Posttraumatic Stress Disorder Correctly Diagnosed
One of the common diagnoses found in medical-legal reports is a Posttraumatic Stress Disorder (PTSD). A Posttraumatic Stress Disorder is an Anxiety Disorder. The diagnostic criteria for PTSD can be found in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM).
According to the DSM-IV-TR, the DSM-5 and the DSM-5-TR, a Posttraumatic Stress Disorder is diagnosed correctly when an individual has been exposed to an extreme life-threatening traumatic stressor that has led to the development of a set of characteristic signs and/or symptoms that have lasted more than one month. These extreme life-threatening stressors may involve actual or threatened death, a serious injury, a threat to one’s physical integrity, witnessing such an event, or learning that a family member or close associate has experienced such an event. Essentially, this level of “exposure” must be present in order for PTSD to be correctly diagnosed.
With respect to the above, such extreme traumatic events include, but are not limited to, military combat, violent or personal sexual and/ or physical assaults that may occur during robberies or muggings, being kidnapped, severe automobile accidents, being taken hostage, terrorist attacks, torture, incarceration as a prisoner of war, natural disasters, or being diagnosed with a life-threatening illness. Witnessed events include, but are not limited to in-person observation of a serious injury or the unnatural death of another person due to a traumatic event such as a major accident, a violent assault, a natural disaster, or an act of war. Witnessing though electronic media when work-related is also included. A Posttraumatic Stress Disorder can also be produced by learning that one’s child has a life-threatening illness.
The essential question is, how does one know if an individual is suffering with Posttraumatic Stress Disorder?
This is an essential question because it is well known that many people experience traumatic events and have some anxious symptoms, yet they do not develop a Posttraumatic Stress Disorder. In conducting a psychological evaluation to determine if someone has a Posttraumatic Stress Disorder the mental health practitioner must follow the normal psychodiagnostic procedures by:
1. giving a Mental Status Examination
2. taking a complete life history including the patient’s complaints or, as they are sometimes called, symptoms and information about their frequency, intensity, duration, onset and course over time
3. administering a battery of objective psychological tests
4. reading the available medical records to see what other mental health practitioners have found
5. obtaining collateral sources of information in the form of interviews with the patient’s relatives, friends and/or co-workers
After collecting data from the five sources noted above, the mental health practitioner is responsible for determining whether or not the individual has met the criteria for a PTSD found in the Diagnostic and Statistical Manual of Mental Disorders (DSM). It is only when the diagnostic criteria are met that a PTSD is correctly diagnosed.
