“Injury,” in the medical context, is primarily based on traditional definitions and categorizations that focus on observable physical harm to the body. Injuries can range from minor cuts and bruises to more severe conditions like fractures, sprains, strains, dislocations, burns, or internal organ damage. Diagnoses related to internal injury are often determined using advanced imaging technology (fMRI, PET scans). The technology can now detect physical changes in the brain following post-traumatic stress (PTS), but it was NOT available in 1980. These changes may include alterations in neural connectivity, activation patterns, or even structural changes in specific brain regions.
While it is understood, and even even accepted, that terminology and conceptual frameworks within medicine often require time to adapt and incorporate advancements, like the ones mentioned above, the time has come to change the current classification/diagnosis of PTSD to PTSI. The once “invisible“ wounds of brain injury following psychological trauma can now be observed in the brains of people diagnosed with post-traumatic stress and, thus, should be considered “injured.”
The efficacy of diagnostic imaging, and the importance of its role in determining treatment for the injured, should not be ignored when considering the effects — and the survivors — of severe trauma. The current model of a “disorder” does not consider the latest, widely-accepted neuroscience developments and, thus, renders the “D” in PTSD to be clearly outdated, from a scientific perspective.
The use of brain scans to diagnose PTS have proved inconclusive, yet there is abundant evidence for changes in the structure and function of different areas of brain involved in fear response and anxiety, regulation of emotions, cognitive processing and memory. For example, Michael T. Alkire, M.D. — featured in a 60 Minutes segment about the use of SGB to treat PTSD — has demonstrated over-activation of the amygdala in patients with PTS as far back as 2015 in his work for VA Long Beach Healthcare System.