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Posttraumatic Stress Disorder’s Traumatic Stressor Criterion: History, Controversy, and Clinical and Legal Implications

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Abstract

This paper discusses posttraumatic stress disorder’s (PTSD) traumatic stressor criterion (Criterion A) in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). The history of the stressor criterion is detailed, including how it has changed over time in successive versions of the DSM. We discuss controversy over the stressor criterion, regarding arguments about whether it is too conservative or too liberal. Studies comparing Criterion A and non-Criterion A events in their association with PTSD are discussed, including the finding across studies that non-Criterion A events are just as (or more) likely to result in PTSD. Potential explanations to account for this finding are discussed, including presentation of solutions to Criterion A’s limitations. Finally, legal implications for Criterion A in evaluating individuals presenting with PTSD in civil and criminal cases are discussed.

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Authors and Affiliations

  1. Houston VA Medical Center, VA South Central Mental Illness, Research, Education and Clinical Center, 2002 Holcombe Drive, Houston, TX, 77030, USA

    Mary E. Long

  2. Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA

    Mary E. Long

  3. Disaster Mental Health Institute, The University of South Dakota, 414 East Clark Street—SDU 114, Vermillion, SD, 57069-2390, USA

    Jon D. Elhai

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Long, M.E., Elhai, J.D. Posttraumatic Stress Disorder’s Traumatic Stressor Criterion: History, Controversy, and Clinical and Legal Implications. Psychol. Inj. and Law 2, 167–178 (2009). https://doi.org/10.1007/s12207-009-9043-6

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