History of PTSD in the DSM

Evolution / History of PTSD in the DSM: Awareness, Research and Resources

“The DSM definition of PTSD is quite straightforward: A person is exposed to a horrendous event “that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others,” causing “intense fear, helplessness, or horror,” which results in a variety of manifestations: intrusive reexperiencing of the event (flashbacks, bad dreams, feeling as if the event were occurring), persistent and crippling avoidance (of people, places, thoughts, or feelings associated with the trauma, sometimes with amnesia for important parts of it), and increased arousal (insomnia, hypervigilance, or irritability). This description suggests a clear story line: A person is suddenly and unexpectedly devastated by an atrocious event and is never the same again. The trauma may be over, but it keeps being replayed in continually recycling memories and in a reorganized nervous system.” ― Bessel van der Kolk

History: From Shell Shock to PTSD

History of PTSD in the DSM Research

Evolution of PTSD in the DSM

"The concept of Post-Traumatic Stress Disorder (PTSD) has evolved significantly over time. Here’s a brief overview of its history:

1. Early Recognition: Symptoms resembling PTSD have been noted throughout history. Ancient texts, including works by Hippocrates, describe symptoms similar to what we now recognize as PTSD 1.
   
   
2. World Wars: During World War I, the term “shell shock” was used to describe soldiers experiencing symptoms like fatigue, tremors, and nightmares. This term evolved into “combat stress reaction” during World War II 1.
   
   
3. Vietnam War: The term PTSD emerged during the Vietnam War, as researchers studied the psychological effects of combat on soldiers. This period saw the term “post-Vietnam syndrome” being used 1.
   
   
4. DSM Inclusion: In 1980, PTSD was officially added to the Diagnostic and Statistical Manual of Mental Disorders (DSM-III). This inclusion marked a significant shift, recognizing that PTSD was caused by external traumatic events rather than inherent individual weaknesses 2 3.
   
   
5. Modern Understanding: Today, PTSD is understood to affect not only war veterans but also survivors of various traumas, including natural disasters, accidents, and personal assaults. The criteria for diagnosing PTSD have been refined over successive editions of the DSM 4 5.
   
   
6. Treatment Evolution: Treatment approaches have also evolved, from early misconceptions and controversial methods to modern therapies like cognitive-behavioral therapy (CBT), eye movement desensitization and reprocessing (EMDR), and medication 6.

The understanding and treatment of PTSD continue to advance, with ongoing research aimed at improving outcomes for those affected by this condition.


PTSD inclusion in the DSM

Post-Traumatic Stress Disorder (PTSD) has been included in the Diagnostic and Statistical Manual of Mental Disorders (DSM) since the DSM-III, which was published in 1980. Over the years, the criteria for diagnosing PTSD have evolved, reflecting advances in understanding and research.

DSM-III (1980)

• Introduction: PTSD was first officially recognized and included as a distinct diagnosis.
• Criteria: Focused on the traumatic event and the individual’s response, which had to involve intense fear, helplessness, or horror.

DSM-IV (1994)

• Refinement: Expanded the criteria to include a broader range of symptoms and stressors.
• Symptom Clusters: Introduced three symptom clusters: re-experiencing, avoidance/numbing, and hyperarousal.

DSM-5 (2013)

• New Category: PTSD was moved to a new category called Trauma- and Stressor-Related Disorders.
• Expanded Criteria: The criteria were expanded to include four symptom clusters: intrusion, avoidance, negative alterations in cognition and mood, and alterations in arousal and reactivity1.
• Additional Features: Included criteria for children under six years old and added a dissociative subtype.

DSM-5-TR (2022)

• Updates:The DSM-5-TR (Text Revision) included updates to reflect scientific advances since the DSM-5’s release but did not change the diagnostic criteria for PTSD 1 2.

