Mental Health: An Anthology of Essays

By C.L. Williams

Looking to learn more about mental health? This book is for you.

Learn about diagnosis, experience and perceptions, assessment and therapeutic skillsets, inlcuding several case studies.

Plus free access to digital presentations. 

• Language: English
• Publisher: Claire Williams
• Release date: Apr 28, 2022
• ISBN: 9780645410556

C.L. Williams

Looking to learn more about mental health? This book is for you. Learn about diagnosis, experience and perceptions, assessment and therapeutic skillsets, inlcuding several case studies. Plus free access to digital presentations.

Book preview

Mental Health

Mental Health

Mental Health

An Anthology of Essays

C.L. Williams

CLW Consulting

Contents

Dedication

1 Post-Traumatic Stress Disorder (PTSD)

2 PTSD and Self-Advocacy

3 Mental Health Advocacy: A Case Study

4 Young Men & Suicide

5 Perinatal Depression in Fathers

6 Personality Traits v Personality Disorders

7 Obsessions v Compulsions

8 Attitudes to Mental Illness

9 Empathy

10 PTSD Facts

11 a disABILITY

12 Intergenerational Trauma

13 Mental Status Exam (MSE) - A Presentation

14 The MSE

15 Undertaking the MSE

16 Zero Tolerance in the Workplace

17 Compassionate Treatment

18 Disclosure of Confidential Information

19 Therapeutic Relationships

20 Communication with a Trauma History

21 Professional Communication

22 Emotional Intelligence and Communication

23 Advance Statements

About The Author

Copyright © 2022 by C.L. Williams

All rights reserved. No part of this book may be reproduced in any manner whatsoever without written permission except in the case of brief quotations embodied in critical articles and reviews.

 The author, editor and publisher cannot take responsibility for information provided in this book. We make no warranty, expressed or implied, as to the results obtained from the use of the information provided. We shall have no liability for the accuracy of the information and cannot be held liable for any third-party claims or losses of any damages. 

First Printing, 2022

For Vanessa and Dani who have helped me more than anyone else

1

Post-Traumatic Stress Disorder (PTSD)

Introduction         

Post-Traumatic Stress Disorder (PTSD) is a diagnosable mental health condition which is triggered by witnessing or directly experiencing a traumatic event (Mayo Clinic 2020). It is an anxiety-based disorder which has previously been known as ‘shell shock’ and ‘battle fatigue’, however, it is not restricted to military veterans. Anyone over 1 year of age who has been exposed to a traumatic event such as a serious accident, terrorism, sexual assault, or physical attack may be diagnosed with PTSD (APA 2021). PTSD can be diagnosed using either the International Classification of Diseases (IDC-10) or the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria, however, in Australia we tend to use the DSM-5. The DSM-5 offers a set of diagnostic criteria for PTSD alongside a variety of other peer-reviewed evidentiary discussion. PTSD can be treated using a variety of psychological and pharmacological, as well as a variety of new treatments which can be considered as the gold standard of PTSD treatment. With any mental health diagnosis comes the stigma due to the vast array of stereotyping and discrimination that goes on in the world today. This report aims to explore the DSM-5 diagnostic criteria for a PTSD diagnosis in depth, alongside a suite of differential diagnoses, information about risk, prevalence, prognosis, potential treatments, and the effect of stigma.

Diagnostic Criteria

The diagnostic criteria for PTSD in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) is found under Trauma- and Stressor-Related Disorders. This category includes disorders which require exposure to a traumatic or stressful event as part of the diagnostic criterion (APA 2013). This group of disorders are closely related to anxiety, obsessive-compulsive, and dissociative disorders (APA 2013).

PTSD, diagnostic code 309.81 (F43.10), has two sets of criteria, the first for adults, adolescents, and children over 6 years of age (DSM-5). The second applies to children aged 6 years or under (DSM-5). Both criteria include symptoms and signs grouped into five main clusters with a total of eight requirements (Cornelius 2013). In adults, pseudo-hallucinations and paranoid ideation can occur (Brewin & Patel 2010). In children, developmental regression may also occur (APA 2013). Individuals may also experience difficulties regulating emotions or maintaining stable interpersonal relationships, or dissociative symptoms following prolonged, repeated, and severe traumatic events (APA 2013). In the case that the traumatic event produces a violent death, problematic bereavement may accompany PTSD symptoms (APA 2013).

The five clusters are:

Cluster A: Exposure to Severe Stress,

Cluster B: Intrusion Symptoms,

Cluster C: Persistent Avoidance,

Cluster D: Negative alterations in cognition and mood associated with traumatic events, and

Cluster E: Hyperarousal.

If we consider each cluster individually.

Cluster A

Exposure to severe stress includes both direct and indirect exposure to a traumatic event (APA 2013). For example, in-person witnessing of the event as it occurred to yourself for others or learning of a traumatic event that occurred to a close family member or friend (APA 2013). In the case of actual or threatened death of a family member or friend, the event must have been violent or accidental for a PTSD diagnosis (APA 2013). There is also the possibility that experiencing repeated or extreme exposure to aversive details of traumatic events can also result in a PTSD diagnosis, for example, where military officers have repeated exposure to human remains (APA 2013). For this criterion to apply, however, exposure cannot be via electronic media such as television or photographs unless this exposure is work related, such as a police officer viewing child abuse materials for the purposes of prosecution of offenders (APA 2013). In the case of children under 6 years of age, exposure to actual or threatened death, serious injury or sexual violence directly, as a witness or learning of the event occurring to a caregiving figure is required (APA 2013).

Cluster B

There is a requirement of at least one of the following intrusion symptoms that began after experiencing the traumatic event (APA 2013). This includes:

Recurring, involuntary intrusion of distressing memories (APA 2013). In children over 6 years of age, this may include repetition of related themes through play (APA 2013).

Recurrent distressing dreams or nightmares (APA 2013). Children may have frightening dreams without being able to recognize the content (APA 2013).

Flashbacks, or other dissociative actions where the induvial feels the traumatic event is re-occurring (APA 2013). Such reactions range in severity along a continuum, the most severe being a complete loss of awareness of current surroundings (APA 2013). In children, trauma-specific reenactment play may occur (APA 2013).

Intense or prolonged psychological distress to internal or external cues that symbolize the traumatic event, such as becoming distressed at the sight of a school if the triggering traumatic event was involvement in a school siege (APA 2013).

Physiological reactions to internal or external cues that symbolize the traumatic event, such as sweating palms or shaking (APA 2013).

Cluster C

Persistent avoidance of any stimuli beginning after the trauma which is evidenced by either or both of the following (APA 2013). Firstly, this may include avoidance of distressing memories, thoughts, or feelings about the traumatic event, and secondly efforts to avoid external reminders such as people, places or things that bring back memories, thoughts, or feelings about the traumatic event (APA 2013).

In children under 6 years old, this category is split into persistent avoidance of stimuli to avoid recollections of the trauma, which includes activities, places, people, conversations and interpersonal situations and the increase of negative emotional states, diminished interest or participation in activities including play, socially withdrawn behavior, and reduction in expression of positive emotions respectively (APA 2013).

Cluster D

Beginning at or worsening after the traumatic event, at least two forms of negative alterations in cognitions and mood must be evidenced (APA 2013). This may include inability to remember an aspect of the traumatic event, generally due to dissociative amnesia, or a persistent and exaggerated negative belief or expectations about self, others, or the world, such as believing no-one can be trusted (APA 2013).