Abstract
In the DSM-5, the diagnosis of posttraumatic stress disorder (PTSD) has undergone multiple, albeit minor, changes. These changes include shifting PTSD placement from within the anxiety disorders into a new category of traumatic and stressor-related disorders, alterations in the definition of a traumatic event, shifting of the symptom cluster structure from three to four clusters, the addition of new symptoms including persistent negative beliefs and expectations about oneself or the world, persistent distorted blame of self or others, persistent negative trauma-related emotions, and risky or reckless behaviors, and the addition of a dissociative specifier. The evidence or lack thereof behind each of these changes is briefly reviewed. These changes, although not likely to change overall prevalence, have the potential to increase the heterogeneity of individuals receiving a PTSD diagnosis both by altering what qualifies as a traumatic event and by adding symptoms commonly occurring in other disorders such as depression, borderline personality disorder, and dissociative disorders. Legal implications of these changes include continued confusion regarding what constitutes a traumatic stressor, difficulties with differential diagnosis, increased ease in malingering, and improper linking of symptoms to causes of behavior. These PTSD changes are discussed within the broader context of DSM reliability and validity concerns.
Similar content being viewed by others
References
Ahern, J., Galea, S., Resnick, H., Kilpatrick, D., Bucuvalas, M., Gold, J., & Vlahov, D. (2002). Television images and psychological symptoms after the September 11 terrorist attacks. Psychiatry: Interpersonal and Biological Processes, 65, 289–300. doi:10.1521/psyc.65.4.289.20240
American Psychiatric Association. (1980). Diagnostic and Statistical Manual Of Mental Disorders (3rd ed.). Washington, DC: American Psychiatric Association.
American Psychiatric Association. (2000). Diagnostic and Statistical Manual of Mental Disorders (4th ed.). Washington, DC: American Psychiatric Association.
American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Arlington: American Psychiatric Publishing.
Andrews, L., Joseph, S., Shevlin, M., & Troop, N. (2006). Confirmatory factor analysis of posttraumatic stress symptoms in emergency personnel: An examination of seven alternative models. Personality and Individual Differences, 41, 213–224. doi:10.1016/j.paid.2005.11.034
Asmundson, G. J., Frombach, I., McQuaid, J., Pedrelli, P., Lenox, R., & Stein, M. B. (2000). Dimensionality of posttraumatic stress symptoms: a confirmatory factor analysis of DSM-IV symptom clusters and other symptom models. Behavior Research and Therapy, 38, 203–214. doi:10.1016/S0005-7967(99)00061-3
Asmundson, G. J., Stapleton, J. A., & Taylor, S. (2004). Are avoidance and numbing distinct PTSD symptom clusters? Journal of Traumatic Stress, 17, 467–475. doi:10.1007/s10960-004-5795-7
Avina, C., & O’Donohue, W. (2002). Sexual harassment and PTSD: is sexual harassment diagnosable trauma? Journal of Traumatic Stress, 15, 69–75. doi:10.1023/A:1014387429057
Bedard-Gilligan, M., & Zoellner, L. A. (2008). The utility of the A1 and A2 criteria in the diagnosis of PTSD. Behaviour Research and Therapy, 46, 1062–1069. doi:10.1016/j.brat.2008.06.009
Blanchard, E. B., Buckley, T. C., Hickling, E. J., & Taylor, A. E. (1998). Posttraumatic stress disorder and comorbid major depression: is the correlation an illusion? Journal of Anxiety Disorders, 12, 21–37. doi:10.1016/S0887-6185(97)00047-9
Bodkin, J. A., Pope, H. G., Detke, M. J., & Hudson, J. I. (2007). Is PTSD caused by traumatic stress? Journal of Anxiety Disorders, 21, 176–182. doi:10.1016/j.janxdis.2006.09.004
Borders, A., McAndrew, L. M., Quigley, K. S., & Chandler, H. K. (2012). Rumination moderates the associations between PTSD and depressive symptoms and risky behaviors in U. S. Veterans. Journal of Traumatic Stress, 25, 853–856. doi:10.1002/jts.21733
Bremner, J. D., Southwick, S., Brett, E., Fontana, A., Rosenheck, R., & Charney, D. S. (1992). Dissociation and posttraumatic stress disorder in Vietnam combat veterans. American Journal of Psychiatry, 149, 328–332.
Bremner, J. D. (1999). Acute and chronic responses to psychological trauma: where do we go from here? American Journal of Psychiatry, 156, 349–351.
