Expert opinions about the ICD-10 category of enduring personality change after catastrophic experience
Abstract
The inclusion of enduring personality change after catastrophic experience (EPCACE) as a diagnostic category in the ICD-10 represents a turning point in the evolution of the nosology of traumatic stress syndromes, yet many aspects of the diagnosis remain contentious. Given the absence of published research concerning this category, an exploratory survey of international experts was conducted using a questionnaire focusing on key aspects of the category, namely whether respondents used the diagnosis of EPCACE in their practice; which features were most salient in making a diagnosis of posttraumatic personality change; the types and characteristics of traumatic events that were judged to be most likely to cause EPCACE; and the possible limitations of the ICD-10 diagnosis. A response rate of 56.3% was obtained. A substantial portion of trauma experts working in the field of human-engendered violence recognize the possibility that certain traumas can result in personality change. However, questions were raised about the specificity of the criteria proposed for the category of EPCACE in ICD-10. A composite profile of proposed additional features suggests that a more comprehensive array of adaptational changes are recognized than are encompassed by EPCACE.
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The EPCACE diagnosis was neither widely taken up by clinicians nor subject to much empirical investigation.
“However, the diagnosis was neither widely taken up by clinicians nor subject to much empirical investigation.”
The description of symptoms of EPCACE was very broad and general, which made clinical application and research difficult.
“Moreover, the description of symptoms of EPCACE was very broad and general, which made clinical application and research difficult 24,25 .”
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- Authors
- Beltran, R. O., & Silove, D.
- Affiliations
- The University of Sydney (AU)
- Corresponding author
- Beltran, Ruth O
- ORCID
- Silove, Derrick
- Venue
- Comprehensive Psychiatry
- Publisher
- Elsevier BV
- Published
- 1999-09
- Volume
- 40
- Issue
- 5
- Pages
- 396-403
- ISSN
- 0010-440X (ISSN-L)
- OpenAlex
- W2037595860
- Cited by
- 50
- References
- 40
- Citations by year
- 2024: 1 · 2023: 1 · 2022: 2 · 2021: 4 · 2019: 2 · 2018: 1 · 2017: 6 · 2016: 3 · 2015: 4 · 2014: 1 · 2013: 1 · 2012: 2
- FWCI
- 1.36
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Comprehensive Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
- Keywords
- ICD-10, disease classification, diagnostic criteria, traumatic events, expert opinion
- MeSH terms
- Expert Testimony, Humans, New South Wales, Personality Assessment, Personality Disorders, Psychiatric Status Rating Scales, Stress Disorders, Post-Traumatic, Violence, Survivors
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