the very least, I would like to suggest external links to the STRONG STAR website, as well as to the website page listing its published research to date. Here are the links: http://tango.uthscsa.edu/strongstar/index.asp http://tango.uthscsa.edu/strongstar/scipubs.asp

The Consortium to Alleviate PTSD, part of President Obama's National Research Action Plan, was built on the success of the STRONG STAR Consortium and has research studies that are just getting underway, so there are no findings to publish yet, but they are going to publish over the next decade.

Wikipedia also may want to consider developing a separate article on the STRONG STAR Consortium. I would not be qualified to do that because of the Wikipedia guidelines for authorship, but we can provide objective background, if needed, including documentation of coverage by third parties.STRONGSTAR (talk) 21:16, 28 February 2017 (UTC)

Not included to link to that website. Doc James (talk · contribs · email) 02:08, 1 March 2017 (UTC)

Semi-protected edit request on 17 March 2017

Add the citation below for this statement: "Preliminary results suggest MDMA-assisted psychotherapy might be effective for individuals who have not responded favorably to other treatments."

Amoroso, T., & Workman, M. (2016). Treating posttraumatic stress disorder with MDMA-assisted psychotherapy: A preliminary meta-analysis and comparison to prolonged exposure therapy. Journal of Psychopharmacology, 30(7), 595-600. 2601:18B:8200:61D8:7CB6:AB0F:5BE5:4F54 (talk) 00:53, 17 March 2017 (UTC)

Sure added to the research section. Doc James (talk · contribs · email) 01:18, 17 March 2017 (UTC)

Content

User:G J Lee I have moved this here for discussion. Doc James (talk · contribs · email) 14:47, 30 March 2017 (UTC)

"In 2016, Westat performed a survey of of 31,683 veterans registered with Wounded Warrior Project, an organization that serves veterans and service members with an injury or illness as a result of military service on or after September 11, 2001. 76.7% of veterans who completed the survey self-reported PTSD, making it the most common self-reported health problem among this large sample of veterans. A Primary Care PTSD Screen (PC-PTSD) within the survey, frequently used by the US Department of Veterans Affairs indicated 72.4% of respondents had positive scores for PTSD."

There are a number of issues: 1) Typically we do not go into great detail on how a trial was performed or who performed it as that is in the ref. We generally just state the conclusions. If every sentence or statement was to begin with the names of the researchers, the number of people randomed, ects WP would not work. 2) We should really be using high quality secondary sources per WP:MEDRS. This is a low quality survey. Doc James (talk · contribs · email) 14:47, 30 March 2017 (UTC)

Thanks for reviewing and fixing this issue.G J Lee (talk) 23:51, 30 March 2017 (UTC)

NEJM

doi:10.1056/NEJMra1612499 JFW | T@lk 08:34, 22 June 2017 (UTC)

Gene therapy and epigenetic treatment

Gene therapy seems to be a method of interest in management of PTSD. Perhaps worth a mention ? Gene therapy of TPH1 and TPH2 could potentially be done (but no such treatments exist yet).

There also seem to be a lot of other genes that can be modified using gene therapy (but again, no such treatments exist yet). Examples are PFBP5 and FKBP5

There also seems to be an epigenetic treatment available, that targets HDAC2, see http://www.cell.com/abstract/S0092-8674(13)01589-4 and http://www.medicaldaily.com/genetic-therapy-deletes-traumatic-memories-could-aid-ptsd-treatment-267279

KVDP (talk) 17:00, 23 June 2017 (UTC)

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Update Comorbidity of Depression reference

Reference 177 isn't a primary reference; it's actually citing a 1995 paper by Kessler et al. Kessler RC, Sonnega A, Bromet E, Hughes M, Nelson CB. Posttraumatic stress disorder in the National Comorbidity Survey. Arch. Gen. Psychiatry52(12), 1048–1060 (1995).

There's also a 2013 meta analysis that addressed this (I'm an author on it) where we investigated co-morbidity across gender and trauma type finding roughly 52% of individuals with PTSD had comorbid depression. https://www.ncbi.nlm.nih.gov/pubmed/23696449

70.181.128.46 (talk) 03:37, 9 August 2017 (UTC)Michael Scur

Lead image

File:A mask, painted by a Marine who attends art therapy to relieve post-traumatic stress disorder symptoms, USMC-120503-M-9426J-001.jpg

USMC-120503-M-9426J-001

This image has been in the lead for a long time. Would be good to see discussion before changing it. Doc James (talk · contribs · email) 09:03, 23 August 2017 (UTC)

PTSD passed on to next generations

I read several articles on that when I google it. Anybody with more knowledge on this topic to add some lines about it on this article? Thy--SvenAERTS (talk) 01:45, 25 August 2017 (UTC)

Help merging Crisis intervention debriefing

I intend to merge Debriefing#Crisis intervention into Posttraumatic stress disorder#Psychological debriefing as I originally proposed at Talk:Debriefing#Propose Crisis Intervention move-out. I want to be thoughtful about this merge, as this article follows WP:MEDRS and is of a higher standard than Debriefing. If anyone else more familiar with Wikipedia standards for medical topics would like to do the merge, please do. If not, I'll do my best. Sondra.kinsey (talk) 01:41, 9 September 2017 (UTC)

there is no useful content here compared to what is here. What do you want to leave there? Jytdog (talk) 04:08, 9 September 2017 (UTC)

I just updated the content here, and copied it there.. Jytdog (talk) 04:28, 9 September 2017 (UTC)

Sourcing

User:Barbara (WVS). Please use MEDRS refs:

• here you added a ref that is a press release about a primary source
• here you added a university website
• here you added another press release about a primary source
• here you restored the university website
• here you added a review from 2000, which fails WP:MEDDATE by a long way.

-- thanks. Jytdog (talk) 00:24, 17 September 2017 (UTC)

Diagnosis

The symptoms and criteria should be updated to match DSM-V. In assessments, is there a reason the CAPS is not mentioned as an assessment measure? BrianSeo1 (talk) 00:50, 22 September 2017 (UTC)

Early in pregancy

We have two refs here - PMID 22754291 (Kirs) and PMID 25734016. The latter is clear that the longer the pregnancy lasts, the higher the risk of PTSD. I have looked at the Kirs ref and I don't see where it says that losing a baby early increases the risk of PTSD. User:Barbara (WVS) where do you find that in the ref? Jytdog (talk) 00:28, 17 September 2017 (UTC)

page 188, first paragraph is where the Kirsten content is located. The whole Kirsten article is about early pregnancy loss...I don't think there is much discussion at all about late pregnancy. Indeed, PTSD develops in response to loss in late pregnancy, that is not an issue. What is being discussed as an issue is whether or not it also occurs early in the pregnancy. Please stop templating the regulars. Best Regards, Barbara (WVS) ✐ ✉ 00:38, 17 September 2017 (UTC)

Please identify where that source supports the content "Women who experience miscarriage early in pregnancy are at risk of PTSD as you made it read here for example.

There are only three mentions of PTSD in that ref:

• "It has been found that women who hold their deceased infant have significantly higher rates of post-traumatic stress disorder (PTSD), anxiety, and depression even 7 years after the event"
• "This is especially relevant if the termination of pregnancy takes place in the 2nd or 3rd trimester of pregnancy.41-43 PTSD and CG reactions have been documented in parents years after a termination on the grounds of abnormality. "
• "A further recent study examining the efficacy of an Internet-based cognitive behavioral therapy for mothers after pregnancy loss67 showed positive treatment effects, with the intervention group showing significantly reduced symptoms of grief, PTSD, and depression after treatment relative to the waiting-list group, and this symptom reduction was maintained at 3-month followup"

None of those support "early". Jytdog (talk) 02:21, 17 September 2017 (UTC)

Here is one that will do: Daugirdaitė, Viltė; Akker, Olga van den; Purewal, Satvinder (2015). "Posttraumatic Stress and Posttraumatic Stress Disorder after Termination of Pregnancy and Reproductive Loss: A Systematic Review". Journal of Pregnancy. 2015: 1–14. ISSN 2090-2727. doi:10.1155/2015/646345.

Miscarriage is an early spontaneous abortion and is defined in the Miscarriage article. If it were up to me I would rather differentiate between induced abortions and spontaneous abortions since the research related to each of these events also does this. But since I understand that this is a heavily watched article, I don't expect this suggestion to be adopted. I have added an appropriate reference to this article. I do question the inclusion of the Horvath article which is not a review article as a citation. The review article by Bellieni contains much content that supports the content that describes PTSD related to induced abortion. I would like to delete the Horvath reference and replace it with Bellieni to support the content that describes the relationship between induced abortion and PTSD. Please don't template me on my talk page. Best Regards, Barbara (WVS) ✐ ✉ 10:11, 22 September 2017 (UTC)

• this diff does not follow the MEDRS sources. That induced abortion causes PTSD is a myth propagated by anti-abortion activists. Do not restore without consensus. Again there are discretionary sanctions on this topic; if you do not understand discretionary sanctions please educate yourself but briefly they provide a means to swiftly end disruption on defined topics (which tend to be controversial ones that have been to arbcom) via blocks, topic bans, and other editing restrictions. Jytdog (talk) 14:42, 22 September 2017 (UTC)

I have added section on PTSD following childbirth. I propose combining the sections on abortion, miscarriage, and childbirth; the topic is similar and having a separate section for each I think perhaps gives the issue undue weight. But as any medical procedure or physically traumatic event can also cause psychological trauma maybe we should have a section on that in general with subtopics. Mvolz (talk)

Semi-protected edit request on 23 September 2017

Jasmine Guidance (talk) 19:21, 23 September 2017 (UTC)

I think we need to show that PTSD can be caused from:

Sexual Assault, Rape Warfare, War, Military Experience, Combat-Related PTSD Traffic Collisions Parental Alienation Any kind of trauma and trauma-related events TBIs/ABIs Child Abuse Domestic Abuse/Violence Psychological Abuse (Mental, Emotional, Verbal, Physical) Grief Suffering the grief of Suicide Suffering the Loss of Children Bullying Abortion Cancer Foster Care, CPS Miscarriage Refugees Genetics Drug and Substance Abuse Hood PTSD Having a disability or loving and caring for someone who has a disability and watching them go through it can also be traumatic on family members, friends, loved ones, and caretakers due to the emotional bond.

Not done: it's not clear what changes you want to be made. Please mention the specific changes in a "change X to Y" format. — nihlus kryik  (talk) 19:32, 23 September 2017 (UTC)

Wiki Education Foundation-supported course assignment

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PTSD and abortion

The references that I added and then were removed by Jytdog are more recent reviews that state that PTSD is associated with spontaneous, induced and selective abortions. These references have no connection to politics or any anti-abortion group nor can the association be considered a myth. The MEDRS do not use the word 'myth'. The primary-source and information that exists in the section now is quite dated. I couldn't even find another reference that would support the primary content that is contained in this section. One primary source citation and the content it 'supports' has to be considered undue weight due to the three MEDRS references that I found. I don't know what else to tell you. The sources I added are neutral and so was the content that was inserted. This doesn't have to be contentious and I am not understanding the problem. I am sorry that this is a sensitive 'thing' on WP. I think this can be handled in a neutral manner. My editing history shows that I have not been involved in any controversies related to this topic so all can be assured that I am editing in good faith, have no conflict of interest, desire consensus and want readers to find the medical information that is supported by high quality references.

Best Regards, Barbara (WVS) ✐ ✉ 22:32, 29 September 2017 (UTC)

You are adding older reviews. Look at the one I added - PMID 28905259 which is a review from September 2017. The other is the Bellini ref from 2013 that you have been using. The author, btw, is a member of the Pontifical Academy for Life and not somebody we should be citing on this. it is remarkable that the review acknowledges:

Only a few of the retrieved studies were prospective; ruled out confounding elements in data analysis; or used validated assessment tools. In contrast, most studies used data taken from big databases on female health, and this is a weak point of these studies, because confounding factors cannot be eliminated, because health assessment is performed at very different times from the event, and because causes of abortion are not explored.

The main restriction on the ability to arrive at a conclusion about the mental risks of abortion, is the scarcity and the heterogeneity of the studies. Different outcomes are studied (depression, anxiety disorders and substance abuse disorders, and several psychological symptoms), different scales or questionnaires have been used to measure them, and different age groups have been analyzed, making difficult any comparison and any conclusion, although a correlation between abortion and subsequent risks for mental health seems realistic.

The last sentence there, reflects their being opposed to abortion.

The more recent review directly addresses the poor quality of the research, and discusses the first well-controlled study of the issue.

I have no idea what you mean by "primary source" or outdated.

There is a long ugly history behind this -- see this for example Jytdog (talk) 06:49, 1 October 2017 (UTC)

Opened a discussion at WT:MED here: Wikipedia_talk:WikiProject_Medicine#Sources_about_PTSD_and_abortion Jytdog (talk) 08:26, 1 October 2017 (UTC)

If we have high quality sources from the last 5 years we should be using those rather than older refs. Doc James (talk · contribs · email) 03:29, 4 October 2017 (UTC)

Very good 2017 review was found at WT:MED -- PMID 28477657 -- which says "The publication of the studies claiming to have found negative mental health effects of abortion has led to consternation in the scientific community and the publication of reanalyses pointing out gross methodological errors, invalidating the conclusions, and ultimately resulting in disavowal of 1 paper by the editors of the journal that published it. Nevertheless, misinformation and misdirection are rampant. ... The decision to terminate a pregnancy may be easy or difficult, depending on a woman’s circumstances and beliefs. After abortion, women experience a wide variety of feelings: guilt, sadness, and, most prominently, relief. These feelings must not be confused with psychiatric disorders; they evolve over time and depend on ensuing circumstances." Jytdog (talk) 15:07, 4 October 2017 (UTC)

Text

"Notable researchers

• Anke Ehlers"

First of all where does the ref say they are a notable research? Second we do not put sections like this in disease related articles.

