Date: 25/03/2015 13:42:51
From: transition
ID: 697628
Subject: PTSD, internal mental states and what's "physical".

Watching 4 Corners other night, though don’t want to talk of that as don’t think anyones troubles even after being in the media are public property, more want to talk about so-called PTSD in a more general way.

Am considering how helpful the term is. How it may not lend to expressions of related uncomfortable internal mental states being understood to be and accepted as more physical pain and physical injury.

I would have thought internal mental states early this century had a substantially well-established physical foundation. I mean science-minded folk are happy to grant gravity the status of a physical force, so why is it that internal mental states can’t be granted a more physical status?

http://en.wikipedia.org/wiki/Posttraumatic_stress_disorder

“Posttraumatic stress disorder (PTSD) may develop after a person is exposed to one or more traumatic events, such as major stress, sexual assault, terrorism, or other threats on a person’s life. The diagnosis may be given when a group of symptoms, such as disturbing recurring flashbacks, avoidance or numbing of memories of the event, and hyperarousal, continue for more than a month after the occurrence of a traumatic event.

Most people having experienced a traumatizing event will not develop PTSD. People who experience assault-based trauma are more likely to develop PTSD, as opposed to people who experience non-assault based trauma such as witnessing trauma, accidents, and fire events. Children are less likely to experience PTSD after trauma than adults, especially if they are under ten years of age. War veterans are commonly at risk for PTSD.

…….Posttraumatic stress disorder is classified as an anxiety disorder in the DSM IV; the characteristic symptoms are not present before exposure to the violently traumatic event. In the typical case, the individual with PTSD persistently avoids all thoughts and emotions, and discussion of the stressor event and may experience amnesia for it. However, the event is commonly relived by the individual through intrusive, recurrent recollections, flashbacks, and nightmares. The characteristic symptoms are considered acute if lasting less than three months, and chronic if persisting three months or more, and with delayed onset if the symptoms first occur after six months or some years later. PTSD is distinct from the briefer acute stress disorder, and can cause clinical impairment in significant areas of functioning”

http://en.wikipedia.org/wiki/Complex_post-traumatic_stress_disorder

“Complex post-traumatic stress disorder (C-PTSD) also known as developmental trauma disorder (DTD) or complex trauma is a psychological injury that results from protracted exposure to prolonged social and/or interpersonal trauma in the context of dependence, captivity or entrapment (a situation lacking a viable escape route for the victim), which results in the lack or loss of control, helplessness, and deformations of identity and sense of self. Examples include people who have experienced chronic maltreatment, neglect or abuse in a care-giving relationship, hostages, prisoners of war, concentration camp survivors, and survivors of some religious cults. C-PTSD is distinct from, but similar to, post-traumatic stress disorder (PTSD), somatization disorder, dissociative identity disorder, and borderline personality disorder.

However, C-PTSD was not accepted by the American Psychiatric Association as a mental disorder. It was not included in DSM-IV or in DSM-5, published in 2013.

Though mainstream journals have published papers on C-PTSD, the category is not formally recognized in diagnostic systems such as Diagnostic and Statistical Manual of Mental Disorders (DSM) or International Statistical Classification of Diseases and Related Health Problems (ICD). It may be included in the upcoming ICD 11. However, the former includes “disorder of extreme stress, not otherwise specified” and the latter has this similar code “personality change due to classifications found elsewhere” (31.1), both of whose parameters accommodate C-PTSD.

C-PTSD involves complex and reciprocal interactions between multiple biopsychosocial systems. It was first described in 1992 by Judith Herman in her book Trauma & Recovery and an accompanying article. Forms of trauma associated with C-PTSD involve a history of prolonged subjection to totalitarian control including sexual abuse (especially child sexual abuse), physical abuse, emotional abuse, domestic violence or torture—all repeated traumas in which there is an actual or perceived inability for the victim to escape.”

