PTSD is overdiagnosed – unless maybe it’s not

Salon.com ran an interview with Stephen Joseph, professor of psychology, health and social care at the University of Nottingham,U.K., and author of, “What Doesn’t Kill Us: The New Psychology of Posttraumatic Growth”. The headline? “How PTSD took over America”.  The subtitle? “The diagnosis is now being applied to everything from muggings to childbirth. An expert explains why it’s bad news.”  Interviewer Alice Karekesi asks questions like, “Do you believe that PTSD is over-diagnosed?”, “Is the emotional pain overblown in such cases?” and “Are there some cultures that are more prone to post-traumatic growth?”  One quick scan and I was ready to ask Dr. Joseph blistering questions such as, “How long does a client need to suffer before they can skip the ‘growth’ and actually get some help?”

Until I re-read his answers. And noticed that Salon and Joseph were talking about different things. Joseph doesn’t claim post-traumatic stress disorder is over-diagnosed. He explains the definition of PTSD has expanded, but doesn’t argue that’s a bad thing. He notes some say the DSM over-medicalizes the human experience, but doesn’t take a stand on whether it does or not.  The only “bad news” he explains in the interview?  People who have a normal reaction to an upsetting event may believe they have PTSD.

I’ll be reading Joseph’s book in the near future. Blurbs for the book suggest it’s not about diagnosis, but the way one can grow during recovery from trauma, and emerge stronger and healthier than before. If there are meaty chapters claiming that PTSD is over-diagnosed, you’ll read the full update here.

Political observers note media coverage is often driven by pre-established narratives – storylines and stereotypes that journalists (overworked, underpaid, overstressed and under-respected, by definition) fall into. Why did Candidate X get labeled as a flip-flopper when Candidate Y changed positions, too? Because it fit a storyline, including people’s perceptions of X’s character. The narrative here seems to be that if you say you have PTSD (or any other DSM diagnosis), it’s more likely you’ve inflated mild symptoms into a mental disorder because you’re weak.

DSM-V comes out next year. Watch for more of this narrative as May, 2013 approaches.

@ 2012 Jonathan Miller All Rights Reserved

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5 Comments

Filed under Diagnosis, Post-Traumatic Stress Disorder

5 responses to “PTSD is overdiagnosed – unless maybe it’s not

  1. I wouldn’t say “weak,” as in the last line of the narrative interpretation. I would say because a person wants answers and they are grasping at straws and feel they need to be in a box. Look at all the advertising for drugs on television. Actors talk openly about their symptoms and people assume they are real people. They identify with them. We are a dx generation, just as we are an over-medicated generation.

    I remember when I worked for CPS (childrens protective services) one supervisor told me “all” our clients have PTSD because they were abused. I thought this was a broad statement and I assume one would pre-suppose they did have PTSD simply because they were abused. However, some had serious mental illness to begin with, the abuse just exacerbated the issue. PTSD was often the dx, but not always.

    • Christy

      Same issue at one of my old jobs. Clinicians diagnosed all the kids with PTSD because they were abused. I remember sitting in group supervision explaining why experiencing trauma does not necessarily mean that one will develop PTSD.

      • And when you have someone who is always right and dead certain they are, there is nothing you can do. Especially when this person is signing off on your hours (which in my case they were back then).

  2. A professor once told me history doesn’t always make pathology. Many people bounce back from critical events. It needs to be stressed that reactions to trauma are normal and education needs to be provided on how to best deal with the critical event.

  3. Pingback: Can Trauma Make Us Stronger? | PsychotherapySphere

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