References

-- Doc James (talk · contribs · email) 17:52, 29 October 2017 (UTC)

I agree that this is not something we normally do and not something we should start doing. Jytdog (talk) 23:06, 29 October 2017 (UTC)

Book citation for PTSD / circumcision

Would someone like to take a look at this ISBN on Google Books: ISBN 0-306-46701-1 and search on PTSD please, before I add some text based on this secondary source? You should find PTSD discussed on pages 4, 254, 263, 268, and 265.

One page says "Results of this study provide strong evidence of a direct causal relationship between circumcision and the subsequent development of PTSD in circumcised Filipino boys."

The book is from Springer Science & Business Media / Kluwer Academic / Plenum Publishers, with primary editors George C. Dennisston, University of Washington, and Frederick Mansfield Hodges, Yale University. (G.C. Denniston, F.M. Hodges, & M.F. Milos (Eds.), Understanding Circumcision: A Multi-Disciplinary Approach to a Multi-Dimensional Problem (Ch. 14, pp. 253-270). New York: Kluwer/Plenum. ISBN 0-306-46701-1 ISBN 9-780306-467011)

Thanks for your help! PolarYukon (talk) 19:00, 16 November 2017 (UTC)

In the paper published in that book, the authors describe their hypothesis, the experiment, their research methods, and the results. If you read the definition of "primary" in WP:MEDDEF you will see that this is exactly a primary source. Jytdog (talk) 20:34, 16 November 2017 (UTC)

@PolarYukon: The book contains a description of a single 20-year-old study which was undertaken by the author of the book. It is a primary source for that study, and that is the second time you've been told that. In the intervening twenty years, there have been no secondary sources replicating the study, or other secondary sources reviewing that primary study with any credence. It is a long way short of the level of evidence required to support a biomedical claim on Wikipedia. You are suffering from a case of WP:IDIDNTHEARTHAT and need to stop flogging this particular dead horse. --RexxS (talk) 20:47, 16 November 2017 (UTC)

The book rerferences multiple sources from different authors but thanks for your input. PolarYukon (talk) 08:12, 17 November 2017 (UTC)

Circumcision and PTSD

User:PolarYukon, there are no MEDRS refs for this. Search is here. Jytdog (talk) 13:53, 16 November 2017 (UTC)

Please see this ref: https://www.ncbi.nlm.nih.gov/pubmed/22114254

Thanks in advance, PolarYukon (talk) 15:05, 16 November 2017 (UTC)

Please also keep in mind these other references:

http://journals.sagepub.com/doi/abs/10.1177/135910530200700310

https://www.ncbi.nlm.nih.gov/pubmed/15863806

https://www.ncbi.nlm.nih.gov/pubmed/23534507

https://link.springer.com/chapter/10.1007%2F978-0-585-39937-9_16

Ramos, S.M., & Boyle, G.J. (2001). Ritual and medical circumcision among Filipino boys: Evidence of post-traumatic stress disorder. http://epublications.bond.edu.au/cgi/viewcontent.cgi?article=1120&context=hss_pubs In G.C. Denniston, F.M. Hodges, & M.F. Milos (Eds.), Understanding Circumcision: A Multi-Disciplinary Approach to a Multi-Dimensional Problem (Ch. 14, pp. 253-270). New York: Kluwer/Plenum. ISBN 0-306-46701-1 ISBN 9-780306-467011

https://hms.harvard.edu/sites/default/files/HMS_OTB_Winter11_Vol17_No1.pdf

https://www.psychologytoday.com/blog/moral-landscapes/201109/myths-about-circumcision-you-likely-believe

http://www.phillyvoice.com/circumcise-your-4-year-old-or-go-jail/

http://health.gov.ie/wp-content/uploads/2014/03/fgm.pdf

Thanks, PolarYukon (talk) 15:08, 16 November 2017 (UTC)

Please do actually read WP:MEDRS. (the key definitions are at WP:MEDDEF, btw) The ireland ref is OK per MEDRS and is limited to FGM but the rest are not OK per MEDRS. If you don't understand MEDRS after you read it, please ask specific questions. Thanks. Jytdog (talk) 15:18, 16 November 2017 (UTC)

When you have a bit of time, please read all of the primary and secondary references. These do indeed meet MEDRS and indicate that symptoms of PTSD do appear in both males and females. Thanks in advance, PolarYukon (talk) 15:27, 16 November 2017 (UTC)

I have read them. I don't comment on refs I haven't read. But we can't have a discussion if you will not engage the policies and guidelines. There is no question that all the refs other than the Ireland one fail MEDRS. It is not ambiguous. Again, if you don't understand MEDRS, please ask. Jytdog (talk) 15:30, 16 November 2017 (UTC)

Sorry for the disagreement but I still come to the conclusion that MEDRS is met. Maybe we can look at these sources one by one? Thanks PolarYukon (talk) 15:34, 16 November 2017 (UTC)

Please identify what sources you understand meet MEDRS that discuss male circumcision. (as I noted in the OP, we have MEDRS sources for FGM) - that is not under dispute and I had added that content with well-formatted refs). My comments here have only been about circumcision. Jytdog (talk) 15:52, 16 November 2017 (UTC)

@PolarYukon: It's probably easier this way:

• pmid:22114254 – An opinion piece, not a systematic review, nor a literature review, nor a meta-analysis. Not MEDRS.
• http://journals.sagepub.com/doi/abs/10.1177/135910530200700310 – exactly the same source as the one above. Same result. Not MEDRS.
• pmid:15863806 – Article on FGM, not on circumcision. Not relevant.
• pmid:23534507 – Article on FGM, not on circumcision. Not relevant.
• https://link.springer.com/chapter/10.1007%2F978-0-585-39937-9_16 – Report on a single study undertaken by the author. Primary source. Not MEDRS.
• http://epublications.bond.edu.au/cgi/viewcontent.cgi?article=1120&context=hss_pubs – A single study. Primary source. Not MEDRS.
• https://hms.harvard.edu/sites/default/files/HMS_OTB_Winter11_Vol17_No1.pdf – Report on a single study undertaken in the 1990s. Primary source. Not MEDRS.
• https://www.psychologytoday.com/blog/moral-landscapes/201109/myths-about-circumcision-you-likely-believe – Pure op-ed journalism. Not even close to being a reliable source, let alone meeting MEDRS. Not MEDRS.
• http://www.phillyvoice.com/circumcise-your-4-year-old-or-go-jail/ – Yellow journalism at its worst. Not MEDRS.
• http://health.gov.ie/wp-content/uploads/2014/03/fgm.pdf – Article on FGM, not on circumcision. Not relevant.

Now let me make this clear: the rag-bag collection of primary sources, opinion pieces, and tabloid journalism that you've adduced would normally be no more than laughable. But you're now reaching the point where your inability to read and understand the distinction made in WP:MEDRS between primary and secondary sources is becoming problematical. I strongly suggest that you read that guidance before editing or commenting further, to avoid wasting any more of your time or other editors' time. You might want to also go back to whatever advocacy group you're editing on behalf of and tell them the the selection of sources they fed to you sucks. --RexxS (talk) 17:29, 16 November 2017 (UTC)

There is no reason for personal attacks here. I am not representing anyone. You're the one waisting my time to add a simple, well-documented fact to Wikipedia.

Since when are Pubmed articles and the Harvard Medical School tabloid journalism?

I've looked at the MEDRS page again, as well as the Harvard Medical School article, and this is clearly a secondary source. It discusses the studies from Hickey/Anand, the 2008 NIH Study, van der Kolk as well as supporting clinical experience form Dr. Stoddard at Harvard Medical School.

Can some other folks take a look at the Harvard and other links? https://hms.harvard.edu/sites/default/files/HMS_OTB_Winter11_Vol17_No1.pdf

Thanks in advance! PolarYukon (talk) 18:15, 16 November 2017 (UTC)

That is not a recent review nor a statement by a major medical or scientific body. It is not a MEDRS source. Jytdog (talk) 20:35, 16 November 2017 (UTC)

@PolarYukon: Are you having difficulty reading plain English? I stated that:

1. http://www.phillyvoice.com/circumcise-your-4-year-old-or-go-jail/ is mere journalism.
2. Three of your sources including pmid:15863806 and pmid:23534507 do not even discuss circumcision.
3. The other pmid:22114254 is an opinion piece, devoid of any evidence.

The Philly Voice is not Harvard, nor is it indexed in PubMed. At no point have I ever suggested "Pubmed articles and the Harvard Medical School [are] tabloid journalism", and your attempt to misrepresent my statements speaks volumes for your inability to communicate competently and your purpose in editing here.

If the Harvard Mahoney Neuroscience Institute newsletter is a MEDRS source, then who is the author? what are the inclusion criteria for the sources reviewed? where is the citation to the "Toronto-based studies in the late 1990s"? why isn't it indexed in PubMed? All of these are red flags for sources. It's an opinion piece, from an organisation whose purpose is to popularise "the latest scientific discoveries about the brain" and has no place supporting biomedical claims in an encyclopedia. --RexxS (talk) 21:28, 16 November 2017 (UTC)

I see it as a valid secondary source but thanks for your inputs. Would other editors like to comment? Thanks! PolarYukon (talk) 08:16, 17 November 2017 (UTC)

Medical journal citation for PTSD / circumcision

Hello, found this second-source article: http://onlinelibrary.wiley.com/doi/10.1046/j.1464-410x.1999.0830s1093.x/abstract

PDF here: http://onlinelibrary.wiley.com/store/10.1046/j.1464-410x.1999.0830s1093.x/asset/j.1464-410x.1999.0830s1093.x.pdf?v=1&t=ja2vz4hy&s=c9089934f90de242fce341f9879e0bd9b67d608f

The article is from BJU International, "Official journal of the British Association of Urological Surgeons, the Urological Society of Australia and New Zealand, the Hong Kong Urological Association, the Caribbean Urological Association, the Irish Society of Urology and the Swiss Continence Foundation, and affiliated journal of the Urological Society of India, the Indonesian Urological Association and the International Alliance of Urolithiasis. Investigative and Clinical Urology is affiliated with BJUI."

Parts of the text say "There is strong evidence that circumcision is overwhelmingly painful and traumatic. Behavioural changes in circumcised infants have been observed 6 months after the circumcision." "The disrupted mother–infant bond has far- reaching developmental implications [99–104] and may be one of the most important adverse impacts of circumcision." "As with other traumas, the psychopathological outcome may vary, but preliminary reports appear to be consistent with the symptom pattern of post-traumatic stress disorder (PTSD) [21]."

The author cites 104 primary sources.

Would apprecaite any feedback before adding text to the article based on this reference. Thanks! PolarYukon (talk) 19:58, 16 November 2017 (UTC)

Fails WP:MEDDATE by about 12 years. What it says about PTSD is "As with other traumas the psychopathological outcome may vary, but preliminary reports appear to be consistent with the symptom pattern of post-traumatic stress disorder (PTSD)"

Recent guidelines and refs on circumcision do not discuss it as putting people at risk of PTSD; these "preliminary reports" have not been borne out. The author is with an anti-circumcision organization that rather hilariously refers to Wikipedia on its mainpage (here). This is what FRINGE medical views look like. Jytdog (talk) 20:32, 16 November 2017 (UTC)

The journal, BJU International is a respectable journal for urology, although I'm not so sure of its track record in publishing articles on psychology. Ronald Goldman (psychologist) is a respectable psychologist, but as the Executive Director of the Circumcision Resource Center in Boston, he does pursue a consistent anti-circumcision agenda. That is not a factor in assessing the quality of the source, but ought to be borne in mind if the source is used. Nevertheless, as a source for this article, PTSD, it leaves much to be desired. Perhaps the following quote from the source itself will put that into perspective:

"Without published studies, current knowledge of men’s feelings about their circumcision is generally based on reports from self-selected men who have contacted the Circumcision Resource Center (CRC) and other circumcision information organizations."

"Without published sources" really does speak for itself. The entire article is a collation by Goldman of anecdotal reports from his organisation, and – taken in conjunction with its age – I wouldn't find it at all useful for making claims about a connection between circumcision and PTSD. --RexxS (talk) 21:05, 16 November 2017 (UTC)

Thanks, any input from other editors? PolarYukon (talk) 08:09, 17 November 2017 (UTC)

Yeah. Stop. --Tarage (talk) 08:27, 17 November 2017 (UTC)

Edit

I am a medical student who is participating in a WikiMedicine course as part of my medical curriculum. I would like to help contribute to improving this article over the next few weeks.

I would like to focus primarily on updating the “Risk Factors” section of this article. That section of the article seems somewhat disorganized and lacks evidence from recent sources. I plan to help clarify this information and provide updated sources related to individual risk factors.

I would also like to better improve the section on PTSD diagnosis. I would like to update information on PTSD symptom clusters as presented in the DSM-5. Finally, I would also like to update information on the epidemiology of PTSD, as some of the information presented in that section of the article is out-of-date.

