DSM-IV Diagnostics of PTSD and “Affect damage by Fright” An Acupuncture / Asian Medicine perspective.
DSM-IV-TR criteria for PTSD
In the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR)(1) the diagnostic criteria for PTSD include a history of exposure to a traumatic event meeting two criteria and symptoms from each of three symptom clusters: intrusive recollections, avoidant/numbing symptoms, and hyper-arousal symptoms.
Criterion A: exposure
1.The person has experienced, witnessed, or been confronted with an event or events that involve actual or threatened death or serious injury, or a threat to the physical integrity of oneself or others.
2.The person's response involved intense fear, helplessness, or horror.
Criterion B: intrusive recollection
The traumatic event is persistently re-experienced in at least one of the following ways:
1.Recurrent and intrusive distressing recollections of the event, including images, thoughts, or perceptions. Recurrent distressing dreams of the event.
2.Acting or feeling as if the traumatic event were recurring (includes a sense of reliving the experience, illusions, hallucinations, and dissociative flashback episodes, including those that occur upon awakening or when intoxicated). Intense psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event.
3.Physiologic reactivity upon exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event
Criterion C: avoidant/numbing
Persistent avoidance of stimuli associated with the trauma and numbing of general responsiveness (not present before the trauma), as indicated by at least three of the following:
1.Efforts to avoid thoughts, feelings, or conversations associated with the trauma
2.Efforts to avoid activities, places, or people that arouse recollections of the trauma
3.Inability to recall an important aspect of the trauma
4.Markedly diminished interest or participation in significant activities
5.Feeling of detachment or estrangement from others
6.Restricted range of affect (e.g., unable to have loving feelings)
7.Sense of foreshortened future (e.g. does not expect to have a career, marriage, children, or a normal life span)
Criterion D: hyper-arousal
Persistent symptoms of increasing arousal (not present before the trauma), indicated by at least two of the following:
1.Difficulty falling or staying asleep
2.Irritability or outbursts of anger
5.Exaggerated startle response
“Affect damage by Fright”: An Acupuncture / Asian Medicine perspective.
The Suwen is a document written more than 2,000 years ago (154 B.C.) in the classic Chinese medicine manual Huang Di Nei Jing. It is a dialogue between the Yellow Emperor and his medical advisors, the chief advisor being Qi Bo. The Yellow Emperor poses a question and the advisor answers. This book mainly deals with Acupuncture theory and practice in the areas of anatomy, physiology, mental health, diagnosis and treatment.
In the Suwen, the diagnosis of PTSD is described as “Affect damage due to fright”. This disorder occurs during war, family death or other traumatic experiences viewed and experienced by the patient. The emotional and physical symptoms of this disorder are:
Staring off into the sky
Frightful dreams and waking with sweat
Startled by unusual sounds
Sleeping with a weapon
Non- responsiveness when name is called
Bouts of unpredictable anger and melancholia.
As you can see PTSD is a disorder that has been part of the Chinese Medical system throughout its history. There have also been effective treatments for this disorder for as long as Acupuncture has existed.
References for DSM Criteria for PTSD:
References for Affect damage by Fright:
Suwen: The Book of Plain Questions
Huangdi Neijing Su Wen(Plain Questions: Yellow Emperor's Internal Canon of Medicine)