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Date: 25/03/2015 15:10:27
From: mollwollfumble
ID: 697712
Subject: re: PTSD, internal mental states and what's "physical".

The DSM-IV definition of Post-Traumatic Stress Disorder is in the process of being changed and moved to a new chapter. See the following:

Posttraumatic Stress Disorder (PTSD) will be included in a new chapter in DSM-5 on Trauma- and Stressor-Related
Disorders. This move from DSM-IV, which addressed PTSD as an anxiety disorder, is among
several changes approved for this condition that is increasingly at the center of public as well as professional
discussion.

The diagnostic criteria for the manual’s next edition identify the trigger to PTSD as exposure to actual or
threatened death, serious injury or sexual violation. The exposure must result from one or more of the
following scenarios, in which the individual:
• directly experiences the traumatic event;
• witnesses the traumatic event in person;
• learns that the traumatic event occurred to a close family member or close friend (with the actual
or threatened death being either violent or accidental); or
• experiences first-hand repeated or extreme exposure to aversive details of the traumatic event (not
through media, pictures, television or movies unless work-related).
The disturbance, regardless of its trigger, causes clinically significant distress or impairment in the individual’s
social interactions, capacity to work or other important areas of functioning. It is not the physiological
result of another medical condition, medication, drugs or alcohol.

Changes in PTSD Criteria
Compared to DSM-IV, the diagnostic criteria for DSM-5 draw a clearer line when detailing what constitutes
a traumatic event. Sexual assault is specifically included, for example, as is a recurring exposure
that could apply to police officers or first responders. Language stipulating an individual’s response to
the event—intense fear, helplessness or horror, according to DSM-IV—has been deleted because that
criterion proved to have no utility in predicting the onset of PTSD.
DSM-5 pays more attention to the behavioral symptoms that accompany PTSD and proposes four
distinct diagnostic clusters instead of three. They are described as re-experiencing, avoidance, negative
cognitions and mood, and arousal.

From http://www.dsm5.org/Documents/PTSD%20Fact%20Sheet.pdf

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Date: 25/03/2015 15:31:45
From: Bubblecar
ID: 697722
Subject: re: PTSD, internal mental states and what's "physical".

>I mean science-minded folk are happy to grant gravity the status of a physical force, so why is it that internal mental states can’t be granted a more physical status?

They can – PTSD is a form of brain damage:

Brain Imaging Helps Link Specific Symptoms of PTSD with Specific Brain Activity

New research using high-resolution positron emission tomography (PET) brain imaging has linked specific symptoms of post-traumatic stress disorder (PTSD), including listlessness and emotional detachment, to specific abnormalities in brain function. This new work, published online September 17th in JAMA Psychiatry, suggests an exciting possible target for future treatments that would “personalize” medication management for this disabling illness.

PTSD is a disabling disorder that causes symptoms such as flashbacks, hypervigilance and emotional numbing or detachment after exposure to trauma. “Our study points toward a more personalized treatment approach for people with a specific symptom profile that’s been linked to a particular neurobiological abnormality,” Alexander Neumeister, M.D., 2007 NARSAD Independent Investigator Grantee and Co-Director of NYU Langone Medical Center’s Steven and Alexandra Cohen Veterans Center for the Study of Post-Traumatic Stress Disorder and Traumatic Brain Injury, told CBS News. “Understanding more about where and how symptoms of PTSD manifest in the brain is a critical part of research efforts to develop more effective medications and treatment modalities.”

The researchers used a new, harmless radioactive tracer with the PET scans to examine different regions of the brain presumed to be associated with symptoms of PTSD. The new tracer binds to a class of opioid receptors, known as kappa (KOR); prior research conducted in animals had established a link between KORs and dynorphin (a naturally occurring opioid released by the body during times of stress) with the PTSD symptoms of depression and emotional numbing. In this study the researchers wanted to determine whether there was a similar link in human subjects. They compared the PET scans of healthy volunteers with those of clinically diagnosed trauma victims with PTSD, major depression and generalized anxiety disorder whose symptoms ranged from emotional detachment to isolation.