I plan to help link important terms to related articles in Wikipedia in order to provide readers with access to more information. I also plan to improve the accuracy of the information presented by adding updated sources. I hope that my work on this article over the course of the upcoming weeks will help make the topic more accurate and accessible to the general public. Morgangoodyear (talk) 20:19, 20 November 2017 (UTC)

Awesome! Great topics to tackle. :O)   - Mark D Worthen PsyD (talk) 09:42, 22 November 2017 (UTC)

Wikidata item description (definition)

I recently edited the item description (definition) for post-traumatic stress disorder (ah, the hyphen controversy returns... ;^) on Wikidata, and I started a Talk (Discussion) page with the first topic being let's discuss any changes to the description first and reach consensus. I am of course open to changes to what I wrote, which is one reason I mention it here.   - Mark D Worthen PsyD (talk) 09:47, 22 November 2017 (UTC)

Also, those of you with the requisite education and training (e.g., MD, PharmD, etc.), might want to look at the drug used for treatment statements under post-traumatic stress disorder because some of the medications look iffy to me (e.g., lithium for PTSD?) and the associated references do not actually provide support.   - Mark D Worthen PsyD (talk) 09:54, 22 November 2017 (UTC)

Super detailed table

Moved here from the article; was added in these diffs.

This is in my view too much detail for an enyclopedia article. It also not self-explanatory. (What is the "SE" column for example? and what is "Table 3" in the notes at the bottom?)

I acknowledge that PMID 29075426 is licensed open access but this kind of extensive copy/pasting needs to be attributed as I did in the edit note where i added this.

Conditional risk of DSM-IV/CIDI PTSD by trauma category in the WMH Surveys

	Risk given trauma exposurea		Number of episodes per 100 peopleb		Proportion of all episodes for each trauma typec
	(%)	(SE)	Est	(SE)	%	(SE)	(n)
I. War related trauma
Combat experience	3.6	(0.8)	0.1	(0.0)	0.9	(0.2)	(535)
Purposely injured/killed someone	4.0	(3.1)	0.1	(0.1)	0.7	(0.5)	(102)
Saw atrocities	5.4	(4.1)	0.4	(0.3)	3.2	(2.2)	(533)
Relief worker or peacekeeper	0.8	(0.7)	0.0	(0.0)	0.1	(0.1)	(139)
Civilian in war zone	1.3	(0.5)	0.1	(0.0)	0.5	(0.2)	(1050)
Civilian in region of terror	1.6	(0.6)	0.1	(0.0)	0.4	(0.1)	(634)
Refugee	4.5	(2.0)	0.1	(0.0)	0.8	(0.3)	(406)
Any	3.5	(1.4)	0.8	(0.3)	6.4	(2.3)	(3399)
II. Physical violence
Physically abused in childhood	5.0	(1.0)	0.4	(0.1)	3.1	(0.6)	(2082)
Physically assaulted	2.5	(0.6)	0.3	(0.1)	2.2	(0.6)	(1201)
Mugged	1.8	(0.4)	0.4	(0.1)	3.4	(0.7)	(3277)
Kidnapped	11.0	(3.0)	0.1	(0.0)	1.0	(0.3)	(216)
Any	2.8	(0.4)	1.3	(0.2)	9.7	(1.2)	(6776)
III. Intimate partner or sexual violence
Physically abused by romantic partner	11.7	(1.3)	0.5	(0.1)	4.1	(0.5)	(1675)
Raped	19.0	(2.2)	1.1	(0.1)	8.6	(1.0)	(1246)
Sexually assaulted (other than raped)	10.5	(1.5)	1.2	(0.2)	9.5	(1.3)	(1574)
Stalked	7.6	(2.0)	0.7	(0.2)	5.6	(1.4)	(1160)
Any	11.4	(1.0)	3.6	(0.3)	27.8	(2.0)	(5655)
IV. Accident
Automobile accident	2.6	(0.4)	0.5	(0.1)	4.0	(0.7)	(3428)
Other life-threatening accident	4.9	(2.4)	0.5	(0.2)	3.5	(1.6)	(1205)
Natural disaster	0.3	(0.1)	0.0	(0.0)	0.3	(0.1)	(1669)
Toxic chemical exposure	0.1	(0.0)	0.0	(0.0)	0.1	(0.0)	(622)
Other man-made disaster	2.9	(1.3)	0.2	(0.1)	1.5	(0.7)	(726)
Accidentally injured/killed someone	2.8	(1.0)	0.1	(0.0)	0.5	(0.1)	(251)
Life-threatening illness	2.0	(0.3)	0.3	(0.1)	2.5	(0.4)	(3249)
Any	2.0	(0.3)	1.6	(0.3)	12.4	(1.9)	(11,150)
V. Unexpected death of loved one
Any	5.4	(0.5)	2.9	(0.3)	22.2	(1.8)	(10,714)
VI. Other traumas of loved ones or witnessed
Child with serious illness	4.8	(0.6)	0.5	(0.1)	3.8	(0.5)	(2452)
Other traumas to loved ones	5.1	(1.3)	0.4	(0.1)	3.4	(0.8)	(1173)
Witnessed parenteral violence	3.8	(0.7)	0.3	(0.1)	2.4	(0.4)	(2000)
Witnessed injury, death, dead body	1.3	(0.3)	0.7	(0.1)	5.5	(1.0)	(5114)
Any	2.4	(0.2)	1.9	(0.2)	15.0	(1.4)	(10,739)
VII. Other traumas
‘Other’ trauma	9.1	(1.0)	0.4	(0.0)	3.0	(0.3)	(1260)
‘Private’ trauma	9.2	(1.1)	0.5	(0.1)	3.5	(0.4)	(1503)
Any	9.2	(0.7)	0.8	(0.1)	6.5	(0.5)	(2763)
VIII. Any	4.0	(0.2)	12.9	(0.7)	100	(0.0)	(51,196)
aThe conditional risk of PTSD associated with the trauma type indicated in the row heading. For example, 3.6% of the combat experiences resulted in DSM-IV/CIDI PTSD. bThe mean number of lifetime episodes of PTSD associated with the trauma type indicated in the row heading per 100 respondents. For example, the 3.5% of lifetime war-related traumas that led to PTSD reported in the first column of Table 3, when multiplied by the 23.9 lifetime occurrences of such traumas per 100 respondents reported in the third column of Table 2, translates into 0.8 lifetime episodes of PTSD due to this category of traumas per 100 respondents. cThe ratio of the entry in the cell of the previous column to the total of 12.9 lifetime episodes of PTSD per 100 respondents. For example, the 0.8 cases of PTSD associated with war-related traumas represents 6.4% of the 12.9 total.

References

-- Jytdog (talk) 02:22, 5 December 2017 (UTC)

Agree. Maybe as a subpage? Doc James (talk · contribs · email) 03:47, 5 December 2017 (UTC)

Thank you for the feedback! I agree that the statistics columns make the table too confusing. Morgangoodyear (talk) 02:48, 6 December 2017 (UTC)

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Risk factors: Trauma

The list of traumatic experiences in this section seems strange to me. I think it would be helpful to group things into broader categories, perhaps like this:

• War-related trauma (military experience, refugees)
• Physical violence
• Sexual violence
• Accidents/injuries (natural disasters, automobile accidents)
• Medical illness (cancer, stroke, acute coronary syndrome)
• Unexpected death of a loved one

Any thoughts on removing the "Abortion", "Foster Care", and "Female genital mutilation" sections?

I would appreciate any suggestions or feedback! Morgangoodyear (talk) 03:18, 6 December 2017 (UTC)

subtopics in sections like often get added by people who have some special real world interest in the subtopic. The best way to decide, would be to look at a few high quality MEDRS sources that look at overall risk factors for PTSD, and following those, give the most WP:WEIGHT to the most prevalent or highest risk factor topics, and put the rest in a list in a single sentence. That would be the source-driven way to do it. Jytdog (talk) 03:47, 6 December 2017 (UTC)

Though I don't have any 'real world interest' in the subtopic of miscarriage (or abortion) the prevalence of PTSD in pregnancy loss is supported by a multitude of quality sources. It would be a misrepresentation to discount the trauma associated with these events and minimize the experience of women. Best Regards, Barbara (WVS) ✐ ✉ 23:43, 6 December 2017 (UTC)

I went ahead and regrouped some of the risk factors into broader categories. Per my review of the literature, conditional risk of PTSD is highest after exposure to sexual violence/intimate partner violence. This is followed by exposure to physical violence, war-related trauma, and unexpected death of a loved one. I will work on creating sections for physical violence (to include physical abuse in childhood, physical assault, and kidnapping) and unexpected death of a loved one. In regards to miscarriage and postpartum PTSD, I agree that these topics are supported in the literature; I have combined them into a single section for simplicity's sake (with link to main article). Thank you so much for your continued input and feedback. Morgangoodyear (talk) 03:03, 7 December 2017 (UTC)

I sure hope you decide to continue to edit after your class has ended. I've not seen any new editor catch on so fast. Just to give an idea how significant this topic is: It is viewed over twice every minute. On 12/6/2016 it was viewed 16,000 times. So don't think what you have done doesn't matter. Best Regards, Barbara (WVS) ✐ ✉ 21:35, 7 December 2017 (UTC)

Section 8. Veterans

I'm not sure that this information should be included on the PTSD page. It's all about benefits that are available for people in military service. Could we incorporate this information into the treatment section? Or move it to another page on Wikipedia (there is already a Veteran page)? Or just delete it? Thanks. Morgangoodyear (talk) 15:29, 8 December 2017 (UTC)

I can't speak to the other countries, but for the United States, there is a detailed article on benefits for veterans with PTSD. Posttraumatic stress disorder#Veterans does link to it. I suspect that brief mention of disability benefits could be integrated into the article without a separate section for veterans.   - Mark D Worthen PsyD (talk) 06:38, 15 December 2017 (UTC)

Risk factors: Drug and substance abuse

Substance use disorders are commonly comorbid with PTSD and can certainly be a barrier to symptom resolution. That said, I personally am unaware of any reliable studies that support pre-morbid substance use as a risk factor for developing PTSD after trauma. Thoughts on moving this info to "Management" section vs. creating an "Associated conditions" type section? Morgangoodyear (talk) 21:44, 8 December 2017 (UTC)

Good call. I like your edit too. :O)   - Mark D Worthen PsyD (talk) 19:55, 15 December 2017 (UTC)

Semi-protected edit request on 15 February 2018

Hello, under the external links sections, I would like to include more resources for parents and teachers on how to provide psychological support for children, teens, and adolescents following a traumatic event. These resources are provided by the Society of Child and Clinical Adolescent Psychology, and are all backed by backed by research. Here are the links

• Psychological impacts of recent shootings
• Tips for parents on shooting media coverage
• Tips to talking to youths about a shooting
• Parent guidelines to helping youths after a shooting
• Tips to talking to children about a shooting
• Caregiver tips for helping teens with traumatic grief
• Caregiver tips for helping school-age children with traumatic grief
• Helping young children heal after a crisis
• Educator tips for helping youths after a community trauma
• Psychological first aid for schools
• Teacher tips for providing psychological first aid
• Resources and manuals on psychological first aid

--Rkang101 (talk) 03:37, 16 February 2018 (UTC)

Do we really need all of the listed resources though? That many seems like a bit overkill to me, though I suppose Wikipedia policy and guidelines would allow a few of them to be listed. Which ones however probably should be discussed. Sakura Cartelet^Talk 04:19, 16 February 2018 (UTC)

@Sakura Cartelet: @Rkang101: These are great resources! Sakura, I agree with your point - I went ahead to add the links, and grouped the links by the demographic that may be interested in them. Ongmianli (talk) 06:34, 16 February 2018 (UTC)

IMO one link to NCTSN is appropriate. 12 is inappropriate. One shooting in one country should also not get this much weight. PTSD occurs due to lots of reasons in many areas of the world. Doc James (talk · contribs · email) 00:31, 17 February 2018 (UTC)

@Doc James: @Sakura Cartelet: That makes sense to me! I have added a single link to NCTSN. Thanks to all for the consensus building! Ongmianli (talk) 01:16, 19 February 2018 (UTC)

Glad that works Doc James (talk · contribs · email) 03:48, 19 February 2018 (UTC)

WP:LEAD

States that leads should generally be 3 to 4 paragraphs. For medical articles we often format the leads in the same order as the layout of the body as suggested at WP:MEDMOS. Thus restored to 4 paragraphs and the ordering to that of the body of the article. Most of our medical article leads are formatted like this. Doc James (talk · contribs · email) 11:03, 6 March 2018 (UTC)

That is no more than a rule of thumb (that was a quote), so in this case, where artificially combining two distinct issues results in an awkward non-sequitur, editor discretion may and should be used to improve this article. Debresser (talk) 19:48, 6 March 2018 (UTC)

By the way, perhaps the history and epidemiology paragraphs should be omitted from the lead altogether. Their contributions don't seem all that necessary to me. Debresser (talk) 19:51, 6 March 2018 (UTC)

I disagree with you on both of these. The lead has been 4 paragraphs for a long time. Not seeing a need to split it into 5 or the need to put history above epidemiology. Some wish epidemiology to be higher within the lead.

How common a condition is, is fairly notable. The history of a condition is also important within an encyclopedia. Doc James (talk · contribs · email) 22:41, 6 March 2018 (UTC)

I can agree with you on the second point, which is why I only suggested it. But I have to insist on the first point: when I read this article for the first time, the non-sequitur sprang out. I can only suggest that you try to see the lead with fresh eyes, or ask a 3rd opinion from somebody who never saw the article before. Debresser (talk) 21:18, 7 March 2018 (UTC)

Generally it is BRD. The article has been stable for many months. I disagree with your change for the policy based reasons above.

