Talk:Posttraumatic stress disorder

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I am concerned that the opening paragraphs on posttraumatic stress disorder (PTSD) convey a psychosocial perspective that implies the biological perspective is of secondary importance. This seems to be a byproduct of the applauded biopsychosocial approach which is taken to mean that biological, psychological and sociological explanations are equelly important no matter what is being talked about or, which is more of a worry, that which of the three is more important is open to a democratic vote. Following the introduction with the Neurophysiology of PTSD redresses the balance somewhat but would leave many people thinking that the biological changes are psychologically generated. The events that lead to PTSD are best discussed in sociological terms and there is no doubt that the personal experiece of such events opens up the possibility of endless psychological discussion. The condition itself also has social and psychological consequences but what it does inside the body is a largely biological concern. We know for instance that all animals respond with similar biological defences to threat and challenge, however well developed. or not. their brains and that past a certain point such stess can lead to illness or even death. As Joseph LeDoux remarks in "The Emotional Brain", Touchstone, New York, 1996, the emotions are less important than the functions that generate them. How can Wikipedia ensure a well balanced presentation of such a centrally important psychiatric condition even though some psychiatric opinion does not see it this way? Paddybw (talk) 08:32, 27 May 2008 (UTC)paddybw 27th May 2008.
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[edit] "I Love the APA Style, but..."

I love the APA style, and I am one of the few people I know who not only love it (I'm usually surrounded by MLA-obsessed folks...yuck!) but I can write in APA format from memory usually (with occasional hints from the stylebook). Unfortunately, this is not an APA-style project, and we need to insure that the referencing system in this Wikipedia article is at least close to Wikipedia's style guide (WP:MOS, IIRC). I took out all the APA-ness of one section but it's late and I'm not going to work on the rest of the page tonight lest my brain turn off and I mess up some other section of the page (done that before). Anyway, just a note. I love the APA style, but Wikipedia is not the right place to be trying to use it. VigilancePrime 07:36, 3 December 2007 (UTC)
Okay, I went through and finished un-APA-ing the article. BUT, many of the "references" need to be properly referenced as many of them I simply put into the WikiFormat of endnotes rather than the full-bore citation (mostly when there was no citation information other than name and year), so the article there still needs a lot of work. Furthermore, I removed a ton of just plain extraneous stuff... like the large paragraph about a Holocaust memorial turning into a city embarrassment... what did that have to do with anything? I also pulled some unsourced statements (if it's a quote, it absolutely needs a citation) and did a bunch of tagging of other statements, mostly with {{fact}} tags and the occasional {{POV-statement}} or {{dubious}} tags. Still, the article overall, I believe you all will find, is far better and much more balanced, and in that belief I also removed one of the POV tags. Please, realize three things: 1. I am a WikiDragon who is Being Bold, 2. it is late and I may have made some mistakes, and 3. this all was done in very good faith. Cheers! VigilancePrime 09:16, 3 December 2007 (UTC)

[edit] Symptoms?

Why are there no symptoms listed? —Preceding unsigned comment added by 72.240.69.236 (talk) 23:10, 8 December 2007 (UTC)


This is the exact reason why I looked up this article, as I was hoping to quickly get a list of the symptoms without having to look it up in the DSM. It's hard to believe that such an obvious section has been left out. I'll have some time in a couple days, during which I'll write up a brief synopsis from the DSM, from which someone else can build upon.124.169.36.244 (talk) 03:40, 29 March 2008 (UTC)

edit: symptoms are listed below diagnosis. i am not sure that if you know what "diagnosis" is... it is hard to believe to see an ignorant wiki reader. (erol)

==Prolonged Exposure==

Such an argument would justify redeployment of troops to never ending rotations of duty, and also justify continued mental abuse under the pretexts of therapy. Becommming emotionally numb or nonreactive to unjustified adverse circumstances is not a therapuetic effect, it is just putting the patient (victim) in a more advanced stage of pathology.