Their primary finding is that after exposure to trauma, a low availability of KOR in the region of the brain where the amygdala is found (and where the fear response originates), is associated with heightened symptoms of listlessness and emotional detachment (but not anxious arousal or hypervigilance). The secondary finding is that this reduced KOR availability may be linked to more severe symptoms due to lower cortisol levels, suggesting a new role for cortisol as a biomarker for certain types of PTSD symptoms. Cortisol is a hormone naturally released by the body when the corticotropin-releasing factor (CRF) system signals release in response to stress.

“People with cancer have a variety of different treatment options available based on the type of cancer that they have,” Dr. Neumeister explained in the interview with CBS. “We aim to do the same thing in psychiatry. We’re deconstructing PTSD symptoms, linking them to different brain dysfunction, and then developing treatments that target those symptoms. It’s really a revolutionary step forward that has been supported by the National Institute of Mental Health (NIMH) over the past few years in their Research Domain Criteria Project.”

The research was conducted in collaboration with scientists at Yale School of Medicine, the School of Medicine at the University of California – San Diego, and the U.S. Department of Veterans Affairs National Center for Post-Traumatic Stress Disorder.

https://bbrfoundation.org/brain-matters-discoveries/brain-imaging-helps-link-specific-symptoms-of-ptsd-with-specific-brain

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Date: 25/03/2015 23:43:10
From: transition
ID: 697899
Subject: re: PTSD, internal mental states and what's "physical".

>They can – PTSD is a form of brain damage:

That ‘it’ happens after a ‘trauma’ and that ‘stress’ may follow is all straightforward enough, and I suppose that it’s something unpleasant that doesn’t resolve in good time probably deserves the term ‘disorder’ (maybe).

Was wondering other night, of the condition, those with it, that if ones internal mental states are greatly changed, that there’re aspects of that experience that are foreign or alien, perhaps self-alienating, that all the person had before and invested in ‘feels’ changed, and that maybe to have it is to find that even ones words, language and word-concepts fail them, and worse perhaps that culture and ideology fail them.

A point of entry on the subject might be the extent ‘the state’ (the apparatus in broad terms, including ideological influences) acknowledge internal mental states (the typical range of I mean, not just alright at one end and at the other end pathologizing). To qualify, what I mean is cultural/social/legal/medical environmental influences have the power to pathologize, and abnormalize.

You know when something goes seriously pear shaped the police are all over it, insurers, lawyers, the media etc. For the most part in day-to-day life for most of us all is going along nicely, culture, conventions and the private and informal things that tend behaviour within parameters all goes along smoothly, but then when adverse forces start swirling around everything is changed. Victims become liabilities or potential liabilities to someone, or something (companies/organizations) and considerations of liabilities tend to generate victims, with all that may go with that from whatever perspective.

What i’m thinking is that for culture (and more local social environments) to be greatly influential about shaping and maintaining behaviours within parameters (adopted optimal behaviours that don’t get adverse attention), that even some of the most apparently well-adjusted creatures that get their somewhat reliable internal mental states forced from equilbrium with no road home, well, I do wonder how helpful a medical term like PTSD will generally be.

And out there in the media there’re terms like ‘trauma’, ‘devastated’, ‘stress’, ‘horrific’, and often whatever is delivered with concern.

The DSM might be seen as a pathogizing manual/toolbox, and medicine in some way might be seen as being in the business of pathologizing (for diagnosis of course to help individuals) . To help there’s healthy.

I’m contemplating the consequences of more regular language and concepts (failing at) explaining internal mental states, assisting perhaps what mood contributes to equilibrium/homeostatic mechanisms. I can see it goes both ways, that a disruption and great change to the latter may impair the former also.