Specifically "As a general rule of thumb, a lead section should contain no more than four well-composed paragraphs" Doc James (talk · contribs · email) 02:40, 8 March 2018 (UTC)

Will you agree to take this to WP:3O with me? Debresser (talk) 16:55, 8 March 2018 (UTC)

The structure of the lead is very normal for medical articles. No good reason has been given to depart from normal practice described in MEDMOS. With regard to the specific claim that the history content somehow doesn't flow from epidemiology, in my view they flow nicely together - the whole paragraph is about occurrences - the first bit wrt current epidemiology and the second bit, back through time. Jytdog (talk) 17:02, 8 March 2018 (UTC)

Okay, I disagree, but won't argue it. Debresser (talk) 14:43, 9 March 2018 (UTC)

Semi-protected edit request on 8 April 2018

In the existing Diagnosis section: Screening and Assessment subsection: At the end of this subsection, add the following: There are also screening and assessment instruments for caregivers of very young children six years of age and younger. These include the Young Child PTSD Screen, the Young Child PTSD Checklist, and the Diagnostic Infant and Preschool Assessment.

Diagnostic and statistical manual subsection: At the end of this subsection, add the following: The DSM-5 included a new category called posttraumatic stress disorder for children 6 years and younger with criteria empirically validated for very young children. This represents the first developmental subtype of a major psychiatric disorder to appear in the DSM.

References

-- Mike Scheeringa (talk) 18:48, 8 April 2018 (UTC)

 Partly done: First paragraph is done and to me seems appropriate. However, second addition was not done as I feel the last sentence is not support by a reliable source and the entire addition is unnecessary detail into the categories of PTSD in the DSM-5 which is far beyond the scope of this Wikipedia article. And possibly puffery as the editor is the publisher of the cited source. Waddie96 (talk) 14:56, 19 April 2018 (UTC)

From the outside

The following discussion is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.

---

Hi, I would like to know how to react to someone with PTSD. What to do, say in order to assist them in gaining control over the situation. It lists support from social circles, however not what type of support. Thanks — Preceding unsigned comment added by 102.250.220.213 (talk) 19:32, 29 June 2018 (UTC)

Not all PTSD is from military experience. Some children who experience trauma will have nightmares and sometimes bedwetting. Eventually they might forget the trauma by keeping busy with school, play, sports, hobbies, etc., but the older the person gets the memory of the trauma will eventually come to mind and need to be dealt with. In the teen years, some act out by using alcohol, drugs, sex, eating disorders, self harm, etc. In the 20's and older, you think you are old enough and wise enough to take care of yourself, but the anxiety caused by the trauma leads you to become more anxious. A therapist is definitely needed. If you think you can be a lay therapist for that person in your life, then study everything you can about PTSD. Search for coping skills. Here is a good link called "22 Ways to Support Someone With PTSD, From People Who Have It":

https://themighty.com/2016/03/22-ways-to-support-someone-with-ptsd-from-people-who-have-it/

Listen to the person with PTSD because a good listener is always appreciated. Good luck!

--CryMeAnOcean (talk) 23:20, 29 June 2018 (UTC)

The discussion above is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.

Details of methods

There are many indicators of the quality of a meta analysis, only one is the number of included trials.

Additionally per the article "66 were selected for the region-of-interest meta-analysis" so thus saying 89 were included in the part that found reduced brain volumn is inaccurate.

Other markers include number of actual subjects, the journal the study was published in, etc. The number of actual studies is minor. Mentioning all these minor factors everytime a meta analysis is discussed would make Wikipedia less readable. Also emphasizing this one is undue weight. Doc James (talk · contribs · email) 10:09, 24 July 2018 (UTC)

The number is one of the indicators, and a very important one. Debresser (talk) 19:23, 24 July 2018 (UTC)

We mostly just present the facts of sources and leave out these sorts of details. I am not seeing consensus for including them in this case. Doc James (talk · contribs · email) 08:17, 26 July 2018 (UTC)

nor am I, this needs consensus, agree--Ozzie10aaaa (talk) 12:16, 26 July 2018 (UTC)

Wiki Education Foundation-supported course assignment

This article is or was the subject of a Wiki Education Foundation-supported course assignment. Further details are available on the course page. Student editor(s): Lohmk.

Above undated message substituted from Template:Dashboard.wikiedu.org assignment by PrimeBOT (talk) 02:35, 18 January 2022 (UTC)

Semi-protected edit request on 2 October 2018

Request to contribute information on PTSD, referenced from https://theoakstreatment.com/ptsd/signs-and-symptoms/; Signs and Symptoms of PTSD Understanding PTSD» Signs and Symptoms of PTSD Davilama805 (talk) 03:25, 2 October 2018 (UTC)

 Not done: please read over our reliable sources guideline for medical articles. The source you provided does not appear to meet our criteria. Additionally, I have removed the insertion of content from the linked article into this talkpage, as it is a violation of Wikipedia policy to reproduce copyrighted material into the encyclopedia beyond brief quotations necessary for citations. cymru.lass (talk • contribs) 20:21, 2 October 2018 (UTC)

"Ulterior revivals"

"Some authors believe that the use of benzodiazepines is contraindicated for acute stress, as this group of drugs promotes dissociation and ulterior revivals."

As far as I'm aware, "ulterior revivals" isn't a medical term. Googling it returns the same sentence copy pasted to various websites. I think it's an artifact of a poorly translated French phrase. — Preceding unsigned comment added by 137.151.174.128 (talk) 18:44, 3 October 2018 (UTC)

Good catch. :-) I changed the sentence (difff) to: "Some authors believe that the use of benzodiazepines is contraindicated for acute stress, as this group of drugs can cause dissociation."   - Mark D Worthen PsyD (talk) 18:48, 9 November 2018 (UTC)

Queen's University Student Editing Initiative

Hello,

We are a group of medical students from Queen's University. We are working to improve this article over the next month and will be posting our planned changes on this talk page. We look forward to working with the existing Wikipedia medical editing community to improve this article and share evidence. We welcome feedback and suggestions as we learn to edit.

Thank you.

Cspag01 (talk) 18:13, 1 October 2018 (UTC)

We have compiled a list of suggestions to improve this article and would appreciate community feedback before we proceed with these edits. Here is a list of our suggestions:

1. Our first proposed change is to supplement the trauma section of the Wikipedia article with the addition of road traffic accidents as a type of trauma that may lead to PTSD development. The proposed paragraph and references can be found in the following sandbox: https://wiki.riteme.site/wiki/User:Cspag01/sandbox — Preceding unsigned comment added by Cspag01 (talk • contribs) 19:10, 5 November 2018 (UTC)

Comment left in sandbox. Thanks.JenOttawa (talk) 03:29, 7 November 2018 (UTC)

Thank you for the feedback. I will incorporate the suggestions into my revision. I've responded to other comments in the sandbox https://wiki.riteme.site/wiki/User:Cspag01/sandbox

Cspag01 (talk) 20:06, 13 November 2018 (UTC)

2. We aim to supplement the page with information regarding other mental health conditions following traumatic experiences. We propose to insert the following content under the Introduction and Signs and Symptoms > Associated medical conditions sections: https://wiki.riteme.site/wiki/User:Chih0519/sandbox

The second sentence about outcome of treatment, seems too general, as it is related not just to PTSD. Debresser (talk) 16:29, 6 November 2018 (UTC)

Thank you for your work on this article! Here's my two cents. (a) I agree with Debresser. (b) Writing suggestions. (b1) Eliminate unnecessary phrases such as "studies have shown". You cite studies in the footnote(s), consequently writing "studies have shown" is redundant. (b2) Whenever possible, use active verbs instead of passive. This often requires rearranging a sentence. For example, you might rewrite your second sentence to read: "Trauma survivors frequently develop depressive, anxiety, and other mental disorders rather than, or in addition to, posttraumatic stress disorder." (c) Along those lines, differentiate between comorbid disorders and other disorders. For example, trauma often leads to PTSD and major depressive disorder (comorbid), but trauma also causes major depression alone (other).   - Mark D Worthen PsyD (talk) 10:31, 11 November 2018 (UTC)

Thank you for the valuable comments! I have incorporated the feedback into my revision. — Preceding unsigned comment added by Chih0519 (talk • contribs) 19:42, 13 November 2018 (UTC)

3. We propose to insert the following content into the “diagnostics” subsection of the “Diagnostics” section. After the last sentence in this section, we propose to add the following: https://wiki.riteme.site/wiki/User:Yiqing.ma90/sandbox

I left Comments in your sandbox. Thanks!JenOttawa (talk) 03:28, 7 November 2018 (UTC)

I do not see a “diagnostics” subsection or a “Diagnostics” section. Would you clarify?   - Mark D Worthen PsyD (talk) 09:59, 11 November 2018 (UTC)

4. We propose to add acupuncture sub-section under the “Management” section: https://wiki.riteme.site/wiki/User:VCastanov/sandbox

I think that this edit should be considered carefully and the wording used should reflect the strength of evidence. In the first meta-analysis you cited, the strength of evidence is very weak so caution should be used when interpreting these findings. (quote from "Most often, the evidence base underpinning meta-analyses was characterized by small trials that involved significant participant attrition and unclear intention-to-treat analysis procedures, contributing to our limited confidence in effect estimates indicating potential benefits of needle acupuncture for adult patients with PTSD. Consequently, it is very possible that further research could change the direction and magnitude of effect estimates"). JenOttawa (talk) 21:01, 5 November 2018 (UTC)

5. We aim to supplement the page with information on children/youth suffering with PTSD. We propose to insert the following content under the Signs and Symptoms > Associated medical conditions section (first proposed change) and the risk factors > trauma sections (second proposed change): https://wiki.riteme.site/wiki/User:Rororoaboat/sandbox

Thanks for posting these suggestions. Please remember to sign off with 4x~ when posting. This makes it easier for us to track the comments and who/when they were made.JenOttawa (talk) 20:52, 5 November 2018 (UTC)

6 We propose to insert the following content into the "Epidemiology" section, and to add a sub-section within the "Epidemiology" section that addresses the types of Traumatic Events TEs that are most likely to lead to PTSD development globally: https://wiki.riteme.site/wiki/User:Nicolipoli/sandbox Nicolipoli (talk) 05:47, 6 November 2018 (UTC)

6 We already have similar information in the Trauma section. Debresser (talk) 16:29, 6 November 2018 (UTC)

Thank you for your feedback. I have re-read over everything carefully, and agree that there is some overlap. As such, I have included only the content in the "Epidemiology" section which does not appear to repeat information listed elsewhere. Please do not hesitate to let me know if you have any subsequent suggestions. Nicolipoli (talk) 01:19, 14 November 2018 (UTC)

7 We propose to make the following additions to the Diagnosis of PTSD section. https://wiki.riteme.site/wiki/User:Michaelmorra/sandbox — Preceding unsigned comment added by Michaelmorra (talk • contribs) 21:37, 9 November 2018 (UTC)

First of all, a big thank you to the Queen's University med students for contributing to this article; doing your homework in advance; and presenting proposed edits here on the Talk page (as opposed to making the edits without soliciting feedback first). Other student-led editing projects can learn from your example.

Regarding the #7 proposed edits, I agree the first one, but not the second, at least not as currently written. The second addition is accurate for moderate or severe TBI, but not mild TBI (mTBI). There's a lot of research indicating that for mTBI, most reported cognitive deficits, particularly several months or years post-injury, are due to depressive, anxiety, or substance use disorders or PTSD. In addition, confirmed (genuine) disorientation and confusion are uncommon with mTBI. (Self-reported disorientation and confusion are more common with mTBI when the patient is seeking disability benefits or compensation in a tort (personal injury lawsuit) context.   - Mark D Worthen PsyD (talk) 09:47, 11 November 2018 (UTC)

Thank you for the very valuable feedback! I have added the first edit into the article, and will reword the second point to just represent moderate and sever TBI cases.Michaelmorra (talk) 20:19, 13 November 2018 (UTC)

References

Text

Ref does not support "Early identification of mental health problems can promote better patient outcome."

Doc James (talk · contribs · email) 03:48, 14 November 2018 (UTC)

References

Acupuncture

Hello, one of the student editors has a suggestion of adding a paragraph that includes two systematic reviews related to using acupuncture to reduce symptoms of PTSD. I suggested that the student share these on the talk page before editing live. Here is the proposed addition:

Acupuncture has been suggested as a method to treat people who have PTSD. Weak evidence suggests that acupuncture may improve functional status and improve PTSD symptoms. There is also weak evidence to suggest that a therapeutic approach that includes a combination of acupuncture and moxibustion or with cognitive behavioural therapy (CBT) may improve PTSD symptoms.

Note on the strength of evidence: (quote from "Most often, the evidence base underpinning meta-analyses was characterized by small trials that involved significant participant attrition and unclear intention-to-treat analysis procedures, contributing to our limited confidence in effect estimates indicating potential benefits of needle acupuncture for adult patients with PTSD. Consequently, it is very possible that further research could change the direction and magnitude of effect estimates").