Breslau, N., & Kessler, R. C. (2001). The stressor criterion in DSM-IV posttraumatic stress disorder: an empirical investigation. Biological Psychiatry, 50, 699–704. doi:10.1016/S0006-3223(01)01167-2
Brewin, C. R., Andrews, B., & Gotlib, I. H. (1993). Psychopathology and early experience: a reappraisal of retrospective reports. Psychological Bulletin, 113, 82–98. doi:10.1037/0033-2909.113.1.82
Brewin, C. R., Andrews, B., & Rose, S. (2000). Fear, helplessness, and horror in posttraumatic stress disorder: investigating DSM-IV Criterion A2 in victims of violent crime. Journal of Traumatic Stress, 13, 499–509. doi:10.1023/A:1007741526169
Brewin, C. R., Lanius, R. A., Novac, A., Schnyder, U., & Galea, S. (2009). Reformulating PTSD for DSM-V: life after Criterion A. Journal of Traumatic Stress, 22, 366–373. doi:10.1002/jts.20443
Bryant, R. A., O’Donnell, M. L., Creamer, M., McFarlane, A. C., Clark, C. R., & Silove, D. (2010). The psychiatric sequelae of traumatic injury. The American Journal of Psychiatry, 167, 312–320. doi:10.1176/appi.ajp.2009.09050617
Cahill, S. P., Rauch, S. A., Hembree, E. A., & Foa, E. B. (2003). Effect of cognitive-behavioral treatments for PTSD on anger. Journal of Cognitive Psychotherapy, 17, 113–131. doi:10.1891/jcop.17.2.113.57434
Carlson, E. B., Dalenberg, C., Armstrong, J., Daniels, J. W., Loewenstein, R., & Roth, D. (2001). Multivariate prediction of posttraumatic symptoms in psychiatric inpatients. Journal of Traumatic Stress, 14, 549–567. doi:10.1023/A:1011164707774
Carlson, E. B., Dalenberg, C., & McDade-Montex, E. (2012). Dissociation in posttraumatic stress disorder: part 1: definition and review of the research. Psychological Trauma: Theory, Research, Practice, and Policy, 4, 479–489. doi:10.1037/a0027748
Chard, K. M. (2005). An evaluation of cognitive processing therapy for the treatment of posttraumatic stress disorder related to childhood sexual abuse. Journal of Consulting and Clinical Psychology, 73, 965–971. doi:10.1037/0022-006X.73.5.965
Creamer, M., McFarlane, A. C., & Burgess, P. (2005). Psychopathology following trauma: the role of subjective experience. Journal of Affective Disorders, 86, 175–182. doi:10.1016/j.jad.2005.01.015
Dalgleish, T., & Watts, F. N. (1990). Biases of attention and memory in disorders of anxiety and depression. Clinical Psychology Review, 10, 589–604. doi:10.1016/0272-7358(90)90098-U
Department of Veterans Affairs. (2010). Stressor determinants for posttraumatic stress disorder (38 CFR Part 3). Federal Register, 75, 39843–39852.
DuHamel, K. N., Ostroff, J., Ashman, T., Winkel, G., Mundy, E. A., Keane, T. M., ... Burkhalter, J. (2004). Construct validity of the posttraumatic stress disorder checklist in cancer survivors: Analyses based on two samples. Psychological Assessment, 16, 255–266. doi:10.1037/1040-3590.16.3.255
Dunkley, J., & Whelan, T. A. (2006). Vicarious traumatisation: current status and future directions. British Journal of Guidance & Counselling, 34, 107–116. doi:10.1080/03069880500483166
Dunmore, E., Clark, D. M., & Ehlers, A. (2001). A prospective investigation of the role of cognitive factors in persistent posttraumatic stress disorder (PTSD) after physical or sexual assault. Behavioral Research and Therapy, 39, 1063–1084. doi:10.1016/S0005-7967(00)00088-7
Eglinton, R., & Chung, M. C. (2011). The relationship between posttraumatic stress disorder, illness cognitions, defence styles, fatigue severity and psychological well-being in chronic fatigue syndrome. Psychiatry Research, 188, 245–252. doi:10.1016/j.psychres.2011.04.012
Elhai, J. D., Kashdan, T. B., & Frueh, B. C. (2005). What is a traumatic event? British Journal of Psychiatry, 187, 189–190. doi:10.1192/bjp.187.2.189-a
Elhai, J. D., Grubaugh, A. L., Kashdan, T. B., & Frueh, B. C. (2008). Empirical examination of a proposed refinement to DSM-IV posttraumatic stress disorder symptom criteria using the National Comorbidity Survey Replication data. Journal of Clinical Psychiatry, 69, 597–602. doi:10.4088/JCP.v69n0411
Elhai, J. D., Ford, J. D., Ruggiero, K. J., & Frueh, B. C. (2009). Diagnostic alterations for post-traumatic stress disorder: examining data from the national comorbidity survey replication and national survey of adolescents. Psychological Medicine, 39, 1957–1966. doi:10.1017/S0033291709005819
Elkit, A., & Shevlin, M. (2007). The structure of PTSD symptoms: a test of alternative models using confirmatory factor analysis. British Journal of Clinical Psychology, 46, 299–313. doi:10.1348/014466506X171540
Felmingham, K., Kemp, A. H., Williams, L., Falconer, E., Olivieri, G., Peduto, A., & Bryant, R. (2008). Dissociative responses to conscious and non-conscious fear impact underlying brain function in post-traumatic stress disorder. Psychological Medicine, 38, 1771–1780. doi:10.1017/S0033291708002742
Foa, E. B., Riggs, D. S., & Gershuny, B. S. (1995). Arousal, numbing, and intrusion: symptom structure of PTSD following assault. American Journal of Psychiatry, 152, 116–120.
