Wednesday, June 06, 2012

Additional to Overdiagnosis

We can identify a group of individuals who were abused, and not merely have to rely on their subjective memory of what happened. Where the records exist, we can check ER records for children brought in for injuries that the treating professionals a) suspected or b) knew they were the result of abuse. Then we can track those people down now as adults and ask them questions. We can't do a lot of this, but we can do some.

We can also add in cases of abuse where there is some sort of confirmation from others that we believe credible. That's a bit weaker, but still valuable.

We immediately think PTSD when we hear about childhood abuse and start asking about its symptoms:  Do you have nightmares about this?  Do you avoid certain situations?  Do you have flashbacks?

The most common diagnosis for people who were abused - sexually, physically, or emotionally - as children is...

No diagnosis.

The second most common is...


The third most common is...

Substance abuse.

The fourth most common is...

Some variant of anxiety disorder - a phobia, GAD, OCD, paraphilia

The fifth most common is...

This gets tricky.  It is personality disorder, but these co-occur with many of the above.  In fact, all of the above occur in people who weren't abused as well.  It is tough to tease out.

PTSD is the sixth most common.  PTSD is in one sense very common.  Shortly after a traumatic event, a majority of people show PTSD symptoms.  Returning vets have a high rate.  But these gradually recede.  Two years out, not many have symptoms which prevent functioning - and while more combat tends to mean more PTSD, the relationship is not particularly linear when applied to individuals.

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