@Markworthen, Jytdog, and Doc James: do you have any suggestions here on how to neutrally present the evidence, or if this evidence is too weak to present at this point? The students (and faculty) are very keen to improve the article and have been working hard. Thank you! JenOttawa (talk) 15:12, 14 November 2018 (UTC)

References

That caveat indicates to me that the first sentence ("Acupuncture has been suggested as a method to treat people who have PTSD") should be followed with a ", but there is limited confidence in research findings about its effectiveness" if - a big if - we decide to include it. I am also wary of using Evidence-Based Complementary and Alternative Medicine as a source for medical treatment information in light of past WP:RSN/WP:FTN discussions. Jo-Jo Eumerus (talk, contributions) 15:26, 15 November 2018 (UTC)

Also note that acuquacks will suggest acunonsense for absolutely anything at all. Roxy, the Prod. wooF 15:29, 15 November 2018 (UTC)

Another point: You are starting at the wrong end. First convince the scientific community, then this will automatically end up in Wikipedia. The other way around does not work - neither the first step nor the second. --Hob Gadling (talk) 18:10, 15 November 2018 (UTC)

Thank you for your suggestions regarding this edit. We appreciate your feedback and will wait a few more days until a consensus can be reached regarding the most neutral way to present this evidence (if it is appropriate to add into the article). — Preceding unsigned comment added by VCastanov (talk • contribs) 21:07, 15 November 2018 (UTC)

Add this to the emerging consensus: The material doesn't belong in the article, the sources fail to conform to our WP:MEDRS policy, and Hob Gadling (see above) hit the nail on the head. --Guy Macon (talk) 02:02, 16 November 2018 (UTC)

agree w/ Guy Macon--Ozzie10aaaa (talk) 22:19, 16 November 2018 (UTC)

Let's start with the obvious: acupuncturists are desperate to establish some legitimate scope of practice in the face of mounting evidence that acupuncture is bollocks. There is a huge industry in trying to weasel quackery into medicine through clinical trials that ignore prior plausibility - this is the field of "integrative" or quackademic medicine. Acupuncture is not used in serious treatment of PTSD other than by True Believers looking to make a name for themselves. The effective treatments for PTSD are psychological (CBT and EMDR) and sometimes medication for the secondary symptoms, largely depression. Even mentioning acupuncture here is WP:UNDUE and plays intot he hands of charlatans marketing quackery to desperate people. Guy (Help!) 23:48, 15 November 2018 (UTC)

The first, more recent study, which was also published in the more solid journal does not provide at all convincing support for acupuncture in PTSD. Confidence intervals of the effect sizes are very close to 0(=no effect) (e.g. [−1.59, −0.01] for PTSD symptoms), only few trials were included (4-7 RCTs) and those were of low quality of evidence. Accordingly the authors conclude at the end of the article: "Overall, the results of this systematic review warrant caution in promoting acupuncture as an evidence-based treatment for adult patients with PTSD despite identified positive treatment effects. We have limited confidence in estimates indicating that needle acupuncture reduces PTSD and depressive symptoms at follow-up compared to passive controls, TAU, and active interventions, and we have very limited confidence in the estimates for PTSD symptoms at post-intervention and functional status." Lucleon (talk) 15:31, 16 November 2018 (UTC)

I might take a different (but complementary) approach to Guy's statement: People affected by PTSD are desperate for effective, acceptable treatments, and just about everything has been "suggested" at some point. Articles such as breast cancer name some ineffective treatments. Maybe this one should, too. "This doesn't work" is just as educational as "That does". I see one line that says talk therapy plus drugs is no better than talk therapy alone. What else could be put in that list? WhatamIdoing (talk) 17:20, 16 November 2018 (UTC)

Perhaps a section on "unproven proposed treatments"? Otherwise, I agree with everyone else that "treatments" with no empirical support should be left out of the article.   - Mark D Worthen PsyD (talk) 06:56, 17 November 2018 (UTC)

Per WP:WEIGHT. I would like to see sources that establish that acupuncture as a treatment for PTSD is a widely held view as opposed to the views of a tiny minority. --Guy Macon (talk) 08:44, 17 November 2018 (UTC)

Mark, I'm not sure that I'd give it a whole section. That might turn into a kind of WP:SPAMBAIT-like section. I think that one paragraph should be enough. The need is for a bit of general background information, perhaps like this: "Over the decades, dozens of treatments have been tried, such as _____, _____, and _____. Most of them don't work". Fill in the blanks with whichever treatments get the most media attention (e.g., combination therapy and acupuncture), and then segue to "The most effective treatments are..." WhatamIdoing (talk) 18:19, 19 November 2018 (UTC)

Good point WhatamIdoing. I like your solution. :o)   - Mark D Worthen PsyD (talk) 21:49, 24 November 2018 (UTC)

About half of people develop PTSD following rape

the reference for this statement cites a survey where this conclusion is not reached.

Hello 2600:387:A:9:0:0:0:AC, when looking at the pdf that you linked, which appears to be same paper as that cited by the source cited in lede for the the claim about rape and PTSD ([9]), I could not find the specific claim. If I happen to find a source that does support such a claim later, then I'll add it. The same should go if someone else can find a source that supports the claim. For now I'll remove it. —T.E.A. (Talk•Edits) 00:28, 7 March 2019 (UTC)

Ref states "and reaches more than 50% in survivors of rape" Doc James (talk · contribs · email) 11:36, 7 March 2019 (UTC)

I agree, but the source that is being referenced by the PubMed article cited on the Wikipedia page, the one ulimately being referenced, does not contain that information nor that claim, as noted by the original IP poster, so I would argue that the claim is not really verifiable through the source cited in the lede, and therefore the source shouldn't be used to support the claim. —T.E.A. (Talk•Edits) 15:10, 7 March 2019 (UTC)

@Doc James:, I'm unsure if you've seen my response. If you have and you're opinion stands I would find it valuable to hear it elaborated upon, if you have not seen it, I would appreciate your response, thanks —T.E.A. (Talk•Edits) 06:14, 10 March 2019 (UTC)

We are referencing the BMJ and the BMJ article supports it. If one looks at the other source it says "The traumas most commonly associated with PTSD are combat exposure and witnessing among men and rape and sexual molestation among women."

We do not need to go and verify the review itself. That is what peer review by the journal and editorial control is supposed to do.

By the source dose say "associated with high probabilities of PTSD when nominated as most upset¬ ting (45.9% for rape and 26.5% for molestation)." Doc James (talk · contribs · email) 06:40, 10 March 2019 (UTC)

Some sources say a third[10] others more than 90%[11]

This says 57% risk.[12] Doc James (talk · contribs · email) 06:48, 10 March 2019 (UTC)

Interesting... I would avoid comparing the numbers to much to each other so basically because it seems that they are not all describing the same thing, some are discussing every developing PTSD over the course of ones life, while others are talking about immediate prevalence of PTSD, which I would be cautious about to call "experiencing PTSD" in someone so soon after the event because the differentiation between such and continued shock would seems difficult to me. As for the ReasearchGate pdf, I'm wondering if you could point me to a specific page so I don't have to go looking myself. With all these ideas of measurement that carry different meaning, which would you think would be most meaningful to a reader in the. Should all be listed somewhere in the body? —T.E.A. (Talk•Edits) 07:04, 10 March 2019 (UTC)

Page 1053 for the second quote. The BMJ review is the best source but the others are books I mentioned are not unreasonable either. Doc James (talk · contribs · email) 07:41, 10 March 2019 (UTC)

Problem wording

Under Diagnosis, it refers to "the potential for over-reporting, e.g., while seeking disability benefits, or when PTSD could be a mitigating factor at criminal sentencing." This is unsourced and bears little relevance to PTSD itself, as it could apply to any disorder. I would propose that sentence to be removed, but please discuss if you disagree. Thanks. — The King of Mars ^«talk» 17:51, 1 April 2019 (UTC)

George Carlin's rant about the euphemism treadmill from “shellshock” to “PTSD”

There is currently no mention of George Carlin's famous rant about the euphemism treadmill which changed the name of that condition from “shellshock” to “post-traumatic stress disorder” over the course of the 20th century. It's definitely relevant and should be added.--Abolibibelot (talk) 04:58, 3 April 2019 (UTC)

I added a paragraph about it myself. English is not my first language so please check if the wording is correct and formal enough.--Abolibibelot (talk) 05:51, 3 April 2019 (UTC)

The wording was fine, the source in the strongest, but it works. I changed the phrasing a little bit in accordance with WP:WORDS.—T.E.A. (Talk•Edits) 14:16, 3 April 2019 (UTC)

Nice addition Abolibibelot. Thank you.   - Mark D Worthen PsyD (talk) (I am a man. The traditional male pronouns are fine.) 21:23, 5 April 2019 (UTC)

Welcome! But... why was "commented" replaced by "commenented" ? ô_o--Abolibibelot (talk) 21:57, 5 April 2019 (UTC)

Oops, that was just a spelling mistake. —T.E.A. (Talk•Edits) 03:30, 6 April 2019 (UTC)

Cannabis

Under Cannabinoids, "Additionally, there are other treatments with stronger efficacy and less risks (e.g., psychotherapy, serotonergic antidepressants, adrenergic inhibitors)." This is unsourced and potentially dangerous, potentially in error, over-simplifying by generalising all cannabinoids together, with no mention of CBD (or THC:CBD or other ratios), nor entourage effects, nor terpenes. And "The use of medical marijuana for PTSD is controversial, with only a handful of states permitting its use for that purpose." switches to the more controversial term "marijuana" rather than "cannabis" as used in the prior paragraph. Both sentences combined read like drug-war propaganda. — Preceding unsigned comment added by 81.135.8.241 (talk) 00:41, 7 April 2019 (UTC)

Hi 81.135.8.241, I've moved your comment to a new section for readability. I'm not knowledgeable on types of cannabis, so I couldn't add anything, but I did try to make it sound a bit more neutral. Thanks for your suggestions! If you have any more, feel free to leave them here and optionally add the code {{Edit semi-protected}} (which will show other users that there's an edit request) and someone may incorporate the changes. — The King of Mars ^«talk» 10:35, 8 April 2019 (UTC)

Section titled Iraq removed

I'll include the full text here, but one citation isn't to be found in PubMed, the other, austinpublishing.com is on Beal's list of predatory journals and the first citation is known predatory researchgate. Removed section:

Iraq

Various academic studies estimate that Iraqis greatly suffer from numerous untreated mental health issues, such as; depression, bipolar disorder, anxiety, post-traumatic stress disorder (PTSD alone affects between 20-60% of population aged 18 and above), whose cause can be traced to Saddam’s horrific human rights abuses, as well as greatly accelerating due to the the aftermath of the 2003 invasion of Iraq and the overall consequences of the Iraqi War such as violence, terrorism, displacement and low socio-economic status.

And of quoted removed section.Wzrd1 (talk) 18:04, 15 June 2019 (UTC)

Semi-protected edit request on 2 June 2019

Under the "Prevention" section, it reads, "The World Health Organization recommends against the use of benzodiazepines and antidepressants in those having experienced trauma.[130]"

The reference (130) indicates that antidepressants are not recommended for, "Does the person have significant symptoms of acute stress after RECENT (within approximately one month) exposure to a potentially traumatic event?" For standard PTSD (lasting for over a month), antidepressants are recommended when EMDR and CBT are not effective or available. It is also not recommended for adolescents with PTSD.

My requested change is, "The World Health Organization recommends against the use of benzodiazepines in those having experienced trauma, as well as the use of antidepressants for those suffering from significant symptoms of acute stress (symptoms lasting less than one month). However, antidepressants are recommended for those suffering from standard PTSD (symptoms lasting over a month), when EMDR and CBT are not effective or available, with the exception of children and adolescents." Excrispy (talk) 23:23, 2 June 2019 (UTC)

  Edit request implemented   Adam Williams (talk) 21:04, 30 June 2019 (UTC)

KZ-Syndrome

Diagnosed among former KZ prisoners. http://www.psychiatriapolska.pl/uploads/onlinefirst/Rutkowski_PsychiatrPolOnlineFirstNr21.pdf Xx236 (talk) 10:11, 1 June 2019 (UTC)

Is there a good English translation of the cited article? There is an English abstract, but the article is in Polish. For the English Wikipedia we need to be able to read cited articles or books in English. Thanks! -   - Mark D Worthen PsyD (talk) (I am a man. The traditional male pronouns are fine.) 12:14, 1 July 2019 (UTC)

Stellate Ganglion Block (SGB)

The following discussion is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.

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Resolved

 – Consensus achieved; from here to here.

I removed a recently added sentence at the end of the Management > Medication section (diff). In the Edit summary, I wrote:

There is not yet any empirical evidence that SGB is an effective treatment for PTSD. There's been only one randomized, double-blind controlled trial of the procedure for PTSD, and it concluded, "Although previous case series have suggested that SGB offers an effective intervention for PTSD, this study did not demonstrate any appreciable difference between SGB and sham treatment on psychological or pain outcomes." Please discuss on Talk page if you disagree.

Please see the following publication for a review-to-date:

Peterson K, Bourne D, Anderson J, Mackey K, Helfand M. Evidence Brief: Effectiveness of Stellate Ganglion Block for Treatment of Posttraumatic Stress Disorder. VA ESP Project #09-199; 2017, https://www.ncbi.nlm.nih.gov/books/NBK442253/

And the RCT the VA review cites:

Hanling SR, Hickey A, Lesnik I, et al. Stellate Ganglion Block for the Treatment of Posttraumatic Stress Disorder: A Randomized, Double-Blind, Controlled Trial. Reg Anesth Pain Med. 2016;41(4):494-500. doi:10.1097/AAP.0000000000000402

  - Mark D Worthen PsyD (talk) (I am a man. The traditional male pronouns are fine.) 12:32, 1 July 2019 (UTC)

• @Markworthen: Thank you for your interest in this topic. It does seem that the evidence is inconclusive (though please note that this is different than the statement, "There is not yet any empirical evidence"). As this is an area of active research, perhaps we can add a neutral statement on the topic? Perhaps the Research section would be apropos. I propose the addition of the following:

"Stellate ganglion block is an experimental procedure for the treatment of PTSD."

