The July Blog Carnival of Mental Health is up. Willfindhope put together a large collection of posts on the theme of stigma and discrimination in all kinds of areas of life. The August carnival will be hosted by OccasionalWallflower. She hasn’t yet posted an annoucnement, but she has told me her theme will be personal journey. More details later.

ETA: OccasionalWallflower has posted the announcement for the August carnival. As she says, the deadline for submissions is August 29.

Adjustment disorder has been a category of its own in DSM-IV. IN DSM-V, the workgroup is proposing that it be included in a category of trauma and stressor-related disorders. I agree to this, as there is a lot of resemblance with other trauma and stressor disorders. Further, the criteria are almost the same as those in DSM-IV. However, a few new subtypes are considered:

  • With PTSD/ASD-like symptoms: if the person experiences symptoms similar to PTSD or acute stress disorder, but the full critieria for trauma or for the symptoms of PTSD/ASD are not met.

  • Related to bereavement: when the stress reaction is related to the death of a close relative or friend, and the person experiences intense longing for the deceased that is in excess to what is normal.

The workgroup also proposes a new disorder for research purposes only: bereavement related disorder. In this condition, after the death of a close relative or friend, the person not only experiences intense longing for the deceased, but also a number of specific symptoms, including social or identity disturbances and reactive distress symptoms. This condition is very controversail, as it is generally believed that grief and distress are normal responses to death, and that even complicated greif is not a psychiatric disorder. I agree to this and feel that bereavement related disorder should not be included in DSM-V.

The disturbance in adjustment disorder must last for no longer than six months after the stressor or its consequences have stopped. An exception is made for the bereavement-related type, where the adjustment problems must last for at least twelve months. I consider that a reasonable timeframe, if bereavement is going to be seen as a disorder at all, but I do not agree to the six months cut-off for the other types, that is also present in DSM-IV. After all, an adjustment problem can last for more than six months, and it is strange that a person must then be diagnosed with another mental illness which they may not have. In my own case, I was diagnosed with impulse control disorder NOS after my six months with adjustment disorder, and this diagnosis was not only incorrect, but failed to reflect the fact that my behavior was in large part a reaction to an unstable situation.

It’s the end of the month again, so here is the June edition of the Blog Carnival of Mental Health, on the theme of hope and despair. Pandora nicely put together the largest carnival we’ve ever had so far.

For the month of July, Willfindhope will be hosting the carnival, on the theme of stigma and discrimination. Please submit your posts via a comment or E-mail by July 28 and watch out for the carnival before the end of the month. Please realize that Willfindhope lives in Australia, so your post likely needs to get in early on July 28 for her to receive it at night.

Remember that I’m still looking for volunteers to host the Blog Carnival of Mental Health from August on (except for September). If you have a blog that is at least partly about mental health, and you are willing to host the carnival, please leave a comment here or send me an E-mail. Hosts get to choose the theme for their carnival edition, of course.

There are many strange disorders being proposed by outside parties or by the American Psychiatric Association for inclusion in DSM-V. Oddly enough, however, complex PTSD is not among them. C-PTSD is not just gradually different from regulat PTSD, but encompasses other features such as those seen in personality disorders. It is a disorder caused by captivity or other situations of long-term, severe trauma.

Of course, the subtype of chronic PTSD is included in DSM-IV as well as DSM-V, but this is merely regular PTSD that lasts for more than six months, without the additional features of impaired self-concept, trust, and emotion regulation, among others. In my opinion, complex PTSD is more warranted as a specific disorder than such things as parental alienation syndrome and body integrity identity disorder, both of which are proposed by outside parties.

There are many people who would meet the criteria for complex PTSD but not the full criteria for regular PTSD. What do they end up being diagnosed with, if anything at all? Do they fall within a treatment loophole, getting no counseling because they don’t have a legitimate mental condition? Or do they end up with stimgatizing and incorrect diagnoses that don’t reflect the fact that they are trauma victims?

Today, June 27, is PTSD Awareness Day. Let’s stand up for the rights of victims of long-term, severe child abuse, war camps, or other states of captivity, to get the recognition and treatment they deserve.

Last week, I heard on an E-mail list that the DSM-V workgroup is considering adding parental alienation disorder to DSM-V. It was only looking for feedback, so my hope is that enough people have campaigned against this diagnosis that it will not be included.

Parental alienation disorder is a specific set of symptoms, where a child chronically denigrates one parent, usually in the context of custody battles. The child may belittle, accuse or otherwise detach themself from one parent. The assumption is that the disorder is caused by unconscious or conscious indoctrination by one parent against the other, as well as the child’s on personality. Included in parental alienation disorder are false accusations of abuse.

In my opinion, if this were a real concept at all rather than a fantasy to cover up actual child abuse, this should be a psychological concept rather than a psychiatric one. Parental alienation disorder, if it exists, is the manifestation of a dynamic between parents and children, rather than a mental disorder on the part of the child. So, for that reason, it does not belong in a psychiatric handbook like the DSM.