Imagine whatever substitutes for ‘internal mental states’ of this greatly advances civilization were tightened up, to the point of lesser existence or acknowledgement, and that what goes into formal and maybe particularly informal behaviour controls (including ideological influences) presented as being quite the opposite. I mean it’s not science that tells us individuals have internal mental states. It’s not ‘the state’, it’s not the apparatus.

What i’m seeing is a somewhat nasty dimension for those individuals trying to find the road back to their home in their heads.

Dunno

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Date: 25/03/2015 23:45:25
From: roughbarked
ID: 697902
Subject: re: PTSD, internal mental states and what's "physical".

transition said:


>They can – PTSD is a form of brain damage:

That ‘it’ happens after a ‘trauma’ and that ‘stress’ may follow is all straightforward enough, and I suppose that it’s something unpleasant that doesn’t resolve in good time probably deserves the term ‘disorder’ (maybe).

Was wondering other night, of the condition, those with it, that if ones internal mental states are greatly changed, that there’re aspects of that experience that are foreign or alien, perhaps self-alienating, that all the person had before and invested in ‘feels’ changed, and that maybe to have it is to find that even ones words, language and word-concepts fail them, and worse perhaps that culture and ideology fail them.

A point of entry on the subject might be the extent ‘the state’ (the apparatus in broad terms, including ideological influences) acknowledge internal mental states (the typical range of I mean, not just alright at one end and at the other end pathologizing). To qualify, what I mean is cultural/social/legal/medical environmental influences have the power to pathologize, and abnormalize.

You know when something goes seriously pear shaped the police are all over it, insurers, lawyers, the media etc. For the most part in day-to-day life for most of us all is going along nicely, culture, conventions and the private and informal things that tend behaviour within parameters all goes along smoothly, but then when adverse forces start swirling around everything is changed. Victims become liabilities or potential liabilities to someone, or something (companies/organizations) and considerations of liabilities tend to generate victims, with all that may go with that from whatever perspective.

What i’m thinking is that for culture (and more local social environments) to be greatly influential about shaping and maintaining behaviours within parameters (adopted optimal behaviours that don’t get adverse attention), that even some of the most apparently well-adjusted creatures that get their somewhat reliable internal mental states forced from equilbrium with no road home, well, I do wonder how helpful a medical term like PTSD will generally be.

And out there in the media there’re terms like ‘trauma’, ‘devastated’, ‘stress’, ‘horrific’, and often whatever is delivered with concern.

The DSM might be seen as a pathogizing manual/toolbox, and medicine in some way might be seen as being in the business of pathologizing (for diagnosis of course to help individuals) . To help there’s healthy.

I’m contemplating the consequences of more regular language and concepts (failing at) explaining internal mental states, assisting perhaps what mood contributes to equilibrium/homeostatic mechanisms. I can see it goes both ways, that a disruption and great change to the latter may impair the former also.

Imagine whatever substitutes for ‘internal mental states’ of this greatly advances civilization were tightened up, to the point of lesser existence or acknowledgement, and that what goes into formal and maybe particularly informal behaviour controls (including ideological influences) presented as being quite the opposite. I mean it’s not science that tells us individuals have internal mental states. It’s not ‘the state’, it’s not the apparatus.

What i’m seeing is a somewhat nasty dimension for those individuals trying to find the road back to their home in their heads.

Dunno

you lost me at brian damage.

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Date: 25/03/2015 23:50:07
From: transition
ID: 697906
Subject: re: PTSD, internal mental states and what's "physical".

>you lost me at brian damage.

you’re quick, enjoying the comfort in a spontaneous mouse click.

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Date: 25/03/2015 23:52:12
From: roughbarked
ID: 697909
Subject: re: PTSD, internal mental states and what's "physical".

transition said:


>you lost me at brian damage.

you’re quick, enjoying the comfort in a spontaneous mouse click.

It is better than dialup fercryssake.

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