What are your thoughts? ―Biochemistry🙴❤ 00:51, 2 July 2019 (UTC)

<< Thank you for your interest in this topic. >>

I have had the PTSD article on my watchlist for a long time. So I’m not sure exactly what you mean.

<< It does seem that the evidence is inconclusive >>

IMHO, the word, “inconclusive”, has become a euphemism for “no evidence“.

<< though please note that this is different than the statement, “There is not yet any empirical evidence”. >>

I am generally opposed to itemizing unproven interventions in encyclopedia articles.   - Mark D Worthen PsyD (talk) (I am a man. The traditional male pronouns are fine.) 09:21, 2 July 2019 (UTC)

• @Markworthen: I was only thanking you for your interest because I recognize that we share a common interest! It's nice to meet people that share the same mission of improving articles like this one. I was not implying that you were new to the page or Wikipedia. (:

On the substantive matter, it is simply not the case that inconclusive = no evidence. I would generally agree that people sometimes state the former in place of the latter euphemistically, but I am not doing that; I ask that you trust me on that. Your statement regarding "unproven" interventions does not reflect how science works. In science, nothing is ever "proven," per say; rather, evidence is found consistent with or inconsistent with a proposition. While I certainly share your value of wanting to create articles that are evidence-based, I believe that we should proportion our focus within articles to the evidence. After all, if we were only to write of things which are "proven" (or perhaps, those things which have overwhelming evidence), we would lose out on a lot of interesting material for our readers. Giving things their due weight doesn't mean that we cannot even mention an intervention like SGB. It's not like I'm talking about abject quackery, suggesting that we add "homeopathy is an experimental treatment modality for PTSD," or other such nonsense. So let's just name and call SGB for what it is within the article: "...an experimental procedure for the treatment of PTSD," as I proposed above, and file it under the Research section. ―Biochemistry🙴❤ 21:52, 3 July 2019 (UTC)

Thank you for your considerate and thoughtful reply. What you write here makes good sense. I now support your proposal, and I appreciate you taking the time to explain it in a collegial manner. All the best - Mark   - Mark D Worthen PsyD (talk) (I am a man. The traditional male pronouns are fine.) 15:14, 5 July 2019 (UTC)

• @Markworthen: My pleasure! I appreciate your taking the time to discuss the matter with me. I will performs the edits per our discussion. Looking forward to working with you again someday in the future! ―Biochemistry🙴❤ 02:13, 6 July 2019 (UTC)

References cited on this Talk page

References

The discussion above is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.

Education on some craft is more beneficial than doing nothing when a soldier returns

Usually and statistically its psychologically beneficial the soldiers who return to learn a craft (or get education in any subject they like).

We need more data.

Also the education has to start immediately in order the side effects don't get expressed.

The state has to pay for the education, because paying and psychology don't work well together.— Preceding unsigned comment added by 2.87.252.135 (talk • contribs) 02:45, 3 August 2019 (UTC)

A myth

It wrong to believe that we should allow psychological problems to be expressed. People don't only react to the original bad memories but also to the copies of the bad memories. Even copies are harmful. Search for data from Stanford University. It's better to immediately ask them if they like some activity or lesson. Some people create furniture, some learn computer programs others walk etc. They should do it in an organized manner with a program. If they have issues some professional should speak to them and check them beforehand.— Preceding unsigned comment added by 2.87.252.135 (talk • contribs) 02:45, 3 August 2019 (UTC)

Thank you for your comments and for your interest in this article. I don't quite understand what you are suggesting. However, if by "It wrong to believe that we should allow psychological problems to be expressed," you are claiming that exposure therapy is morally "wrong" or lacks efficacy for PTSD, I would disagree, noting that it is strongly recommended by experts in the field. I am unfamiliar with the "data from Stanford University" that you mentioned. Please provide more concrete suggestions and/or links to references that you think would be useful for this page, and I would be happy to take a look at them. ―Biochemistry🙴❤ 14:04, 3 August 2019 (UTC)

Screening and assessment section

I started a section on assessment - it's only one sentence right now but I will gradually expand it.

The assessment section was a level 4 subsection. But I separated out screening and assessment from the Diagnosis section. It is now Posttraumatic stress disorder#Screening and assessment. Inaccurate assessment leads to significantly less effective treatment. Thus, PTSD assessment is a vital aspect of PTSD treatment and deserves a more prominent place within the article.   - Mark D Worthen PsyD (talk) (I am a man. The traditional male pronouns are fine.) 15:32, 31 August 2019 (UTC)

I see that Doc James moved the section back under Diagnosis, but kept "Screening" and "Assessment" as separate subsections (diff). I am guessing that screening and assessment usually go under Diagnosis and that we want to keep article organization consistent, which makes sense.   - Mark D Worthen PsyD (talk) (I am a man. The traditional male pronouns are fine.) 18:13, 1 September 2019 (UTC)

In my opinion it makes most sense / fits well there. Doc James (talk · contribs · email) 02:31, 2 September 2019 (UTC)

I trust you. :0)   - Mark D Worthen PsyD (talk) (I am a man. The traditional male pronouns are fine.) 22:37, 2 September 2019 (UTC)

Merge Old sergeant's syndrome?

Not long ago, I accepted Draft:Old sergeant's syndrome into mainspace. Now I'm thinking it would have made more sense to merge that into Posttraumatic stress disorder. -- RoySmith (talk) 16:58, 17 April 2020 (UTC)

This condition has been known by a lot of names over the years. Sure could go in the history section of this article. Doc James (talk · contribs · email) 18:39, 17 April 2020 (UTC)

I've specialized in PTSD assessment and treatment for many years, but I hadn't heard about "Old Sergeant's Syndrome". I like it! ¶ I prefer keeping the separate article, with brief mention in this article along with a hatnote. One reason for my preference is that when folks search the Google for "old sergeant's syndrome" an article is more likely to appear at the top of the SERPs, compared to an article subsection.   - Mark D Worthen PsyD (talk) (I'm a man—traditional male pronouns are fine.) 16:01, 27 April 2020 (UTC)

sexual assault

Something wrong with this picture:

"About half of people develop PTSD following rape.[2][9] "

"The risk of developing PTSD after a traumatic event varies by trauma type[33][34] and is highest following exposure to sexual violence (11.4%), particularly rape (19.0%)." — Preceding unsigned comment added by Bsharvy (talk • contribs) 19:48, 8 February 2020 (UTC)

Yes indeed. This article needs a lot of work. Although we (the Wikipedia community) have thousands of great editors, we need many more to improve all the articles that need attention. So be bold and edit this section if you believe you can improve it. I bet you can. Anyone who has The Love Song of J. Alfred Prufrock on his talk page has gotta be literate, smart, and dedicated to excellence. :0) All the best   - Mark D Worthen PsyD (talk) (I'm a man—traditional male pronouns are fine.) 16:10, 27 April 2020 (UTC)

Risk factors - Trauma section contradicts itself.

The risk of developing PTSD after a traumatic event varies by trauma type[33][34] and is highest following exposure to sexual violence (11.4%), particularly rape (19.0%).

It is not. The very next paragraph shows that the risk is higher "following a road traffic accident".

also: "22% of cancer survivors present with lifelong PTSD like symptoms". 92.73.164.225 (talk) 13:26, 27 April 2020 (UTC)

Good point! ¶ It would be cool if you became a Wikipedian and went to work on that section to improve it. We need more good editors like you! The getting started page is very helpful. All the best   - Mark D Worthen PsyD (talk) (I'm a man—traditional male pronouns are fine.) 15:52, 27 April 2020 (UTC)

Done. The RTA meta-analysis was unreliable given that it just summed up studies reporting anything from 4.6% to over 50% PTSD rates - the real finding was that the PTSD tool used determined the rate. I swapped this for the World Health Organization source used for the rape statistic since this covers multiple types of trauma and a much wider sample. It's well established that any interpersonal trauma has a higher PTSD risk than accidents, also perhaps we should rephrase to "collisions" since some won't be "accidental".

Haven't done the cancer rate yet but life-threatening illness is in the World Health Organization study. It's possibly worth adding the ICU rate which is also high. Amousey (they/them pronouns) (talk) 02:24, 25 June 2020 (UTC)

Excellent! :)   - Mark D Worthen PsyD (talk) (I'm a man—traditional male pronouns are fine.) 21:14, 27 June 2020 (UTC)

Remove old sargent's syndrome merge request?

Look like it was decided not to merge. Can the tag go from the top of the page? Amousey (they/them pronouns) (talk) 23:37, 7 July 2020 (UTC)

 Done   - Mark D Worthen PsyD (talk) (I'm a man—traditional male pronouns are fine.) 01:11, 12 July 2020 (UTC)

Requested move 7 July 2020

The following is a closed discussion of a requested move. Please do not modify it. Subsequent comments should be made in a new section on the talk page. Editors desiring to contest the closing decision should consider a move review after discussing it on the closer's talk page. No further edits should be made to this discussion.

The result of the move request was: Moved I-82-I | TALK 01:59, 21 July 2020 (UTC)

Posttraumatic stress disorder → Post-traumatic stress disorder – Relatively minor thing in the grand scheme, but I believe that a hyphen should be included in the title of this article. While I'm aware that there were previous discussions around the DSM's, ICD's, etc spelling, the actual weight and adaption of these pieces of literature didn't seem to be explored. While the DSM does use the linguistics "Posttraumatic stress disorder", the DSM is used almost exclusively in North America and Western Europe - it's published by the American Psychiatric Association, lists mental disorders only found in Western societies, and is inaccessible to most people not in the profession. On the other hand, the ICD, which uses "Post-traumatic stress disorder" (ICD Online - 6B40), is used much more broadly across much more of the world, is developed by an international consortium (the WHO, not an American company), and is not only more accessible, but is free to access online (icd.who.int/browse11). The current title presents a very strong Western-centric bias and doesn't represent the international nature of Wikipedia by assuming all readers use an American, expensive, inaccessible, and highly criticised piece of literature, rather than the global (literally the World Health Organisation), accessible, and slightly less criticised health publication. Side note, but the DSM does also fail WP:MEDDATE by a couple years. ItsPugle (talk) 13:23, 7 July 2020 (UTC)

• Support - seems like a reasonable move. Interstellarity (talk) 14:36, 7 July 2020 (UTC)
• Oppose per WP:TITLEVAR -- "all national varieties of English are acceptable in article titles; Wikipedia does not prefer one in particular. American English spelling should not be respelled to British English spelling, and vice versa." Calidum 15:40, 7 July 2020 (UTC)

I don't think this is an issue of American English spelling, just because it's the spelling that the DSM chooses to use. I'm American and I would never think to spell this without a hyphen. It just looks very odd to me without a hyphen, especially having the two T's together like that. Having said that, google ngrams does seem to indicate that spelling it without a hyphen is more common.[13] Rreagan007 (talk) 19:47, 7 July 2020 (UTC)

I second Rreagan007 - this isn't a thing of regional variations of English. ItsPugle (talk) 11:11, 8 July 2020 (UTC)

• Oppose - the ICD-11 viewed at the link above does not include a hyphen in the name. Amousey (they/them pronouns) (talk) 23:34, 7 July 2020 (UTC)

Funky ICD website! It seems like the ICD site is inconsistent with its use of spaces and hyphens. The disorder's title on the site uses a space, but the first line uses a hyphen. Going back to ICD 10 though, which is more arguably more stable (as the ICD-11 only takes over as the default reporting system in 2022), that uses a hyphen. If you wanted to step away from the ICD website though because of this inconsistency, then the WHO (who is most definitely more authoritative then the APA) consistently uses "post-traumatic stress disorder" outside of the ICD (1, 2, 3, 4, and 5). ItsPugle (talk) 11:11, 8 July 2020 (UTC)

• Support The hyphen is used by multiple US sources such as NIH and Mayo Clinic. If usage is 50/50 in the US and the hyphen is clearly preferred in the rest of the world, we should go with the hyphen. -- King of ♥ ♦ ♣ ♠ 19:48, 10 July 2020 (UTC)
• Oppose per WP:COMMONNAME/WP:NCMED. As SandyGeorgia noted in 2008 (back in the yonder years of DSM-IV), the ICD-10 name for Tourette syndrome was "Combined vocal and multiple motor tic disorder [de la Tourette]" (albeit, in the updated ICD-11, this was amended to Tourette syndrome). To my knowledge, no one was arguing that we amend Tourette syndrome per ICD-10 at that time. As we did not grant Posttraumatic stress disorder the gift of a hyphen then, I see no pressing need to change it now. Despite the DSM-5 being >5 years-old (no pressure, DSM-6 task force—but wasn't that supposed to come out in 2019?), it is still the most commonly used resource by English speakers (criteria per WP:NCMED), and it omits the hyphen (and it's not like the DSM-5 doesn't use hyphens elsewhere; they are not strictly anti-hyphen—and nor am I, apparently).―Biochemistry🙴❤ 22:57, 10 July 2020 (UTC)

