Is PTSD Being Over-Diagnosed? Essay Example

In recent decades the issue of Post-Traumatic Stress Disorder (PTSD) has become more commonly and openly discussed, and this rise in public awareness has led to a corresponding rise in diagnoses of PTSD that are, according to some critics, sometimes incorrectly applied. For many of those who view PTSD as a serious, legitimate psychological or psychiatric disorder, concerns about over-diagnosis may be unfounded; by contrast, there are those who believe that post-traumatic stress (PTS) is a normal component of responding to and dealing with trauma, and PTS may be too often diagnosed as PTSD. While there are strong arguments to be made by both sides in the debate over PTSD, the rise in public awareness of how trauma and stress are linked –along with developments and advances in the treatment of PTS and PTSD- are ultimately beneficial.

In the essay “Has PTSD Taken Over America?” author Stephen Joseph argues that one of his fundamental concerns about PTSD is that simply defining what constitutes PTSD has been an evolving process. According to Joseph, the diagnostic criteria related to PTSD as defined in the DSM are generally applied as they are “meant to be used” (Joseph, 2011), but he asserts that this has led to PTSD being diagnosed “too widely” (Joseph, 2011). At the core of Joseph’s position is the notion that responses to posttraumatic stress manifest along a spectrum of different behaviors and other responses, and that diagnoses of PTSD simply involve drawing a line somewhere along this spectrum; those whose symptoms fall above this line are diagnosed with PTSD while those below it are not. According to Joseph this approach does not allow for a “clear cut distinction…between those who are suffering from PTS and those who are suffering from PTSD” (Joseph, 2011). Despite Joseph’s concerns and misgivings, such an argument may ultimately be pointless; what matters most is simply whether or not an individual is suffering and what, if anything, can be done to help alleviate this suffering.

The article “Is Posttraumatic Stress Disorder Over-Diagnosed and Over-Treated,” published by the National Center for PTSD at the U.S. Department of Veteran Affairs, offers a broad overview of PTSD, including a diagnostic definition, a description of the types of events or experiences that can cause PTSD, and a discussion about the primary therapeutic approaches that are available to treat PTSD. Despite the question posed in the article’s title, little discussion is given over to the actual question about whether PTSD is in fact over-diagnosed. The editorial perspective offered in this article seems to presumptively accept the current level of PTSD diagnoses as being appropriate. The focus in this article, then, is not on whether PTSD is over-diagnosed, but on issues related to its causes and treatments.

According to the article, “going through trauma is not rare;” 50% or more Americans have suffered some form of serious trauma (ptsd.va.gov, 2007). The question arises, though, of how many of these people will develop PTSD as a result of such trauma; as described in the article, most people who experience trauma will exhibit some form of post-traumatic symptoms, and 1 in 3 will develop long-lasting or ongoing symptoms (ptsd.va.gov, 2007). It is here that the divergence between the position taken by the National Center for PTSD and the position of someone like Stephen Joseph can be seen. Joseph advocates for a more concerted effort to differentiate between those who are suffering from PTS and those who are suffering from PTSD. Those on both sides of the debate seem to agree that some PTS –and with it, various symptoms- is entirely normal; Joseph believes it is important to determine where the severity of dysfunction becomes an actual disorder, and advocates fort the idea that PTSD is being over-diagnosed in the absence of making accurate determinations about the difference between dysfunction and a disorder.

The National Center for PTSD, in contrast with the position held by Joseph, appears to take the view that the marking the divide between dysfunction and disorder is much less strict than that which is made by Joseph. Simply put, those on the side of the debate held by Joseph and others hold that PTSD is over-diagnosed, while those on the side held by the National Center for PTSD appear to be less concerned about this issue and more concerned about how to recognize and treat the symptoms of PTSD. The National Center for PTSD makes a strong and through case for its position on PTSD, offering a fairly comprehensive list of the types of traumatic events that can trigger PTSD and also providing an informative discussion about some of the most well-known treatments available for PTSD. Such treatments include cognitive behavioral therapy, exposure therapy, group therapy, and the use of SSRIs and other medications to treat the symptoms of PTSD.

Joseph, by contrast, provides a much more general discussion about the various approaches to treating PTSD. In order to make his point, Joseph draws analogies from a therapist to an automobile mechanic and a gardener. At the risk of over-simplifying Joseph’s analogies, he describes the mechanic approach as the one that attempts to fix problems as they arise, and the other as one that seeks to cultivate growth on the part of the sufferer. In the context of Joseph’s argument, the decision about what treatment approach to take is tied directly to the actual diagnosis, and must be made on a case-by-case basis. Where Joseph’s argument ultimately falls short, then, is that while he identifies what he believes to be a problem of over-diagnosis, he fails to adequately answer the questions he raises about distinguishing between normal responses (PTS) and response that fit the criteria of a disorder (PTSD).

Where the argument put forth by the National Center for PTSD ultimately prevails in this debate is found in the forthright manner in which it addresses the subject. Joseph raises what may well be legitimate concerns, but does little to explain what can or should be done in responder to these concerns. He offers readers some compelling food for thought, but fails to explain what if any danger is posed by the possible over-diagnosis of PTSD; if PTSD is in fact being over-diagnosed, so what?  Readers are left wondering what actual harm could arise from such a phenomenon. The National Center for PTSD, by way of comparison, offers a thorough and detailed discussion about PTSD, and makes it clear that not only is it something to be taken seriously, but it is something that can be treated. In this case, erring on the side of caution means offering treatment to those who are or simply may be suffering from PTSD. To the degree that such treatments may be made available to those who do not fully qualify as having a disorder, such a possibility is still better than not offering treatment to those who do need it.

Works Cited

Joseph, Stephen. “Has PTSD Taken Over America?.” Psychology Today Blog Post: That Which Doesn’t Kill Us, (2011): Print.

Unknown. “Is Posttraumatic Stress Disorder Over-Diagnosed and Over-Treated?.” Ptsd.va.gov, 2007. Web. 22 Mar 2014. <http://www.ptsd.va.gov/>.