I, personally, do not believe in parental alienation enough to consider it an actual condition at all. Sure, it may happen on occasion, but not on the large scale that proponents assume it occurs.

Besides, even if a child denigrates a parent without reason, this does not mean it has to occur in the context of custody battles or that it is the other parent’s ffault. It may be that a child has an attachment issue, which in the DSM can only be caused in the context of pathological care, but which, in my opinion, can be caused by a number of factors. Also, it may be that a child has a problem with irritability, such as oppositional defiant disorder, and is acting it out specifically towards the less assertive parent.

I do not deny that indoctrination in the context of custody battles happens, but if it does, it is not something the child is responsible for, and therefore does again not reflect a disorder of the child. Rather, if indoctrination is present, the parent doing it has a serious psychological problem, though not a mental disorder. So, rather than concluding that parental alienation is a disorder, look at the broader picture of whether the child may have other issues causing them to act out against one parent, whether either parent has a psychological problem, etc. And please don’t pathologize problematic but non-medical behavior.

This is just a note to let you all know that the May Blog Carnival of Mental Health, themed patients and professionals is up at The Madosphere. It is a nice collection of posts, so check it out.

The June carnival will be hosted by Pandora from Confessions of a Serial Insomniac, and the theme will be hope or despair. Please submit your post by midnight British summer time on June 29, and check back the next day for the carnival.

Also, I want to let you all know that the Blog Carnival of Mental Health has slots open for hosts starting the month of August – I seem to remember Mental Fool wanted to host in August, so please let me know if you read this if this is still the case. Otherwise, anyone who has a blog that has at least some content on mental health is free to host the carnival. You will choose the theme, deadline within your destined month, and how bloggers can submit their posts. If you are willing to host the carnival in an upcoming month, please leave a comment here.

Welcome to May’s Disability Blog Carnival, on the theme of care. I’m two days early, but I was finished compiling the posts already. We have a very small carnival, but it is beuaitful nonetheless. Most people have written about interactions with professionals, but there is a good post on self-care, too.

Carl Thompson of Working at Perfect writes Dear Surgeon, I Have a Name:

Surgeons and specialists are extremely important in society, they save lives and make people feel better. They also usually drive swanky cars. Qualities such as persistence, enthusiasm and intelligence are common amongst these medical practitioners. What is not common however, and entirely absent in a large proportion of cases is emotional intelligence. But who am I to cast aspersions on, and make generalisations to an entire group of diverse individuals?

Cara of Butterfly Dreams writes Self-Care Is a B*tch:

I never thought too much about self care before I went to college.  Sure, some aspects of self care were more difficult for me, but I had been completely independent in all my self-care activities since my mid teens. Surely self care wouldn’t be difficult for me in college, after all, I took care of myself every day. I didn’t need a personal assistant like some of my friends, I could do everything on my own. Taking care of myself in college would be a breeze;
in fact, I barely thought about it before I left.

Lastly, Sharon Wachsler of After Gadget submitted two posts on the same encounter with a docotor. The first is Waspish Wednesday: Yes, I DO Know How to Operate My Power Chair. The second is Waspish Wednesday: Yes, Lyme Did Cause This.

Tomorrow, the Ugandan Parliament will vote on a gay death penalty bill. This is horrible. Gay people are already in danger of the death penalty, but this bill could make it even worse. AVAAZ has created a
to sign against this bill. The site is not very accessible, so don’t blame me for not having signed it myself. I am just passing this on for everyone who is opposed to homophobia like I am.

In South Africa, a 13-year-old girl is the latest victim of “corrective” rape. “Corrective” rape involves the raping of lesbians in order to “cure” them of their sexual orientation. The goveornment condemns this crime, but I wonder whether they will genuinely act upon it. It is obviously at least as serious a crime as other forms of rape. Probably more so, because a hate crime is involved, too. Maybe I’m too cynical, but my inclination is that the police won’t do much with this presumed epidemic of “corrective” rape. Gay rights may be human and constitutional rights according to the government spokesperson, but there are probably more important things on the police’s mind.

In DSM-IV, if you hear voices, you can be diagnosed with schizophrenia even if this is the only “psychotic” symptom. This has been controversial for a while, because many people hear voices without being actually psychotic. Not only other conditions – such as dissociative identity disorder – are characterized by voice-hearing, but voice-hearing may be a normal symptom related to stress.

Thankfully, the DSM-V workgroup is recommending that someone must have two or more characteristic symptoms of schizophrenia for a substantial period of time in order to be diagnosed. These two symptoms must include at least one core symptom, which are determined to be delusions, hallucinations and disorganized speech. In addition, people must display a significant deterioration in their social or occupational functioning. This criterion was considered for elimination, but the workgroup thankfully decided against this. Again, this protects functioning voice-hearers from a false diagnosis.

Of course, there is the newly considered diagnosis of attenuated psychosis syndrome, which includes symptoms suggesting a person is at risk of a psychotic disorder. This diagnosis may cause voice-hearers to be pathologized after all, which is a very sad thing.


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