Key Criteria in DSM-5-TR

1. Exposure to Trauma: Directly experiencing, witnessing, learning about, or repeated exposure to traumatic events.
2. Intrusion Symptoms: Unwanted memories, nightmares, flashbacks, and severe distress or physical reactions to reminders of the trauma.
3. Avoidance: Efforts to avoid trauma-related thoughts, feelings, or external reminders.
4. Negative Alterations in Cognition and Mood: Inability to recall aspects of the trauma, negative beliefs, distorted blame, persistent negative emotions, diminished interest in activities, and feelings of detachment.
5. Alterations in Arousal and Reactivity: Irritability, reckless behavior, hypervigilance, exaggerated startle response, concentration issues, and sleep disturbances.
6. Duration: Symptoms must persist for more than one month.
7. Functional Impairment: Symptoms cause significant distress or impairment in social, occupational, or other important areas of functioning 1 2. (Source: Microsoft Copilot

175 Years of Progress in PTSD Therapeutics: Learning From the Past Psychiatry Online

Evolving DSM Diagnostic Criteria for PTSD: Relevance for Assessment and Treatment Springer Link

From Shell Shock and War Neurosis to Posttraumatic Stress disorder (PTSD): A History of Psychotraumatology NIH

From Shell Shock to PTSD: Proof of War’s Traumatic History The Conversation

From Shell Shock to PTSD, a Century of Invisible War Trauma PBS News

From Shell Shock to PTSD and Traumatic Brain Injury: A Historical Perspective on Responses to Combat Trauma American Psychological Association

History of PTSD and Trauma Diagnoses Trauma Dissociation

History of PTSD in Veterans: Civil War to DSM-5 U.S. Department of Veterans Affairs

How Veterans Created PTSD JSTOR

PTSD History and Overview U.S. Department of Veterans Affairs

Posttraumatic Stress Disorder as a Diagnostic Entity – Clinical Perspectives Taylor and Francis Online

Redefining Posttraumatic Stress Disorder for DSM-5 ScienceDirect

Shell Shock and PTSD: A Tale of Two Diagnoses Mary C. Vance, MD, MSc; Joel D. Howell, MD, PhD PDF Download

The History of Forgetting, From Shell Shock to PTSD Listen ABC

The PTSD Criterion A debate: A brief history, current status, and recommendations for moving forward Wiley Online Library

The PTSD History Timeline Banyan Treatment Center

The Organization of DSM-5-TR™ Updated Edition Mental Health and Motivation

Trauma Redefined in the DSM-5: Rationale and Implications for Counseling Practice The Professional Counselor

The Historical Evolution of PTSD Diagnostic Criteria Springer Link

Understanding the History of PTSD Verywell Health

What’s Shell Shock & Is There a Difference Between It and PTSD? Moment of Clarity

The Evolution Of Post Traumatic Stress Disorder - Video

🎓 Mental Health, Psychology and Relationship Resources

Mental Health Crisis and Emergency Resources

Mental Health Crisis and Emergency Awareness, Information and Guidance

“It is during our darkest moments that we must focus to see the light.” — Aristotle

“If you’re going through hell, keep going.” — Winston Churchill

Mental Health Crisis Resources 

Mental Health Emergencies

Mental Health Crisis and Emergencies

"It’s crucial to seek help immediately. Here are some resources and steps you can take:

• Emergency Services: If someone’s life is at risk or you feel you cannot keep yourself or someone else safe, call 999 or go to the nearest A&E (Accident & Emergency) department.

• Mental Health Helplines: Samaritans: Call 116 123 for confidential support available 24/7.
  
  
• Shout Crisis Text Line: Text SHOUT to 85258 for support via text message.
  
  
• Childline: For those under 19, call 0800 1111.

• NHS 111: For urgent mental health support, you can call 111 and select the mental health option to speak with a trained professional.

• Crisis Teams: Local crisis resolution and home treatment teams (CRHTs) can provide immediate support and help manage mental health crises at home.

• Mental Health Charities:
   
• Mind: Offers information on coping during a crisis and planning for future crises.
  
  
• Mental Health Foundation: Provides practical tools and resources for crisis care.

