Monday, March 29, 2010

Posttraumatic Stress Disorder a Social Diagnosis?

One of my favorite subjects, two years ago, was Posttraumatic Stress Disorder (PTSD); actually the controversy of this diagnosis and a completely different side of it that is quite popular lately. Although it has been one of those subjects that have been very popular in the last five or six decades, we just can’t ignore the fact that this concept has been developing for hundreds of years, so that its discovery by Hans Selye was more of a rediscovery.
I was quite intrigued by the abundance of articles that I read about different law suites arguing the infliction of trauma and PTSD as a consequence, which drew my attention to one of the most “vulnerable” aspects of PTSD which is the possibility that this could be a subjective diagnosis. I conducted a research project on this subject taking into consideration 3 different stressful situations, the intensity of the perceived stress and coping strategies, and found that there are very big differences between the diagnosis at the moment it was born and what people understand by it nowadays.
There haven’t been any differences recorded regarding the coping behaviors that the subjects use, either they were confronted with PTSD or grief and loss or just an ordinary stressful situation, which tells us that what trauma is to one individual might just be a problematic situation to another, a situation that he could surpass easily. All this proves that the contemporary clinical approach might not be always right; it might just be a case of global labeling tendency of patients.
The explanation resides in the interaction of many variables like individual characteristics and the social representation of trauma; the social aspect will dictate to the person to consider traumatic an event that socially speaking is considered to be a trauma, although the person has enough resources to surpass it. At this point it appears to be obvious the need to change the psychological definition of trauma and maybe some changes to the PTSD diagnosis, adapting to the characteristic features of the individual, and not including him in a general category. 
To better understand the results of the research we should take into consideration the following case scenarios: the psychiatrist or psychologist, either listens to the symptoms of the patient and establishes a diagnosis, in which case we can conclude that there is indeed a general tendency of these professionals to immediately put a psychopathology label on patients, or in the case of patients that cannot express very well their symptoms, they go through the structured interview, in which case the results of the research may be explained by the clinician's expectancies or by the fact that the individual starts playing the role of patient. The patient might exaggerate the symptoms or just become submissive under the authority of the clinician, this is the case of individuals that are actually experiencing part of some symptoms and are seeking relief, but there is another category of individuals that are only after the material gains.
Another important aspect to be considered is the relationship between the two, the clinician and the patient, they influence each other and they both bring their personal baggage in the situation. This is quite relevant because the clinician might just categorize the patient’s experience as a trauma according to his own experience. For future research a lot more variables should be taken into consideration, especially both the patient’s personality and the clinician’s and the patient’s major life events and life style.

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1 comment:

psychologycollegefinder said...

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