Question:
I know nothing about psychology, but this seems the most
appropriate newsgroup, so:
A friend of mine was involved in a car crash and apart from
the physical injuries his Doctor says he suffered from
Post Traumatic Stress Disorder. He is claiming compensation
from his insurer which he will get for his physical injuries.
However, one of the clauses in the contract states that they
will *not* pay out for psychiatric or mental illness.
The contract was written in 1987. My naive questions are:
1. Was PTSD a recognised condition in 1987 ?
2. Is it a psychiatric or mental illness ( I dunno.... :-) ) ?
Answer:
That is more a legal question than a psychological one. From our
perspective, it is a Disorder (the 'D' in PTSD). It is emminently
treatable, but can become a significant problem if left untreated.
In here, there is a LOT of evidence that PTSD is actually a PHYSIOLOGICAL
disorder, because the traumatic event screws up your noradrenergic system's
ability to respond because of hyperarousal. Armed with the evidence
cited in this book, you have a good case for PTSD being a physical,
not mental, disorder.
"Dissociative disorder" is a general heading for certain, related disorders
just as "cookbook" is a term for certain related books (eg Italian cooking,
vegetarian cooking, etc). The essential commonality of dissociative
disorders is that the the mind "dissociates" from reality - eg amnesia,
multiple personality disorder. However, as far as I am aware, PTSD is not
considered a dissociative disorder, rather it is an *anxiety* disorder.
In fact, the DSM-IV committee on dissociation agreed that PTSD is a
dissociative disorder. In fact, dissociative symptoms are a common
feature of PTSD. The most frequently used test of trait dissociation
shows higher dissociation scores than for the general population.
So while PTSD is not officially classed as a dissociative disorder, it
has a substantial association with dissociative features. For example,
combat veterans with PTSD with heavier combat exposure have higher
dissociation scores than those without PTSD, and higher dissociation
than those with less heavy combat exposure.
There are various interpretations of "dissociative," the most
theory-neutral being that selected mental contents are split-off from
conscious awareness yet still exert an influence on behavior. The classic
examples are conversion disorder, where "hysterical" physical symptoms
arise, and psychogenic amnesias, fugues, or depersonalization, where
selected aspects of identity or memory are lost to awareness. THe most
extreme example is dissociative identity disorder.
PTSD, as previously explained, is generally considered an anxiety
disorder.
It is often an example of extreme "one-trial-learning" in which a
traumatic event such as a rape, an earthquake, or the death of a child,
may produce severe intrusive symptoms for many years, including flashbacks
and emotional numbing.
THe term "dissociative" is vague enough to include some aspects of PTSD
potentially, but the taxonomy currently used in most places does not
consider it a dissociative disorder