Foa, E. B., Ehlers, A., Clark, D. M., Tolin, D. F., & Orsillo, S. M. (1999). The posttraumatic cognitions inventory (PTCI): development and validation. Psychological Assessment, 11, 303–314. doi:10.1037/1040-3590.11.3.303
Foa, E. B., & Rauch, S. A. (2004). Cognitive changes during prolonged exposure versus prolonged exposure plus cognitive restructuring in female sexual assault survivors with posttraumatic stress disorder. Journal of Consulting and Clinical Psychology, 72, 879–884. doi:10.1037/0022-006X.72.5.879
Forbes, D., Haslam, N., Williams, B. J., & Creamer, M. (2005). Testing the latent structure of posttraumatic stress disorder: a taxometric study of combat veterans. Journal of Traumatic Stress, 18, 647–656. doi:10.1002/jts.20073
Forbes, D., Parslow, R., Creamer, M., O’Donnell, M., Bryant, R., McFarlane, A., ... Shalev, A. (2010). A longitudinal analysis of posttraumatic stress disorder symptoms and their relationship with fear and anxious-misery disorders: implications for DSM-V. Journal of Affective Disorders, 127, 147–152. doi:10.1016/j.jad.2010.05.005
Forbes, D., Fletcher, S., Lockwood, E., O’Donnell, M., Creamer, M., Bryant, R., ... Silove, D. (2011). Requiring both avoidance and emotional numbing in DSM-V PTSD: will it help? Journal of Affective Disorders, 130, 483–486. doi:10.1016/j.jad.2010.10.032
Freedy, J. R., Resnick, H. S., Kilpatrick, D. G., Dansky, B. S., & Tidwell, R. P. (1994). The psychological adjustment of recent crime victims in the criminal justice system. Journal of Interpersonal Violence, 9, 450–468. doi:10.1177/088626094009004002
Freeman, T., Powell, M., & Kimbrell, T. (2008). Measuring symptom exaggeration in veterans with chronic posttraumatic stress disorder. Psychiatry Research, 158, 374–380. doi:10.1016/j.psychres.2007.04.002
Friedman, M. J., Resick, P. A., Bryant, R. A., & Brewin, C. R. (2011). Considering PTSD for DSM-5. Depression and Anxiety, 28, 750–769. doi:10.1002/da.20767
Frueh, B. C., Hamner, M. B., Cahill, S. P., Gold, P. B., & Hamlin, K. L. (2000). Apparent symptom overreporting in combat veterans evaluated for PTSD. Clinical Psychology Review, 20, 853–885. doi:10.1016/S0272-7358(99)00015-X
Frueh, B. C., Elhai, J. D., Gold, P. B., Monnier, J., Magruder, K. M., Keane, T. M., & Arana, G. W. (2003). Disability compensation seeking among veterans evaluated for posttraumatic stress disorder. Psychiatric Services, 54, 84–91. doi:10.1176/appi.ps.54.1.84
Insel, T. (2013). Director’s blog: Transforming diagnosis. Retrieved October 1, 2013, from http://www.nimh.nih.gov/about/director/2013/transforming-diagnosis.shtml
Giesbrecht, T., Lynn, S. J., Lilienfeld, S. O., & Merckelbach, H. (2008). Cognitive processes in dissociation: an analysis of core theoretical assumptions. Psychological Bulletin, 134, 617–647. doi:10.1037/0033-2909.134.5.617
Gold, S. D., Marx, B. P., Soler-Baillo, J. M., & Sloan, D. M. (2005). Is life stress more traumatic than traumatic stress? Journal of Anxiety Disorders, 19, 687–698. doi:10.1016/j.janxdis.2004.06.002
Griffin, M. G., Resick, P. A., & Mechanic, M. B. (1997). Objective assessment of peritraumatic dissociation: psychophysiological indicators. American Journal of Psychiatry, 154, 1081–1088.