71.114.183.105 (talk) —Preceding comment was added at 21:42, 2 January 2008 (UTC)

==Politics==

Can we please make a new article or whatever about the politics of PTSD? This article here should be fairly clinical and objective. By having all these 'real world' examples such as the prevalence of PTSD following Katrina and whatever, it makes this article seem more inflammatory than anything else. I know that situations such as wartime exposure are high up there in terms of eliciting these traumatic reactions, but please, don't overburden this article with more writings about that.124.169.36.244 (talk) 03:45, 29 March 2008 (UTC)

[edit] Prevalence section rewrite

I removed the Hurricane Katrina and 911 references in the "prevalence" section (and did a small rewrite). Hurricane Katrina is a major disaster that caused almost 2000 lives and 911 caused 3000 - a large number in American standards, but not anywhere else. It is nothing compared to the tsunami (last count was 230000) and certain other catastrophes that happened around the world and seem to be unnoticed by our comrades living in America, who continue to mourn over the nearly three deaths a day in Iraq. In fact, even the Iraq war caused more American casualties than 911, and for many, it is a much more daunting experience (with over a million casualties including civilians, directly or indirectly). I am in no way undermining the impact Hurricane Katrina and 911 had on many's emotional lives, but, in my assessment, it is ridiculous to compare it with the impact of the tsunami. I don't believe a significant number of PTSDs would result in 911 - the people directly affected, after all, are small, and I believe they have the ability to withstand the emotional impacts. The Indonesians would beg for a place on the World Trade Towers if they could. Herunar (talk) 19:37, 17 February 2008 (UTC)

[edit] What Happened?

Since I took this page off my watchlist? It's gone downhill. I worked a little bit tonight, but there's a lot of work ahead on it. Argh... Which brings me to the next point...

[edit] NO HYPHENS PLEASE

The DSM-IV and DSM-IV-TR do not hyphenate posttraumatic. This is (therefore) the correct page/name for this article. If anything, bringing it to lowercase would be appropriate, but no hyphens please! We've covered this before as well.
Thank you all. Have a good night/morning/day. • VigilancePrime • • • 08:54 (UTC) 17 Mar '08
Wow, I didn't mean to push a button. In your edit summary, you shouted: "PLEASE SEE THE TALK PAGE. What "most sources" state and what the official name is are two different things, and we have discussed this AD NASEUM." I note that our naming conventions call for us to use the name most commonly found in print sources, and explicitly do not call for the "official" or "most correct" name. I'm not sure there's a general consensus to ignore that naming convention in this particular case. -GTBacchus(talk) 18:20, 17 March 2008 (UTC)
Let me first apologize for the somewhat knee-jerk reaction. We HAVE been over this before, maybe not quite ad naseum (it seems like it, but in researching back, I found less than I had thought). After the fact I was able to track links and stuff back to a "non-controversial page moves" bit and see that you were only the messenger, so to speak... I didn't mean to shoot you. ;-)
As for the name, we - those of us with expertise and who have been working on the article - had come to this consensus long before. It seems that if Wikipedia wants credibility, it needs to be accurate, and that means using the most reliable of reliable sources. In this (and other psychiatric cases), that would mean using the DSM-IV-TR as the firstmost reference. Do also note that since moving the page back, I have added reference marks to the lead paragraph which also makes the DSM literally reference #1.
As for shouting, while (apparently - feel the chagrin) caps is usually considered shouting, realize that - as far as I know - using boldface in an edit summary is not possible, so one (me) must revert to the old-school method (before we had AOL-speak and that crap)... the intent was to garner attention, as "see talk page" has historically not worked. If you were offended, please realize that was completely not the intent and become un-offended if possible.  :-D
Anyway, again, please do not take it personally as I did come to realize that you were only carrying out what you thought was an already consensused or routine series of page moves. "No harm/no foul" my old Battery Commander would tell me (though sometimes he used it in the strangest of contexts), and I'm perfectly content with your intent and comfortable with the article at this time.
Cheers, • VigilancePrime • • • 07:37 (UTC) 18 Mar '08
Thanks for your explanation, that helps. Do you think it would be fair to say that there is a consensus among those working on mental health articles to use terminology as standardized by DSM, rather than defaulting to WP:COMMONNAME? If that's the case, then we could write that down somewhere, and save the trouble later on if someone makes the same mistake I did. -GTBacchus(talk) 18:21, 19 March 2008 (UTC)
Totally!!! (or, in an edit summary where boldface is not an option, "TOTALLY!")...
             ;-)
• VigilancePrime • • • 19:37 (UTC) 19 Mar '08
Ah, there seems to already be something in place, at Wikipedia:Manual of Style (medicine-related articles)#Naming conventions. If this comes up in the future, you can refer people to "WP:MEDMOS", and I'll remember that, too.

