Controversies With a PTSD Diagnosis

As a society, we tend to take the word of medical and mental health professionals at face value—even when they’re wrong.

When you think about this notion a bit further, you realize how troubling of an outlook it could be. It's not unheard of for doctors to misdiagnose patients for physical ailments, or at the very least not be able to identify the cause of a problem. That's why people seek different opinions for physical ailments.

These very same issues exist with mental health professionals. One psychiatrist might diagnose someone with depression while another says they're perfectly fine.

This problem becomes even more troubling when you combine this lack of agreement or lack of accuracy with the legal system.

Often, when Child Protective Services social workers discover a child has been diagnosed with Post Traumatic Stress Disorder (PTSD), the social worker will attribute the cause of the PTSD to an individual. This is especially true of the professional who made the diagnosis attributes the cause to an individual. When that happens, the social worker will conclude that that person who “caused” the PTSD actually abused the child mentally or emotionally.

Since you’re reading this, maybe that’s exactly what happened to you—you were falsely accused of mental abuse of a child as a result of that child being diagnosed with PTSD.

Since you're innocent of the accusation though, you must dispel the notion of taking the mental health provider’s word at face value.

More specifically, to build evidence in your favor, discrediting a PTSD diagnosis is integral to your cause. With the findings I'll be discussing, you'll realize that the basis for a post-traumatic stress disorder diagnosis is often quite ambiguous and unsettled.

Let’s discuss research compiled in "The Criterion A Problem Revisited: Controversies and Challenges in Defining and Measuring Psychological Trauma." (See Frank W. Weathers, Terence M. Keane, Journal of Traumatic Stress, Vol. 20, No. 2, Aril 2007, pp. 107-121.)

In the US, the discovery and formalization of the diagnosis of PTSD phenomon was a tremendous catalyst in learning more about psychological trauma.

PTSD may be seen in various types of trauma – be it through combat or sexual assault, for instance – but is recognized by similarities in symptoms. It was revolutionary in how traumatic stress was looked at and helped psychiatric professionals streamline their studies and examine these issues on a deeper level, despite the fact that the symptoms arose in so many different settings and contexts.

However, as you'll notice when dealing with the obstacles of our legal system, once something like PTSD becomes so commonly widespread and accepted as a legitimate diagnosis, many "facts" go unchecked. For this reason, critics have questioned many of the core assumptions involved with the post-traumatic stress disorder diagnosis.

Below are some of the sticking points that question the validity of a PTSD diagnosis.

What is Criterion A?

When a doctor or mental health professional is evaluating a patient to determine whether the person meets the standard for a PTSD diagnosis, the professional is weighing a variety of official “criteria.” Criterion A is the stressor criterion for PTSD, and it's been widely challenged for decades.

Many psychiatric professionals take issue with how PTSD is diagnosed based on these two points:

• The broadness or narrowness applied to the definition of trauma
• Measuring the validity and reliability of trauma

How is Trauma and PTSD Defined?

Defining trauma is integral for those involved in studying and treating traumatic stress, but that doesn't make coming up with a consensus meaning of trauma (or what qualifies as trauma) any easier.

There are so many factors that complicate the issues, making it difficult to come up with an accurate, universally applicable definition and standard. Obstacles such as magnitude, frequency, and duration of the trauma make the process undeniably tough.

In fact, there exists no distinct line between regular stressors (a minor hassle) from traumatic stressors (a catastrophe). This means that mental health counselors and therapists are free to draw the line wherever they each feel it’s appropriate.

From there comes the matter of subjectivity and perception with appraising stressors. In other words, what one person perceives as a relatively mild frustration can be regarded by another as a harrowing life-altering disaster.

For this reason, a PTSD diagnosis tells us little about how bad the stressor was that result in PTSD and also very little about the person who was diagnosed with PTSD.

Broadness and narrowness make defining trauma and PTSD even more difficult. If the scope of scenarios that can result in an official PTSD diagnosis is too narrow, it's almost guaranteed that some people's plights will be ignored. If, on the other hand, the scope is too broad and any stressor at all can qualify as inducing “trauma” under the definition of Criterion A, people could claim to be traumatized for insignificant slights.

Over the years, a feasible definition of trauma has been reached, but it is still vague and there is still plenty of room for improvement.

How is PTSD Measured?

The metrics used to measure PTSD have been created on the fly and not adopted in the broader field.

Professional didn’t even always pay that much attention to trauma measures during psychometric procedures. This lack of attention has been accompanied by a shortage of validation and peer reviewed findings.

This lack of development of the understanding of how to diagnose PTSD might be due to how hard it is to define and depict a traumatic experience. Initially, with PTSD, a lot of the research depended on the mere occurrence of trauma.

The article mentioned above points out that recent efforts have been made to amend this problem, and strides forward have been taken. However, there's still much work to be done in how to quantify and measure PTSD.

It is a miscarriage of justice for CPS social workers to take a PTSD diagnosis at face value and deem someone guilty for child abuse based solely on that diagnosis. If this has happened to you, it’s worth disputing and fighting.