Remember, reaching out for help is a crucial step, and there are many resources available to support you through difficult times." (Source: Microsoft Copilot)

Behavioral Emergencies Psych Guides

Behavioral Health Crisis Intervention Multnomah County

Creating a Mental Health Crisis Plan Psych Central

Children’s Mental Health is in Crisis American Psychological Association

Coping with Mental Health Crises and Emergencies Here To Help

Core Elements to Responding to Mental Health Crises US Department of Health and Human Services PDF Document Download

Definition of Emergency specific to Mental Health Public Health

Disaster Mental / Behavioral Health and Emergency Preparedness Department of Health

Disaster Mental Health Planning and Response Resources Office of Mental Health New York

Emergency Mental Health and Psychiatry University of Michigan Health

Getting Help in a Mental Health Crisis Mind

How to Help in an Emotional Crisis American Psychological Association

How to Spot the Signs of a Mental Health Crisis in Someone You Love WebMD

Recognising a Mental Health Crisis New Vista

Mental health Crisis Lines Washington State Health Authority

Mental Health Emergencies TUFTS

Mental Health in Emergencies Fact Sheet World Health Organization WHO

Mental Health Resources During an Emergency (Buffalo Tragedy) View PDF New York State

Mental Health Resources for People in Crisis PSYCOM

National Guidelines for Behavioral Health Crisis Care Best Practice Toolkit
PDF Download SAMHSA

Navigating a Mental Health Crisis A NAMI PDF Download Resource Guide  

Procedures in the Event of Mental Health Emergency or Crisis Everett Community College

Support for adults experiencing a mental health crisis or urgent care need NHS

Urgent Treatment for Mental Illness Better Health Channel

What Is a Mental Health Crisis: Signs, Causes, and How to Get Help Psych Central

What is a Psychiatric Emergency? American Academy of Child & Adolescent Psychiatry

What to Do in a Mental Health Crisis NHS

What Does a Mental Health Crisis Look Like? KVC Health Systems

What to Do In a Mental Health Crisis National Alliance on Mental Health NAMI

When Behavioral Health Emergencies Arise, Who Responds Can Affect Outcomes PEW

When Is Mental Health a Crisis? Crisis Response

When is Mental Health a Medical Emergency? Life Healthcare

Where to get Urgent Help for Mental Health NHS

🎓 Mental Health, Psychology and Relationship Resources

Mental Health and Motivation Website in Top 100 Index

 Mental Health and Motivation Website in Top 100 Mental Health Global Index

The Mental Health and Motivation website is currently in its best position. The website was launch in 2021 and gradually made its way into the Top 100 Mental Health Global Index during 2023. The RSS / Subscription Feed is currently 7th globally - and the website 'competes' and add value to a variety of Tier 1 International websites with regard to Research and Resources (in well over a 150 psychiatric, psychology and neuroscience categories).

An abundance of personal motivation, research and references went into building this platform together with the support of many local (personal / professional) and international Mental Health institutional stakeholders. I'm deeply touched by / and grateful for their unwavering support.

Top position is still NAMI - National Alliance for Mental Health (USA). I'm grateful for each and every visitor that stops by to read and learn - from Mental Health academics, institutions, professionals, the military and / or troubled individuals (and family members). Also for the 1000s of international Mental Health students searching for postgraduate research funding via South African Bursaries and International Scholarships which I list for their benefit.

The Vernon Chalmers' Mental Health And Motivation website is gaining continuous traction in the international 'Best Mental Health Blogs / Websites to Follow on the Planet in 2024'.

Global Mental Health Ranking Improvement:
Since August 2021 the 'Mental Health and Motivation' website has evolved into an international research / resource sharing platform for assisting academia, mental health service providers and interested individuals across the world - currently assisting visitors from more than 131 Countries / 50 US States - with various (academic / personal / family / community / employment-related) Mental Health and Motivation research and resources.

More than 35 international mental health care institutions / providers are actively promoting related mental health care services and / or content on the website.

From Feedspot: "The best Mental Health blog / website RSS feed list curated from thousands of RSS feeds on the web and ranked by traffic, social media followers, domain authority & freshness."

From the Owner of Feedspot
" I'm the Founder of Feedspot. I would like to personally congratulate you as your blog Mental Health and Motivation has been selected by our panelist as one of the Top 100 Mental Health Blogs on the web.

