Trauma etiology and the DSMV

An interesting article

"They are proposing that there be a stress and trauma spectrum section which will include PTSD and the dissociative disorders. In so doing, the DSM5 will emphasis the common etiology of these "disorders." This would be a controversial move, since the current version focuses more on description of symptoms. Even though there would still not be a diagnostic requirement of a trauma for a dissociative disorder to exist, placing dissociation squarely into a section with an emphasis on trauma etiology would be a blow to the false memory advocates. It would be a validation and positive step for those of us who appreciate that dissociative disorders do have a strong basis in trauma. "

more...

http://www.mindparts.org/2010/10/the-ds ... ation.html

It is past time for DSM to abandon classification by symptom. That is so primitive. ICD already uses classification by etiology. Abandoning classification by symptom is an important step toward making adequate differential diagnosis. Good differential diagnosis involves consideration of a matrix of all symptoms exhibited by the client, and all disorders in which those symptoms may occur.

The problem with classification by symptom is this: it necessarily puts special emphasis on just one or two key symptoms. When a key symptom is not present at the time of diagnosis, the result frequently is misdiagnosis. In the case of DID, one key symptom is amnesia. However, very often the client has amnesia for their amnesia or simply does not recognize it by name, so unless the diagnostician consciously looks for signs of amnesia, amnesia won't be noticed and the correct diagnosis of DID will be missed.

^Got to agree with that one, until I really started examining my life, after my alters had started introducing themselves, I thought I didn't lose time at all. Because I don't black out for days. Instead, it's little chunks here and there, it's...if I wasn't specifically looking for it, I wouldn't know at all, and I still don't realize a lot of the time that I'm missing time.

So I think revamping toward looking at etiology is a really good idea.

If the client can't readily give the professional a traumatic event or stress that may have been the cause of the disorder; would the client then be misdiagnosed? Just a thought.

What does this mean for people who don't have a known history of trauma? Even Chris Sizemore (Eve) has said that her condition was not caused by trauma, and what trauma she did experience was not typical of DID cases. How would the psychiatric community receive her now? Are they going to look for trauma to blame the disorder on?

I'm always a little suspicious when people try to force a cause-effect relationship where there may be none, because in my experience, there's rarely agreement between practitioners unless the trauma is really obvious. Sometimes the symptoms really are the only facts.

Not all DID is caused by early childhood trauma. Many cases of DID have been reported when a young child undergoes early childhood surgeries and such.



Chris was forced to kiss her dead grandmother... right? That does not mean there is not deeper abuse she cannot recall. Psychologist were lacking back in those days. Many are today even, but those that take on DID are usually very good.


I like how the DSM5 is setup. At least for me, the symptoms explained fit me perfectly including the 2 things they might add: pseudoseizures and somatic illness.

The question will come down to how trauma is defined.

tylas wrote:when a young child undergoes early childhood surgeries

I personally call this trauma.

tylas wrote:Chris was forced to kiss her dead grandmother

And this.

Point: trauma is subjective.

good point, but still not the usual type of trauma that is associated with DID.

tylas wrote:good point, but still not the usual type of trauma that is associated with DID.

You mean abuse. Nobody can stop people from taking words and changing the sense. Pop psychology will never disappear.
I think it makes sense to make it trauma related. There is enough evidence that it is more common than not. It will help people take dissociation more seriously, I think. Trauma sells.

I am not disagreeing. I too vote for it being trauma related.