With all due respect, I don't particularly see how a lack of action on an article in 2008 on a completely unrelated disorder is relevant? Since the ICD-10 name was wildly out of touch/not the common reference, that's a different circumstance? I agree that there's no pressing urgency in moving this article, but that shouldn't detract from the actual basis of this RM; that there is a better, more recognised, more common, and more global stylisation. And with those medical naming conventions that you brought up, the DSM is the pretty much the primary text for mental health in just North America and Australia (even the NHS suggests using the DSM as a general guide only), but the ICD is still very much authoritative and conclusive in those regions, as well as everywhere else. The only relevant area where the ICD differs from the DSM is that the ICD is more widely used and more authoritative. If a Chinese, German, South African, or Portuguese medical student, for example, wanted to look at this article (remembering that we're a wiki written in English, not the wiki for only western countries), they're coming from the ICD, not the DSM - I'm not saying we should name this article in pinyin or anything like that, but I think that using eurocentric titles from regional texts instead of what is undoubtably considered a more global English version is a rather clearcut case of eurocentristic bias. And yes, the DSM-VI task force really needs to get a move on, it's about time for an update! ItsPugle (talk) 13:33, 11 July 2020 (UTC)

To clarify, the article in question in 2008 was Posttraumatic stress disorder; the reference to Tourette syndrome was an argument made in favor of keeping the page per DSM, not per ICD. While I am sensitive to concerns of eurocentrism, many (it is hard to say "most" without systematically attempting to survey them all) diverse, "recent, high-quality, English-language medical sources" (WP:NCMED) omit the hyphen. E.g. The Encyclopedia of Clinical Psychology (2015), Dr. Bremner's Posttraumatic Stress Disorder (2016), the Psychiatric Genomics Consortium Posttraumatic Stress Disorder Group (the authors of the world's largest GWAS study on PTSD), and numerous articles within JAMA Psychiatry. Whether a person is an English speaking German or South African, if they are in the field of psychiatry, I highly doubt that they are not going to be using the world-famous DSM. There's a reason why it has been translated into numerous languages, including Chinese, German, Turkish, etc. As the DSM is the most well-known and authoritative source on this subject, I see no reason to give the ICD precedent over it now (as we have declined to in the past every time this subject has been relitigated).―Biochemistry🙴❤ 17:01, 11 July 2020 (UTC)

• support per NIH[14] --Ozzie10aaaa (talk) 16:04, 11 July 2020 (UTC)
• Oppose, ICD uses hyphen, DSM does not, no need to change now for a hyphen. SandyGeorgia (Talk) 16:15, 11 July 2020 (UTC)
• Support Looks bizarre without a hyphen. GPinkerton (talk) 00:36, 12 July 2020 (UTC)
• Support because the current name shortens to PSD not PTSD. -Roxy the elfin dog . wooF 00:42, 12 July 2020 (UTC)

@Roxy the dog: Tell that to ultraviolet (UV).―Biochemistry🙴❤ 16:52, 12 July 2020 (UTC)

PSD, UV, PTSD, W?F, -Roxy the elfin dog . wooF 17:28, 12 July 2020 (UTC)

• Support - When it comes to mental disorders, we (English Wikipedia) exhibit a strong preference for American conceptualizations, spelling, diagnostic criteria, etc. See our articles on substance use disorders, including addiction, alcoholism, and other related terms, which exemplify this USA bias.   - Mark D Worthen PsyD (talk) (I'm a man—traditional male pronouns are fine.) 00:54, 12 July 2020 (UTC)
• Support, per nom, discussion, and Roxy's observation (the common abbreviate name is PTSD not PSD). Randy Kryn (talk) 12:46, 12 July 2020 (UTC)

@Randy Kryn: Should monoamine oxidase inhibitor be mono-amine oxidase inhibitor because the common abbreviation is "MAOI"?―Biochemistry🙴❤ 17:45, 12 July 2020 (UTC)

Never heard of it, whereas the initials PTSD are well known and understood. But I base my i!thing on the nom and discussion. Roxy's comment just stood out as a real-world example of how many people mental-map the name (which is why some people are surprised the article's not already at the proposed title). Randy Kryn (talk) 18:46, 12 July 2020 (UTC)

I won't rehash my criticism for the nom then, suffice to point out that the abbreviation "MAOI" is well known and understood in the field of psychiatry (and by the people that take those medications).―Biochemistry🙴❤ 16:53, 13 July 2020 (UTC)

Yep. Good example. SandyGeorgia (Talk) 16:26, 18 July 2020 (UTC)

• Support per nom. Stavd3 (talk) 06:46, 20 July 2020 (UTC)

Notes, additional comments, and data related to this Requested Move

I was surprised to discover that the most-searched term per Google Trends is "post traumatic stress disorder".   - Mark D Worthen PsyD (talk) (I'm a man—traditional male pronouns are fine.) 01:05, 12 July 2020 (UTC)

Well I'll be damned! Look at that. I mean, I don't really think that's an option since post is a modifying prefix to traumatic so it more or less needs to be connected to be grammatically correct, but that's really interesting. I wonder if that's just because we're all too lazy to put in a hyphen (I mean, two keys at once!) or if it's because we see post as a descriptor not a modifier 😂 ItsPugle (talk) 12:18, 12 July 2020 (UTC)

Noting that the abbreviation of posttraumatic stress disorder is PTSD, not PSD, is simply not a valid argument. There are many compound words in English that are not abbreviated using only the first letter of each word/prefix/etc—especially in science and medicine. For your reading pleasure, see these examples:

• Ultraviolet (UV), not "U", and certainly not "ultra-violet"
• Electrocardiogram (ECG), not "E" (I shudder to mention "EKG")
• Electroencephalography (EEG), not "E" (and thank goodness—an EEG would look very strange if hooked up to the chest...)
• Bachelor of Science (BS), not "BoS" or "BOS" (death to prepositions!)
• Acetylcholinesterase (AChE), not "A" or "AC"
• Antidiuretic hormone (ADH), not "AH", and certainly not "anti-diuretic hormone"
• Alanine aminotransferase (ALT), not "AA" or even "AAT"
• Monoamine oxidase inhibitor (MAOI), not "MOI", and certainly not "mono-amine oxidase inhibitor"

And so on and so forth.―Biochemistry🙴❤ 17:28, 12 July 2020 (UTC)

I always thought BS meant something else. -Roxy the elfin dog . wooF 18:19, 13 July 2020 (UTC)

I'm a fan of good BS myself.―Biochemistry🙴❤ 18:36, 13 July 2020 (UTC)

---

The discussion above is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.

Semi-protected edit request on 28 June 2021

The article about post-traumatic stress disorder contains a small mistake under the management-counselling

"Counselling The approaches with the strongest evidence include behavioral and cognitive-behavioral therapies such as prolonged exposure therapy,[147] cognitive processing therapy, and eye movement desensitization and reprocessing (EMDR).[148][149][150] In addition, brief eclectic psychotherapy (BEP), narrative exposure therapy (NET), and written narrative exposure therapies also have a evidence.[151]"

In the last sentence there is an error with the " -therapies also have a evidence" wich should be an "an" But even then it would sound much better with: " -exposure therapies have some evidence as well" Im.just.here.for.minor.mistakes (talk) 08:42, 28 June 2021 (UTC)

 Done, thanks for the suggestion. Writ Keeper ⚇♔ 13:13, 28 June 2021 (UTC)

Semi-protected edit request on 19 August 2021

link text "peritraumatic dissociation" to https://wiki.riteme.site/wiki/Dissociation_(psychology)#Peritraumatic_dissociation Montheus (talk) 13:08, 19 August 2021 (UTC)

 Done -- S.Hinakawa (talk) 14:04, 19 August 2021 (UTC)

Semi-protected edit request on 18 September 2021

I would like to request edit access for this page to supplement the section on diagnosis and assessment of PTSD. I am a doctoral student in psychology. Thank you. Nicolekha (talk) 17:28, 18 September 2021 (UTC)

 Not done: this is not the right page to request additional user rights. You may reopen this request with the specific changes to be made and someone will add them for you, or if you have an account, you can wait until you are autoconfirmed and edit the page yourself. (pinging Nicolekha) — LauritzT (talk) 17:38, 18 September 2021 (UTC)

Cannabinoids & core principles

I removed the following, which had recently been added to the Infobox under Medication: "Cannabinoids (possibly)".

The editor who added that purported medication, wrote in their edit note: "Last I checked, Rick Doblin’s study concluded that cannabinoids were more effective than any of the current established medications for treating PTSD. Also not sure why this section only lists SSRIs. Section needs expanding/updating."

Three points:

(1) The PTSD article article, under Management » Medication contains an accurate description of cannabinoids' current status as a possible treatment, viz., "Cannabis is not recommended as a treatment for PTSD because scientific evidence does not currently exist demonstrating treatment efficacy for cannabinoids."[citations omitted]

(2) Regarding the other editor's assertion, ""Last I checked, Rick Doblin’s study concluded that cannabinoids were more effective than any of the current established medications for treating PTSD", I could not find any such study and I keep up with this literature reasonably well. In addition—and this is just an aside—there is this recent article, which lists Doblin as one of the authors:

Bonn-Miller MO, Sisley S, Riggs P, Yazar-Klosinski B, Wang JB, Loflin MJE, et al. (2021). The short-term impact of 3 smoked cannabis preparations versus placebo on PTSD symptoms: A randomized cross-over clinical trial. PLoS ONE 16(3): e0246990.

From the article abstract:

Results: The study did not find a significant difference in change in PTSD symptom severity between the active cannabis concentrations and placebo by the end of Stage 1. All three active concentrations of smoked cannabis were generally well tolerated.

Conclusions and relevance: The present study is the first randomized placebo-controlled trial of smoked cannabis for PTSD. All treatment groups, including placebo, showed good tolerability and significant improvements in PTSD symptoms during three weeks of treatment, but no active treatment statistically outperformed placebo in this brief, preliminary trial. Additional well-controlled and adequately powered studies with cannabis suitable for FDA drug development are needed to determine whether smoked cannabis improves symptoms of PTSD.

(3) Re: "Also not sure why this section only lists SSRIs. Section needs expanding/updating." → The Infobox contains a very concise summary, which should be consistent with the relevant section in the body of the article. In this case, the Management » Medication subsection seems to summarize the topic reasonably well (I did not read it in depth today), and SSRIs are the frontline psychopharmacological treatment with PTSD, although their efficacy is ho-hum (discussed in the article).

IMPORTANT NOTE: I am not writing all this to castigate the other editor. Goodness knows I've made plenty of mistakes over the last 13 years as a Wikipedian, and I continue to stumble and learn. An editor suggested to me years ago that I review Wikipedia's core principles once a year or so to remain focused on why we do things the way we do, and not get bogged down in heated arguments over minutiae. I originally thought reviewing core principles every year was a bit much until I realized that most years when I read the 5 Pillars and their progeny, I swear some of it is brand new (it's not).

The core principles I'm thinking about today are the following.

In the English Wikipedia, verifiability means other people using the encyclopedia can check that the information comes from a reliable source. → Source: Wikipedia's Five Pillars (principles).

Biomedical information must be based on reliable, third-party published secondary sources, and must accurately reflect current knowledge. This guideline supports the general sourcing policy with specific attention to what is appropriate for medical content in any Wikipedia article, including those on alternative medicine. Sourcing for all other types of content – including non-medical information in medicine-articles – is covered by the general guideline on identifying reliable sources. → Source: Reliable sources for biomedical information.

Mark D Worthen PsyD (talk) [he/his/him] 05:23, 4 December 2021 (UTC)

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Talk:Post-traumatic stress disorder

Post-traumatic stress disorder

• Post-traumatic stress disorder (edit | talk | history | links | watch | logs)

Add "Women who experience reproductive challenges, undergo fertility treatments or/and experience infertility are also at risk for PTSD." to Pregnancy-related trauma section of this page. KristinStella (talk) 19:27, 12 May 2022 (UTC)

KristinStella (talk) 19:27, 12 May 2022 (UTC)

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Post-traumatic stress disorder

Add "Additional symptoms include agitation, nervousness, problems with concentration, headaches, crying spells, suicidal thoughts or attempts, obsessive-compulsive tendencies, panic episodes, paranoia, shakiness and hypervigilance." to the Symptoms section of this page. KristinStella (talk) 19:07, 12 May 2022 (UTC)

Do you have a good WP:MEDRS source that supports your suggestion? -Roxy the grumpy dog. wooF 19:17, 12 May 2022 (UTC)

Sadly not just one singular source. Sources list below!

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3974501/

https://www.nimh.nih.gov/health/publications/post-traumatic-stress-disorder-ptsd#part_6127

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2366105/

https://pubmed.ncbi.nlm.nih.gov/20112140/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4346088/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3821375/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4211931/

https://www.healthquality.va.gov/guidelines/MH/ptsd/DCoEPTSDTool5PatientTool23May2013v1HiResPrint.pdf

https://psychiatry.org/patients-families/ptsd/what-is-ptsd KristinStella (talk) 19:45, 12 May 2022 (UTC)

Talk:Post-traumatic stress disorder

Post-traumatic stress disorder

• Post-traumatic stress disorder (edit | talk | history | links | watch | logs)

Add "Additional traumas include adoption, bullying or hazing. COVID-related trauma (e.g., hospitalization for COVID, post-COVID health challenges), divorce, homelessness, LGBTQ+ trauma (e.g., harassment, rejection, identity crisis), personal health issues or sports injury, racial trauma, secondary PTSD, witnessing a traumatic event, workplace injury or job-related accident and workplace abuse, loss and harassment." as a final paragraph under the Trauma section. KristinStella (talk) 20:15, 12 May 2022 (UTC)

KristinStella (talk) 20:15, 12 May 2022 (UTC)

Talk:Post-traumatic stress disorder

Post-traumatic stress disorder

• Post-traumatic stress disorder (edit | talk | history | links | watch | logs)

Add the below to the Management section.