I personally give you a high-five and want to thank you for your contribution to this world. This is the most comprehensive list of Top 100 Mental Health Blogs on the internet and I'm honored to have you as part of this!" - Anuj Agarwal

Source: Feedspot 100 Best Mental Health Blogs

Image Source: Mental health and Motivation Blog / Website Listing on Feedspot Photography Blogs

🎓 Mental Health, Psychology and Relationship Resources

Vernon Chalmers Personality Disorder Research

ASPD, BP, BPD and NPD Research Synopsis

“Personality disorders belong on Axis II of a mental health diagnosis chart, along with other developmental disorders. In other words, someone who is a histrionic or psychopath (narcissist) can never fully be rehabilitated. The diagnosis is grouped with other developmental delays, the only difference is the psychopath, narcissist, etc. are a little bit higher functioning but lack the reasoning and empathy to make the choices for the betterment of society. These are the people that run our country and various other high-ranking institutions because they crave power. Would you allow your child with Down's Syndrome to drive your car? Why elect an unfit person to speak for you in the world? At least the person with Down's Syndrome can feel empathy and love, a narcissist, psychopath, histrionic, etc. cannot.” ― Kara D. Spain

"Vernon Chalmers has conducted extensive research on various personality disorders, including Antisocial Personality Disorder (ASPD), Borderline Personality Disorder (BPD), Bipolar Disorder (BP), and Narcissistic Personality Disorder (NPD).

Here’s a brief synopsis of his work on these disorders:

Antisocial Personality Disorder (ASPD):

• Chalmers explores the behavioral patterns and neuropsychological aspects of ASPD, focusing on the lack of empathy, impulsivity, and chronic violation of social norms 1.
  
  
• His research emphasizes the importance of understanding the underlying motivations and environmental factors contributing to ASPD 1.

Borderline Personality Disorder (BPD):

• Chalmers investigates the emotional dysregulation, impulsivity, and unstable interpersonal relationships characteristic of BPD 1.
  
  
• He highlights the significance of early intervention and the role of therapeutic approaches in managing BPD symptoms 1.

Bipolar Disorder (BP):

• His work on BP includes examining the cyclical nature of mood episodes, ranging from manic to depressive states 1.
  
  
• Chalmers underscores the importance of a comprehensive treatment plan that includes medication, psychotherapy, and lifestyle modifications 1.

Narcissistic Personality Disorder (NPD):

• Chalmers delves into the grandiosity, need for admiration, and lack of empathy seen in NPD 2.
  
  
• He discusses the challenges in treating NPD and the necessity for tailored therapeutic strategies to address the unique needs of individuals with this disorder 2.

Vernon Chalmers Cluster B Personality Disorder Research Criteria

Vernon Chalmers’ research on Cluster B personality disorders, which include Antisocial Personality Disorder (ASPD), Borderline Personality Disorder (BPD), Histrionic Personality Disorder (HPD), and Narcissistic Personality Disorder (NPD), is grounded in the criteria outlined in the DSM-5-TR.

Here are some key aspects of his research criteria:

Emotional Dysregulation:

• Chalmers focuses on the intense and often unstable emotions experienced by individuals with Cluster B disorders. This includes rapid mood swings and difficulty managing emotions 1.

Distorted Self-Image:

• His research examines how individuals with these disorders often have a distorted or unstable self-image, which can lead to issues with self-esteem and identity 1.

Impulsivity:

• Impulsive behaviors are a significant criterion in Chalmers’ research. This includes actions taken without forethought or consideration of the consequences, which can be harmful to oneself or others 1.

Pathological Behavior:

• Chalmers investigates the patterns of behavior that are considered abnormal or pathological, such as manipulative actions, deceitfulness, and a lack of empathy 1.

Interpersonal Relationships:

• His work also delves into the instability and intensity of interpersonal relationships seen in Cluster B disorders. This includes patterns of idealization and devaluation in relationships 1.

Chalmers’ research is instrumental in providing a deeper understanding of these complex personality disorders and developing effective intervention strategies.

Comorbidity of Cluster B Personality Disorders

Cluster B personality disorders, which include borderline, antisocial, histrionic, and narcissistic personality disorders, often co-occur with other mental health conditions.
 

