Thread:User talk:Danny/Bugs to be aware of with Mediawiki/reply (2)

Dissociative PTSD is not the same as Complex PTSD because complex PTSD has many additional criteria not mentioned in Dissociative PTSD, and dissociative PTSD is found in significant numbers in vets, i.e. not just caused by interpersonal trauma. The best explanation of what the DSM rules "allow" for subtypes and specifiers and how they relate to PTSD with dissociative features and Complex PTSD is this one from the year before DSM5 publication:

[https://drive.google.com/drive/u/0/#folders/0B9N_0OGb6vlqdFFsQ2cybFlUOWM Dalenberg, C. J., Glaser, D. and Alhassoon, O. M. (2012), STATISTICAL SUPPORT FOR SUBTYPES IN POSTTRAUMATIC STRESS DISORDER: THE HOW AND WHY OF SUBTYPE ANALYSIS. Depress. Anxiety, 29: 671–678. doi: 10.1002/da.21926]


 * Complex PTSD does include "dissociation" but does not insist that it is depersonalization and/or derealization, where as Dissociative PTSD does (and has been criticizing for being so selective). The reason Dissociative PTSD got in the DSM is because of the lab tests which showed fundamental differences in the way the brain works for those with depersonalization/derealization as a symptom of PTSD.


 * I've changed links to this page to PTSD_dissociative_subtype which is a currently redirect to the criteria on the PTSD page but can easily be changed, and this also means I could add it under "diagnoses" even though it's not separate. It may be worth using this new page to explain the differences once you have read the papers below, or they could be summed up on the Complex PTSD or PTSD pages.


 * The majority of people with Complex PTSD will have the Dissociative subtype of PTSD but that does not make them the same disorder. Studies on vets with the Dissociative subtype were key in establishing this, a third had the (more) Dissociative form of PTSD. Complex PTSD is also described in the ICD-10 named as Enduring Personality Change After Catastrophic Event (EPCACE) so keeping pages separate is important.


 * Neurobiology provided key evidence of a distinct subtype, which is why depersonalization and derealization are considered key to D-PTSD

 Draft ICD-11 summarizes these:
 * Complex PTSD has "5 broad domains" beyond the PTSD criteria, see p3-4

The dissociative subtype of PTSD: A replication and extension - partly written by Friedman
 * Friedman, who writes much of the PTSD material in the DSM, sums up the changes for the Dissociative specifier of PTSD (written after DSM5 publication)


 * Dissociation in posttraumatic stress disorder: Evidence from the World Mental Health Surveys. Biological Psychiatry

- Can dissociation address an entire range of symptoms discussed in Complex PTSD including problems related to social, interpersonal, or attachment difficulties? If not, where should these problems be classified? - If Complex PTSD is an overarching one, how does it differ from personality disorder of borderline type?
 * Sar, writing prior to publication (2011), makes some good points: