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No Trauma, no Problem: Symptoms of Posttraumatic Stress in the Absence of a Criterion A Stressor

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Abstract

Previous research on Posttraumatic Stress Disorder (PTSD) has investigated the sentinel role of Criterion A to the diagnosis. Some researchers have found that PTSD symptom measures are elevated in the absence of a Criterion A stressor. Therefore, the current study sought to extend this research to the Diagnostic and Statistical Manual, fifth edition (DSM-5; American Psychiatric Association 2013) using the PTSD Checklist for DSM-5 (PCL-5; Weathers et al. 2013b). Data from 222 veterans presenting to a general outpatient mental health clinic at a Veterans Health Administration were asked to complete the PCL-5 after indicating the presence of a stressful or traumatic life event. In line with previous research, the current study revealed no differences between veterans with (n = 92) and without (n = 120) a Criterion A stressor on PTSD symptom severity, clinically-indicated levels of PTSD, or symptom clusters. However, these groups differed on empirically-identified core symptoms of PTSD (Brewin et al. Journal of Traumatic Stress 22 (5), 366-373, 2009), such that veterans with a Criterion A stressor reported significantly more core PTSD symptoms. A significant limitation to these findings is that Criterion A status was examined only via self-report on the PCL-5. The findings highlight the need for more research on the definition of a Criterion A stressor, use of the PCL-5, and the current composition of PTSD symptoms that make up the DSM-5 diagnostic criteria. In the future, clinicians are encouraged to conduct a thorough trauma assessment in conjunction with a PTSD screening measure to facilitate diagnostic accuracy and treatment planning.

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Acknowledgements

The contents of this report do not represent the views of the Department of Veterans Affairs or the U. S. Government.

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Correspondence to C. Laurel Franklin.

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C. Laurel Franklin, Amanda M. Raines and Margo C. Hurlocker declare that they have no conflict of interest.

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Institutional Review Board (IRB) approved use of this information for research purposes.

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There was no informed consent, as the information was collected as part of routine clinical practice in a mental health clinic.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Laurel Franklin, C., Raines, A.M. & Hurlocker, M.C. No Trauma, no Problem: Symptoms of Posttraumatic Stress in the Absence of a Criterion A Stressor. J Psychopathol Behav Assess 41, 107–111 (2019). https://doi.org/10.1007/s10862-018-9692-4

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  • DOI: https://doi.org/10.1007/s10862-018-9692-4

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