Actually, looking at it closely, it recommends using ICD names for diseases, and I read in our article on ICD that ICD and DSM are mostly in accord. It might be worthwhile to add to that naming convention that, for mental illnesses, we use the DSM-IV standard. Does that seem right? -GTBacchus(talk) 22:48, 19 March 2008 (UTC)

I left a note there about possibly updating the guideline. -GTBacchus(talk) 23:02, 19 March 2008 (UTC)
...and it didn't turn out too conclusively: see this section. -GTBacchus(talk) 06:06, 20 March 2008 (UTC)
May I recommend, though it may seem US-centric, that perhaps the DSM should be the standard naming convention for psychiatric/psychological issues? The example of Tourette's Disorder was ideal... the "Syndrome" page can redirect to "Disorder" and no harm done, and no need to make the lengthy ICD page. No drama, simple, effective. Just a thought. • VigilancePrime • • • 06:33 (UTC) 20 Mar '08
If you wish to recommend that, go to WP:MEDMOS and do so. That seems to be the relevant guideline. -GTBacchus(talk) 14:12, 20 March 2008 (UTC)
Hi folks. A thought: the issue of the spelling is actually kind of interesting, and the lack of the hyphen (or simply a space) sticks out like a sort thumb. I think it would be a good idea to add a short explanation to the article. Also, I don't think the non-hyphenated version is appropriate anywhere except in the title, according to my understanding of the style guidelines for medical articles (use the scientific name in the title, write for the average person in the body of the article, avoid jargon.) I've never seen the unhyphenated version anywhere else except here and in the DSM. I'd say the "common names" are PTSD, post-traumatic stress disorder, and post traumatic stress disorder. Perhaps we should start a petition to get them to put a hyphen in for DSM-V ! SeattleJoe (talk) 05:56, 24 March 2008 (UTC)
No... I agree with the above that "posttraumatic stress disorder" is correct and ought to be used, but whichever form is used, it must be consistent throughout the article. It may be confusing to some people to see "posttraumatic" if they are used to "post traumatic" or "post-traumatic," but it would be much more confusing to have one form in the title and another in the body of the article. Regardless, I think this is rendered moot by the fact that "PTSD" is used in most of the body anyways, which is both clear and an accepted acronym. Zefryl (talk) 15:19, 24 March 2008 (UTC)
Hi Zefty. That's part of the reason I suggested giving an explanation in the text. That would relieve the confusion. But I have to stick to my guns. I agree about it being a moot point, but it is used once, as the first word in the article. Whether or not someone changes it, I still think an explanation of the odd spelling is called for. It is completely counter-intuitive, and sticks out like a sore thumb. SeattleJoe (talk) 19:00, 24 March 2008 (UTC)
OK, this arrogant newbie has put his neck out and added an edit, explaining the various spellings. It is in the History/Earliest reports section, where the coining of the term is discussed, and where the hyphen already scandalously appears. This will give you folks a chance to see if my idea really sucks or not, if nothing else.
I do this in a spirit of good-will and peace among all nations, and it shall be my final contribution on this subject, no matter the fate of my sterling prose. SeattleJoe (talk) 20:01, 24 March 2008 (UTC)

While I give the ICD credit for trying, even in countries that technically use it (like Australia), the DSM is still pretty much the de facto standard. 124.169.36.244 (talk) 14:14, 30 March 2008 (UTC)

[edit] Double redirects

I've moved this talk page to match the article, but I see the article has a number of double redirects remaining from the move. I've fixed a few, but a number remain, and I don't have time to do these. See Special:WhatLinksHere/Posttraumatic Stress Disorder. Could someone fix these please. —  Tivedshambo  (t/c) 11:22, 20 March 2008 (UTC)

[edit] Vandalism Revert

Just that. Someone had typed in a few rather malicious and misleading remarks. (NohraK (talk) 08:54, 21 March 2008 (UTC))

