# Acute Stress Disorder, Post-Traumatic Stress Disorder, and "Complex" PTSD



## David Baxter PhD (Aug 2, 2008)

*Re: One more positive update*

Note that "Complex PTSD" is not at present a recognized diagnosis:

Complex PTSD - (National Center for PTSD)



> The diagnosis of PTSD accurately describes the symptoms that result when a person experiences a short-lived trauma. For example, car accidents, natural disasters, and rape are considered traumatic events of time-limited duration. However, chronic traumas continue or repeat for months or years at a time. Clinicians and researchers have found that the current PTSD diagnosis often does not capture the severe psychological harm that occurs with such prolonged, repeated trauma. For example, ordinary, healthy people who experience chronic trauma can experience changes in their self-concept and the way they adapt to stressful events. Dr. Judith Herman of Harvard University suggests that a new diagnosis, called Complex PTSD, is needed to describe the symptoms of long-term trauma. Another name sometimes used to describe this cluster of symptoms is: Disorders of Extreme Stress Not Otherwise Specified (DESNOS).
> 
> Because *results from the DSM-IV Field Trials indicated that 92% of individuals with Complex PTSD/DESNOS also met criteria for PTSD, Complex PTSD was not added as a separate diagnosis*. Complex PTSD may indicate a need for special treatment considerations.



To my mind, individuals who show only short-term reactions to trauma are not properly diagnosed as PTSD in the first place. Rather, they should be given the diagnosis of 308.3 Acute Stress Disorder (or possibly 309.81 Posttraumatic Stress Disorder, Acute):



> *Diagnostic criteria for 308.3 Acute Stress Disorder*
> 
> A. The person has been exposed to a traumatic event in which both of the following were present:
> 
> ...



as opposed to:



> *Diagnostic criteria for 309.81 Posttraumatic Stress Disorder*
> 
> A. The person has been exposed to a traumatic event in which both of the following were present:
> 
> ...



This, if clinicians followed published criteria for these two diagnoses, there would be no confusion and no need for an additional diagnosis, since only individuals with enduring post-traumatic stress reactions would be given the diagnosis PTSD or PTSD, Chronic, which is exactly what the DSM-IV Committee concluded.


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## braveheart (Aug 2, 2008)

*Re: Acute Stress Disorder, Post-Traumatic Stress Disorder, and "Complex" PTSD*

Why's dissociation included in ASD but not PTSD? [and of course it's included, quite rightfully, in Complex PTSD.]

:juggle:


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## David Baxter PhD (Aug 2, 2008)

*Re: Acute Stress Disorder, Post-Traumatic Stress Disorder, and "Complex" PTSD*

It _is_ included in PTSD:



> (3) acting or feeling as if the traumatic event were recurring (includes a sense of reliving the experience, illusions, hallucinations, and *dissociative flashback episodes*, including those that occur on awakening or when intoxicated).


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## GDPR (Jun 13, 2014)

*Re: Acute Stress Disorder, Post-Traumatic Stress Disorder, and "Complex" PTSD*



> Note that "Complex PTSD" is not at present a recognized diagnosis



Is it now?I don't think it is....

But,I think it is a 'proper' term. I have been diagnosed with PTSD,a personality disorder and a dissociative disorder.But Complex PTSD,I think,would be a more accurate diagnosis instead of 3 separate ones.


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## David Baxter PhD (Jun 16, 2014)

*Re: Acute Stress Disorder, Post-Traumatic Stress Disorder, and "Complex" PTSD*

No. See http://forum.psychlinks.ca/just-chat/30137-what-are-you-currently-reading-6.html#post231588


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## Potcake (Sep 12, 2015)

*Re: One more positive update*

Is it possible that a diagnosis of PTSD after a traumatic event as a teenager could reignite in later years...as long as 30 to 40 years after the event? I suppose you wouldn't know for sure without interviewing the patient, but if they are resistant to professional intervention, we are left to guess work and walking on eggshells.


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## David Baxter PhD (Sep 12, 2015)

*Re: One more positive update*



Potcake said:


> Is it possible that a diagnosis of PTSD after a traumatic event as a teenager could reignite in later years...as long as 30 to 40 years after the event? I suppose you wouldn't know for sure without interviewing the patient, but if they are resistant to professional intervention, we are left to guess work and walking on eggshells.



Yes it's possible.


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