He also does this with substance use disorders—forget that data doesn’t support any differences in the rates at which that population experiments w substances or significant differences in rates of trauma or ACEs (and that the strongest evidence supports a diathesis which simply makes some people more prone to develop addiction)…it’s all TRAUMA.
From a certain (ridiculously imprecise) perspective...all 'stress' is adaptation of the organism to changing environmental conditions, therefore, all experiences of an organism throughout life promote organismic adaptations that fall
somewhere along the dimension of the 'trauma- and stressor-related disorder' construct. It's one of dem 'truisms.' A one degree Fahrenheit increase in temperature from 70 to 71 degrees is an environmental change that the organism has to adapt to (and therefore is 'stress' of a sort).
Of course, if
everybody has it, then...
nobody 'has it.' If a category literally applies to every single living human (or organism) then it is an utterly meaningless category.
Criterion A does not neatly 'cleave nature at his/her joints' and there is no barely perceptible implicit 'dotted line' necessarily clearly demarcating the boundary between 'crosses threshold' to qualify for Criterion A vs. 'fails to cross threshold.' Often, there is room for debate/disagreement on this, though most experienced (and competent) clinicians can probably make reliable determinations that frequently agree (depending on the nature of the event(s)). The current guidelines for Criterion A in the DSM are 'pretty good,' I'd say but the literature (and clinical experience) yields plenty of room for debate/discussion around the proposed 'boundaries' separating 'traumatic' vs. 'non-traumatic' (perhaps merely 'tragic').
I'm definitely solidly in the camp of trying to limit further 'bracket creep' of expanding Criterion A, however, though current trends in the literature don't look to favorable in that regard. There are ostensibly
serious clinicians/researchers in traditionally
reputable journals arguing that 'bad experiences' in terms of ostracism, people calling you bad names, or other more subtle social stressors should count as Criterion A stressors to serve as a basis for a PTSD diagnosis.
www.inclusivetherapists.com