[edit] EL restoration

I have restored some ELs deleted from the page w/o explanation. Several of these definitely look appropriate to the topic of PTSD. ResearchEditor (talk) 18:48, 30 March 2008 (UTC)

User:Arcadian was the reverter. You may want to discuss with him, he's an admin who's opinion I wouldn't discount easily (personally, I'm completely terrified of him). Also, being related to PTSD isn't sufficient. Sources must be reliable, contain information that is above and beyond what a featured article would contain, and all the other criteria of WP:EL. I've removed those links before, here, and my reasoning is in the edit summary. I can go through in detail for each link if you'd like. The editor in question, 70.190.94.117 (talk · contribs · deleted contribs · logs · block user · block log), has a history of spamming the EL section of PTSD-related pages [1]. These are not good links. WLU (talk) 20:31, 30 March 2008 (UTC)
I did have a question on two of the links:
http://www.ncptsd.va.gov
http://www.carlisle.army.mil/library/bibs/PTSD.pdf
Also, I have found a couple of other links that may be more appropriate as ELs.
NIMH · Post-Traumatic Stress Disorder (PTSD)
Post-traumatic stress disorder (PTSD) - MayoClinic_com
Post-Traumatic Stress Disorder (PTSD) Causes, Symptoms, Treatment and Diagnosis on MedicineNet_com
Please let me know what you think of them. ResearchEditor (talk) 01:25, 31 March 2008 (UTC)
I wouldn't mind Arcadian's opinion on things. The first is dubiously acceptable, it is an organization about PTSD, but it's US-specific (see WP:CSB), and it's an organization, not an encyclopedic source of information. If there's an international organization I'd have no problem with it but US-specific is arguable, particularly with the DMOZ link that has its own links to associations. The second could possibly go in the further reading section but a better solution would be tracking down and using the refs in it to expand the page. Either way, it shouldn't be in EL, but further reading would be legit. The last three are basically all the same things - organization's summaries of PTSD. Really, I'd say none are good ELs because they won't contain anything beyond what PTSD would were it a featured article. They're adequate as sources, arguably one could be OK, but if you look in the disease infobox at the top of the page, there's already two general info links - MedlinePlus and eMedicine. Also, the Mayo clinic link is in the DMOZ page. Given that, I'd say none of the final three are good choices is greatly preferred over a bloated EL section. WLU (talk) 22:47, 31 March 2008 (UTC)
Agreed with the above. If I do find some better ELs on the topic, I will add them. ResearchEditor (talk) 03:06, 1 April 2008 (UTC)

[edit] updated causes section

I have updated the causes section, adding refs to the statements and deleting "or prolonged or extreme childhood neglect" since I was unable to find any support for this statement. I also added a ref from a recent JAMA study. ResearchEditor (talk) 03:51, 1 April 2008 (UTC)

[edit] fixing reference on veterans

I have fixed the LATimes ref on veterans, so it is wikified and easier to find if it moves.ResearchEditor (talk) 14:56, 18 April 2008 (UTC)

[edit] Hippocampal Volume doesn't change

It is more likely that a small hippocampus is a risk factor in developing PTSD than PTSD causing shrinkage of the hippocampus. (Pitman et al., 2002) Therefor, a nuance must be made in the wiki-article.

[edit] reverting vandalism

I have reverted recent vandalism to the page. ResearchEditor (talk) 14:23, 19 April 2008 (UTC)

[edit] is this vandalism?

"In some cases it can also be from great emotional stress when someone has tinkered with their brain, but no one is actually hurt."

english is not my first language, but this sounds like complete nonsense. should it be removed? —Preceding unsigned comment added by 193.180.9.6 (talk) 07:31, 2 May 2008 (UTC)

[edit] recent edit to causes section

I deleted an unsourced phrase, replaced it and moved it to a more appropriate part of the paragraph with DSM-IV TR sourced info. I was unable to find information on refugees in the DSM-IV, but this would be good to add to the article if it can be found. ResearchEditor (talk) 16:28, 2 May 2008 (UTC)

[edit] deleting OR, restoring quote

I have deleted a section added by an anon IP w/o sources and restored a quote deleted by another anon IP w/o reason. IMO, the quote may be too long and undue weight. ResearchEditor (talk) 03:49, 13 May 2008 (UTC)