Grubaugh, A. L., Long, M. E., Elhai, J. D., Frueh, B. C., & Magruder, K. M. (2010). An examination of the construct validity of posttraumatic stress disorder with veterans using a revised criterion set. Behaviour Research and Therapy, 48, 909–914. doi:10.1016/j.brat.2010.05.019
Hagenaars, M. A., van Minnen, A., & Hoogduin, K. A. (2010). The impact of dissociation and depression on the efficacy of prolonged exposure treatment for PTSD. Behaviour Research and Therapy, 48, 19–27. doi:10.1016/j.brat.2009.09.001
Holmes, E. A., Brown, R. J., Mansell, W., Fearon, R., Hunter, E. C. M., Frasquilho, F., & Oakley, D. A. (2005). Are there two qualitatively distinct forms of dissociation? A review and some clinical implications. Clinical Psychology Review, 25(1), 1–23. doi:10.1016/j.cpr.2004.08.006
Hopper, J. W., Frewen, P. A., van der Kolk, B. A., & Lanius, R. A. (2007). Neural correlates of reexperiencing, avoidance, and dissociation in PTSD: symptom dimensions and emotion dysregulation in responses to script-driven trauma imagery. Journal of Traumatic Stress, 20, 713–725. doi:10.1002/jts.20284
Jaycox, L. H., Foa, E. B., & Morral, A. R. (1998). Influence of emotional engagement and habituation on exposure therapy for PTSD. Journal of Consulting and Clinical Psychology, 66, 185–192. doi:10.1037//0022-006X.66.1.185
Jaycox, L. H., Zoellner, L. A., & Foa, E. B. (2002). Cognitive-behavior therapy for PTSD in rape survivors. Journal of Clinical Psychology, 58, 891–906. doi:10.1002/jclp.10065
Kanwar, A., Malik, S., Prokop, L. J., Sim, L. A., Feldstein, D., Wang, Z., & Murad, M. H. (2013). The association between anxiety disorders and suicidal behaviors: a systematic review and meta-analysis. Depression and Anxiety. doi:10.1002/da.22074
Karam, E. G., Andrews, G., Bromet, E., Petukhova, M., Ruscio, A. M., Salamoun, M., & Kessler, R. C. (2010). The role of criterion A2 in the DSM-IV diagnosis of posttraumatic stress disorder. Biological psychiatry, 68, 465–473. doi:10.1016/j.biopsych.2010.04.032
Kaufman, M. L., Kimble, M. O., Kaloupek, D. G., McTeague, L. M., Bachrach, P., Forti, A. M., & Keane, T. M. (2002). Peritraumatic dissociation and physiological response to trauma-relevant stimuli in Vietnam combat veterans with posttraumatic stress disorder. The Journal of Nervous and Mental Disease, 190, 167–174. doi:10.1097/00005053-200203000-00005
Kessler, R. C., Sonnega, A., Bromet, E., Hughes, M., & Nelson, C. B. (1995). Posttraumatic stress disorder in the national comorbidity survey. Archives of General Psychiatry, 52, 1048–1060. doi:10.1001/archpsyc.1995.03950240066012
Kihlstrom, J. F. (2005). Dissociative disorders. Annual Review of Clinical Psychology, 1, 1–27. doi:10.1146/annurev.clinpsy.1.102803.143925
Kilpatrick, D. G., Resnick, H. S., & Acierno, R. (2009). Should PTSD criterion A be retained? Journal of Traumatic Stress, 22, 374–383. doi:10.1002/jts.20436
King, D. W., Leskin, G. A., King, L. A., & Weathers, F. W. (1998). Confirmatory factor analysis of the clinician-administered PTSD Scale: evidence for the dimensionality of posttraumatic stress disorder. Psychological Assessment, 22, 90–96. doi:10.1037/1040-3590.10.2.90
Kraemer, H. C., Kupfer, D. J., Clarke, D. E., Narrow, W. E., & Regier, D. A. (2012a). DSM-5: how reliable is reliable enough? American Journal of Psychiatry, 169, 13–15. doi:10.1176/appi.ajp.2011.11010050