Headline: Biological interventions

Body Copy: Biological treatments for PTSD involve treating the physical source of the symptoms in attempt to reset or alter physiological function through precision medicine.

Headline: Stellate Ganglion Block (SGB)

Body Copy: Stellate Ganglion Block (SGB) is a biological treatment for PTSD that treats the physical symptoms of trauma. SGB is most known for PTSD treatment within the Veteran community due to SGB’s ability to target the six key symptoms of hyper-reactivity: sleep difficulties, chronic hypervigilance, startle response, difficulties concentrating, floods of anxiety, and irritability or anger/rage.

A recent study concluded that there was a statistically significant improvement in PTSD symptoms independent of the causative trauma type, gender, age, previous suicide attempts, or use of prescription medications for PTSD. KristinStella (talk) 20:38, 12 May 2022 (UTC)

KristinStella (talk) 20:38, 12 May 2022 (UTC)

Post-traumatic stress disorder

Add section 'Anthropology' below 'Epidemiology' section. Add the following to 'Anthropology' section.

The experience of trauma (and resulting PTSD) is often expressed through the outermost limits of suffering, pain and fear. Expression of the images and experiences relived through PTSD often defy easy description through language. Therefore, the translation of these experiences from one language into another is problematic, when applied within the context of primarily Euro-American research on trauma . The Sapir-Whorf hypothesis suggests that people perceive the world differently according to the language they speak: language and the world it exists within reflect back on the perceptions of the speaker . For example, ethnopsychology studies in Nepal have found that cultural idioms and concepts often don’t translate to western terminologies: piDaa is a term that may align to trauma/suffering, but also people who suffer from this are considered paagal (mad) and are subject to negative social stigma, indicating the need for culturally appropriate and carefully tailored support interventions . In summary, different cultures remember past experiences within different linguistic and cultural paradigms. As such, cultural and medical anthropologists have questioned the validity of applying the diagnostic criteria of PTSD cross-culturally, as defined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-III), and constructed through the Euro-American paradigm of psychology .

There remains a dearth of studies into the conceptual frameworks that surround trauma in non-Western cultures. There is little evidence to suggest therapeutic benefit in synthesizing local idioms of distress into a culturally constructed disorder of the post-Vietnam era, a practice anthropologist believe contributes to category fallacy . For many cultures there is no single linguistic corollary to PTSD, psychological trauma being a multi-faceted concept with corresponding variances of expression . Designating the effects of trauma as an affliction of the spirit is common in many non-Western cultures where idioms such as “soul loss” and “weak heart” indicate a preference to confer suffering to a spirit-body or heart-body diametric. These idioms reflect the emphasis that collectivist cultures place on healing trauma through familial, cultural and religious activities while avoiding the stigma that accompanies a mind-body approach . Prescribing PTSD diagnostics within these communities is ineffective and often detrimental. For trauma that extends beyond the individual such as the effects of war, anthropologists believe applying the term “social suffering” or “cultural bereavement” to be more beneficial.

Every facet of society is affected by conflict; the prolonged exposure to mass violence can lead to a ‘continuous suffering’ among civilians, soldiers, and bordering countries . Entered into the DSM in 1980, clinicians and psychiatrists based the diagnostic criteria for PTSD around American veterans of the Vietnam war . Though the DSM (in its fifth edition at the time of writing) gets reviewed and updated regularly, it is unable to fully encompass the disorder due to its Americanization (or Westernization). That is, what may be considered characteristics of PTSD in western society, may not directly translate across to other cultures around the world. Displaced people of the African country Burundi experienced symptoms of depression and anxiety, though little symptoms of PTSD were noted . In a similar review, Sudanese refugees relocated in Uganda were ‘concerned with material [effects]’ (lack of food, shelter, and healthcare), rather than psychological distress (ibid.). In this case, many refugees didn’t present symptoms at all, with a minor few developing anxiety and depression. War-related stresses and traumas will be ingrained in the individual , however they will be affected differently from culture to culture. It’s clear that the “clear-cut” rubric for diagnosing PTSD doesn’t allow for culturally contextual reactions to take place. 1.145.145.184 (talk) 08:05, 27 August 2022 (UTC)

 Done Thanks for putting this together. Of the universe (talk) 15:22, 4 September 2022 (UTC)

I've left some citation neededs on sentences that you left unsourced. Even when one sentence obviously follows from the others, every claim should be backed up by reliable sources, especially in medical articles (see WP:OR and WP:MEDRS). I'll work on touching up this section, but it would be great if you could fill in some of the gaps, since you're far more familiar with the literature and the subject than I am. Of the universe (talk) 15:40, 4 September 2022 (UTC)

References

Section entitled: Intimate partner violence

This section contains the following sentence "However, being exposed to a traumatic experience does not automatically indicate that an individual will develop PTSD". I would appreciate feedback as to whether this sentence is relevant in it's current place. My opinion's are that firstly, this sentence has been covered in the opening section of this article and that, being a broad statement, it's not really suitable to have a place in a subsection, unless that section/subsection explores the whole subject of likelihood of developing PTSD after the event in question.

This is one of my first inputs regarding the possible amendment of an article. If I haven't lived up to the expectations of others, give me a shout. Remember! Please do not bite the newcomers! I need help, not punishment!!! BenBrownBoy (talk) 19:47, 13 September 2022 (UTC)

@BenBrownBoy Be bold! Go ahead and make changes like this one, briefly explain your reasoning in your edit summary, and if people disagree, then it can be discussed (hopefully respectfully) on the talk page. Of the universe (talk) 09:40, 16 September 2022 (UTC)

Thank you for the words of encouragement, Of the universe! I shall indeed be bold and make the edit. Thanks again! BenBrownBoy (Aye?) 10:35, 16 September 2022 (UTC)

Wiki Education assignment: Foundations of Clinical Trauma Psychology Fall Quarter2022

This article was the subject of a Wiki Education Foundation-supported course assignment, between 15 September 2022 and 1 December 2022. Further details are available on the course page. Student editor(s): MLRomo (article contribs).

— Assignment last updated by Rebeccah.obrien (talk) 21:15, 6 October 2022 (UTC)

Article issues and classification

This article fails the WP:B-class criteria #1, The article is suitably referenced, with inline citations. It has reliable sources, and any important or controversial material which is likely to be challenged is cited and #4, The article is reasonably well-written.

The article is in the categories:

• Articles with specifically marked weasel-worded phrases from December 2011
• Articles with incomplete citations from January 2014
• Articles lacking reliable references from January 2014
• Articles with unsourced statements from October 2015
• Wikipedia articles needing clarification from September 2022
• Articles with unsourced statements from September 2022
• Articles needing additional references from October 2022
• Wikipedia articles in need of updating from November 2022

These categories are not indicative of "suitably referenced" nor likely considered "reasonably well-written". -- Otr500 (talk) 08:54, 18 April 2023 (UTC)

Per the above, reassessed to C-class. Otr500 (talk)

External links

There are six entries in the "External links". Three seems to be an acceptable number and of course, everyone has their favorite to add for four. The problem is that none is needed for article promotion.

• ELpoints #3) states: Links in the "External links" section should be kept to a minimum. A lack of external links or a small number of external links is not a reason to add external links.
• LINKFARM states: There is nothing wrong with adding one or more useful content-relevant links to the external links section of an article; however, excessive lists can dwarf articles and detract from the purpose of Wikipedia. On articles about topics with many fansites, for example, including a link to one major fansite may be appropriate.
• ELMIN: Minimize the number of links. --
• ELCITE: Do not use {{cite web}} or other citation templates in the External links section. Citation templates are permitted in the Further reading section.
• WP:ELBURDEN: Disputed links should be excluded by default unless and until there is a consensus to include them. -- Otr500 (talk) 08:54, 18 April 2023 (UTC)

Wiki Education assignment: Psychology Capstone

This article was the subject of a Wiki Education Foundation-supported course assignment, between 8 May 2023 and 11 August 2023. Further details are available on the course page. Student editor(s): Uiseon1012 (article contribs). Peer reviewers: Casseygray, CleanBean, Mrs.Egyptian, JonesGMorg, IanWilliams25, Mgjones2.

— Assignment last updated by Rahneli (talk) 13:54, 13 July 2023 (UTC)

Semi-protected edit request on 21 July 2023

Add a wikilink to s:Henry IV Part 1 (1917) Yale/Text/Act II#line40 in the third paragraph of "History". 93.72.49.123 (talk) 04:25, 21 July 2023 (UTC)

Please say exactly what needs to be linked. Should the existing wikilink for "Henry IV, Part 1" be changed to this, or another part of that paragraph? --Ferien (talk) 09:22, 21 July 2023 (UTC)

"act 2, scene 3, lines 40–62" 93.72.49.123 (talk) 12:16, 21 July 2023 (UTC)

It seems like that part already has an inline citation leading to the play. A wikilink would be redundant. Deauthorized. ^(talk) 20:09, 21 July 2023 (UTC)

Cleanup needed?

I was casually reading this page when I came across a strange usage of a word, that I fixed. However, with further reading it appears there's a lot more strangely worded passages in this article than I thought. I'm fairly new to Wikipedia so I'm not sure I'm the best person to start working on this. I'd appreciate some help if at all possible.

Some passages appear to be written by someone with a poor grasp of English, or maybe the wording got jumbled when paraphrasing the sources. Either way, they read very clunky and strange. Any help cleaning it up would be appreciated. GoldenKiwiCat (talk) 17:49, 16 July 2023 (UTC)

GoldenKiwiCat, what are some example passages? I've just had a quick look through, and the writing seems to be fairly typical of Wikipedia.Transient-understanding (talk) 05:54, 22 July 2023 (UTC)

These three paragraphs from "Risk Factors" are what stood out to me the most:

"The girls (32.9%) had more risk of being exposed to interpersonal trauma, such as violence; however, the boys (8.4%) who stand a chance of risk were of exposure to non-interpersonal trauma, likely injured due to accidents and disasters. Female children (34%) prevalent at risk of sexual violence impacted by the social system induced the severe PTSD syndrome;[51] proximity, sexually abused girls (27.8%) were diagnosed with the clinical level of PTSD syndromes.[52] Concealed the victimization of sexual violence was reinforced by the gender-biased in society; proof of more victims from gender-biased, additional research will be required."

"It has been difficult to find consistently aspects of the events that predict, but peritraumatic dissociation has been a fairly consistent predictive indicator of the development of PTSD.[58] Proximity to, duration of, and severity of the trauma make an impact. It has been speculated that interpersonal traumas cause more problems than impersonal ones,[59] but this is controversial.[60] The risk of developing PTSD is increased in individuals who are exposed to physical abuse, physical assault, or kidnapping."

"Child sexual abuse could be the cause of risking PTSD. Seriously, the youth population of experienced sexual abuse in childhood was 16% of age between 13-17.[67] Sexually victimized experienced in early life had less insecure attachment with their parents than children who had never been victims.[68] Increasing of risking PTSD possibly caused the relationship between family and friends.[69] Overall, Early experience of sexual victimization could cause low self-esteem, excessive repulsion of having sex, mistrust, and the possibility of suicide."

Just some awkward wording and grammar that doesn't make much sense. GoldenKiwiCat (talk) 06:00, 22 July 2023 (UTC)

Relationship between PTSD and CPTSD needs clarification

I know this is a tall order since the sources don't all agree on whether it's a distinct condition or a subtype of PTSD. But I think it's important to at least acknowledge this disagreement and its implications, even if it can't be resolved neatly.

Example: One source claims that the condition is a subtype, and that this is reflected in the ICD. Another source made the perhaps semantically accurate but pragmatically bizarre claim that (and I'm paraphrasing) a person who experienced prolonged childhood trauma "surprisingly developed PTSD." The latter claim makes no sense if CPTSD is a subtype, but much more sense if it is a distinct condition. 2603:7081:1603:A300:2CC4:A198:82DB:C8BF (talk) 15:35, 25 September 2023 (UTC)

10x prevalence in US citizens? Common, folks, this is BS

The article claims that US population has 10-20x higher prevalence of PTSD in its population. This is a clue for bad science. Maybe the definitions are to loose, maybe US therapists enjoy financial kickbacks. Anyways, something is odd in the kingdom of PTSD.

--~~~ 2A01:C22:AC2F:F900:2805:68CE:2EB3:10CA (talk) 18:07, 4 February 2024 (UTC)

Post-traumatic or Posttraumatic?

Recently a user changed the title of the article previously called Post-traumatic stress disorder, now the title is "Posttraumatic stress disorder. What is the real name of this illness does anyone know more about it? Rafaelosornio (talk) 05:44, 7 March 2024 (UTC)

Wiki Education assignment: The Impact of Cancer

This article was the subject of a Wiki Education Foundation-supported course assignment, between 8 January 2024 and 4 May 2024. Further details are available on the course page. Student editor(s): Pothosjoy3 (article contribs). Peer reviewers: Loyola2024.

— Assignment last updated by Dandelions-love-to-fly (talk) 19:23, 15 March 2024 (UTC)

Veterans

Would someone with editing access please change the name of the section 'Veterans' to 'Military Veterans'. The reason is veterans is not specific to former military personnel, yet that is how it's been used here. Thank you. 2003:D3:FF2C:3F2B:9446:6972:DB4B:9DC0 (talk) 18:59, 27 April 2024 (UTC)