• This comorbidity can complicate diagnosis and treatment. For instance, individuals with Cluster B disorders frequently experience mood disorders like depression and bipolar disorder 1 2. 
  
  
• Substance abuse is also common, which can exacerbate symptoms and hinder treatment 1.
  
  
• The presence of multiple disorders can lead to more severe symptoms and a poorer prognosis. 

Therefore, it’s crucial for mental health professionals to carefully assess and address all co-occurring conditions to provide effective treatment 1 2." (Microsoft Copilot)

Effects of Child Abuse on Adults

Leaving a Bipolar Personality Disorder (BP) Relationship

Leaving a Borderline Personality Disorder (BPD) Relationship

Leaving a Narcissistic Personality Disorder (NPD) Relationship

🎓 Mental Health, Psychology and Relationship Resources

Leaving a Bipolar Personality Disorder (BP) Relationship

 Leaving a Bipolar Relationship (BP): Awareness, Research and Resources

“In giving her existence, a great law had been broken; and the result was a being, whose elements were perhaps beautiful and brilliant, but all in disorder; or with an order peculiar to themselves, amidst which the point of variety and arrangement was difficult or impossible to be discovered.”

― Nathaniel Hawthorne

Leaving a Bipolar Personality Disorder (BP) Relationship Research

Leaving a Bipolar Personality Disorder (BP) Relationship

"Leaving a relationship where one partner has Bipolar Personality Disorder (BP) can be emotionally challenging and complex. 

Here's a guide that might help navigate such a situation:

1. Acknowledge the Challenges

Bipolar Personality Disorder is characterized by extreme mood swings, including manic and depressive episodes. These can make relationships intense, with frequent ups and downs. Recognizing the impact on your mental health is essential in deciding whether to stay or leave.

2. Evaluate the Relationship

Reflect on the nature of your relationship. Ask yourself:

• Is there mutual respect and understanding?
• Are you feeling emotionally exhausted or unsupported?
• Have you tried setting boundaries, and are they respected?

If the relationship is toxic or harmful to your well-being, it may be time to consider leaving.

3. Prepare Emotionally and Logistically

• Support System: Reach out to trusted friends, family, or a therapist to help you through the transition. Breaking off a relationship with someone who has a mental health condition can be emotionally taxing.
• Logistics: If you live together or share finances, create a plan for how to separate these areas. Organize your belongings and be financially prepared for the move.

4. Communicate Clearly and Compassionately

When you decide to leave, try to approach the conversation with empathy but also clarity. Be direct about your reasons, but avoid triggering a defensive reaction. If necessary, choose a time when your partner is more stable, such as during a balanced phase of their mood cycle.

5. Ensure Your Safety

If the relationship has elements of emotional, psychological, or physical abuse, prioritize your safety. In such cases, consider seeking help from professionals or organizations specialized in helping those in unhealthy or abusive relationships.

6. Expect Reactions

Your partner might react with anger, sadness, or even relief. In some cases, they may try to convince you to stay, using guilt or promises of change. Stay firm in your decision, especially if leaving is vital to your mental health.

7. Seek Therapy or Counseling

Both during and after the breakup, therapy can be incredibly helpful. It provides a space to process the emotions involved, establish healthier patterns, and heal from the relationship.

8. Focus on Self-Care

After the relationship, focus on rebuilding your emotional resilience. Spend time engaging in activities that bring you joy, and surround yourself with supportive people.

Leaving a relationship with someone who has Bipolar Personality Disorder can evoke feelings of guilt or fear, but prioritizing your emotional health is essential." (Source: ChatGPT 2024)

"Leaving a relationship with someone who has bipolar disorder can be incredibly challenging and emotionally taxing.

Here are some key points to consider:

Signs the Relationship May Be Unhealthy

• Constant Caretaking: Feeling like you’re always the caretaker can lead to burnout 1.
• Sacrificing Personal Goals: If you’re consistently putting your life goals and needs aside, it might be a sign 1.
• Feeling Unsafe: Any relationship where you feel unsafe or scared is a red flag 1.
• Consistent Anxiety: Feeling anxious or stressed about the relationship regularly 1.
• Partner Stopping Treatment: If your partner stops their treatment or medication, it could be a cautionary sign 1.

Steps to Take Before Ending the Relationship

• Open Communication: Try to have an honest conversation about your feelings and concerns.
• Seek Professional Help: Couples therapy can sometimes help manage the challenges.
• Self-Care: Ensure you’re taking care of your own mental and emotional health.

How to End the Relationship

• Be Compassionate: Approach the breakup with empathy and understanding 2.
• Clear Communication: Clearly explain your reasons without placing blame.
• Plan for Safety: If you feel unsafe, make sure you have a plan in place for your safety.

After the Breakup

• Self-Care: Focus on your own healing and well-being 1.
• Support System: Lean on friends, family, or support groups for emotional support.
• Professional Help: Consider seeing a therapist to help navigate your feelings and the transition.

It’s important to remember that while bipolar disorder can present unique challenges, your well-being and safety are paramount. If you need more personalized advice, consulting a mental health professional can be very beneficial." (Source: Microsoft Copilot)

Bipolar Disorder and Relationships: How to Navigate the Challenges Papillon Recovery Centre

Bipolar and Relationships: Breaking Up Is Hard to Do bphope

Can Relationships Be Affected by Bipolar Disorder? Psych Central

Four Reasons Bipolar Disorder Disrupts Relationships Psych Central

How Bipolar Disorder affects Relationships, plus Tips Medical News Today

It’s Complicated: Bipolar and Relationships FHE Health Restore

Mental Illness in a Relationship: When Leaving May Be Necessary FHE Health Restore

Relationships and the Bipolar Trap bphope

Should People With Bipolar Be In Relationships? HealthyPlace

Understanding Bipolar Breakup Cycles: 7 Tips on How to Cope Choosing Therapy

Ten Reasons Why Bipolar Relationships Fail & How to Cope Choosing Therapy

The Impact of Bipolar Disorder on Couple Functioning: Implications for Care and Treatment. A Systematic Review NIH

The Impact of Bipolar Disorder on Relationships and Family Dynamics: Coping Strategies and Support Authoria

The Ten Most Common Triggers for Bipolar Mood Episodes Everyday Health

What to Do When Someone with Bipolar Disorder Pushes You Away SummitStone Health Partners

When and How Should You End a Relationship with a Person Diagnosed with Bipolar Disorder? Healthline

Bipolar Disorder and Relationship Breakups

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Vernon Chalmers Mental Health AI Research

Mental Health AI Research and Application

“Anything that could give rise to smarter-than-human intelligence – in the form of Artificial Intelligence, brain-computer interfaces, or neuroscience-based human intelligence enhancement – wins hands down beyond contest as doing the most to change the world. Nothing else is even in the same league.” — Eliezer Yudkowsky

"Vernon Chalmers has made notable contributions to the field of mental health, particularly through his exploration of artificial intelligence (AI) and its applications. His work is primarily showcased on the Mental Health and Motivation website, which he created to share resources and insights on emotional well-being, neuropsychology, AI, and the sense of self 1 2.

Here are some key aspects of his research:

• AI in Emotional Well-being: Chalmers investigates how AI can be used to assess and improve emotional well-being. This includes using AI tools to analyze emotional states and provide personalized mental health support 1 2.

• Neuropsychological Insights: His research delves into the cognitive and emotional decision-making processes, exploring how AI can help understand and mitigate biases in these areas 1 2.

• Resource Sharing: The website serves as an international platform for sharing mental health and motivation resources, assisting academia, mental health service providers, and individuals worldwide 1 2.

Chalmers’ work aims to bridge the gap between scientific understanding and practical applications, making mental health resources more accessible and effective. His work focuses on understanding cognitive and emotional decision-making biases and their impact on behavior.

His research and resources aim to provide a comprehensive understanding of mental health and emotional well-being 1 2.

If you’re interested in how AI can impact mental health, Vernon Chalmers’ work offers a wealth of knowledge and resources" (Source: Microsoft Copilot)

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