Kraemer, H. C., Kupfer, D. J., Clarke, D. E., Narrow, W. E., & Regier, D. A. (2012b). Response to Spitzer et al. letter. American Journal of Psychiatry, 169, 537–538. doi:10.1176/appi.ajp.2012.12010083r
Lanius, R. A., Williamson, P. C., Boksman, K., Densmore, M., Gupta, M., Neufeld, R. W., & Menon, R. S. (2002). Brain activation during script-driven imagery induced dissociative responses in PTSD: a functional magnetic resonance imaging investigation. Biological Psychiatry, 52, 305–311. doi:10.1016/S0006-3223(02)01367-7
Lanius, R. A., Vermetten, E., Loewenstein, R. J., Brand, B., Schmahl, C., Bremner, J. D., & Spiegel, D. (2010). Emotion modulation in PTSD: clinical and neurobiological evidence for a dissociative subtype. American Journal of Psychiatry, 167, 640–647. doi:10.1176/appi.ajp.2009.09081168
Lanius, R. A., Brand, B., Vermetten, E., Frewen, P. A., & Spiegel, D. (2012). The dissociative subtype of posttraumatic stress disorder: rationale, clinical and neurobiological evidence, and implications. Depression and Anxiety, 29, 701–708. doi:10.1002/da.21889
Lynn, S. J., Lilienfeld, S. O., Merckelbach, H., Giesbrecht, T., & van der Kloet, D. (2012). Dissociation and dissociative disorders: challenging conventional wisdom. Current Directions in Psychological Science, 21, 48–53. doi:10.1177/0963721411429457
Marshall, G. N. (2004). Posttraumatic stress disorder symptom checklist: factor structure and English–Spanish measurement invariance. Journal of Traumatic Stress, 17, 223–230. doi:10.1023/B:JOTS.0000029265.56982.86
McFarlane, A. (2013). Biology not cultural explains dissociation in posttraumatic stress disorder. Biological Psychiatry, 73, 296–297. doi:10.1016/j.biopsych.2012.11.026
McHugh, P. R., & Treisner, G. (2007). PTSD: a problematic diagnostic category. Journal of Anxiety Disorders, 21, 211–222. doi:10.1016/j.janxdis.2006.09.003
McNally, R. J. (2003). Progress and controversy in the study of posttraumatic stress disorder. Annual Review of Psychology, 54, 229–252. doi:10.1146/annurev.psych.54.101601.145112
McNally, R. J., Lasko, N. B., Clancy, S. A., Macklin, M. L., Pitman, R. K., & Orr, S. P. (2004). Psychophysiological responding during script-driven imagery in people reporting abduction by space aliens. Psychological Science, 15, 493–497. doi:10.1111/j.09567976.2004.00707.x
McNally, R. J. (2009). Can we fix PTSD in DSMV? Depression and Anxiety, 26, 597–600. doi:10.1002/da.20586
McWilliams, L. A., Cox, B. J., & Asmundson, G. J. (2005). Symptom structure of posttraumatic stress disorder in a nationally representative sample. Journal of Anxiety Disorders, 19, 626–641. doi:10.1016/j.janxdis.2004.06.003
Messman-Moore, T. L., Walsh, K. L., & DiLillo, D. (2010). Emotion dysregulation and risky sexual behavior in revictimization. Child Abuse and Neglect, 34, 967–976. doi:10.1016/j.chiabu.2010.06.004
Miller, M. W., Wolf, E. J., Kilpatrick, D., Resnick, H., Marx, B. P., Holowka, D. W., ... Friedman, M. J. (2012). The prevalence and latent structure of proposed DSM-5 posttraumatic stress disorder symptoms in U.W. national and veteran samples. Psychological Trauma: Theory, Research, Practice, and Policy. doi:10.1037/a0029730
Naifeh, J. A., Elhai, J. D., Kashdan, T. B., & Grubaugh, A. L. (2008). The PTSD symptom scale’s latent structure: an examination of trauma-exposed medical patients. Journal of Anxiety Disorders, 22, 1355–1368. doi:10.1016/j.janxdis.2008.01.016
Nishith, P., Nixon, R. D. V., & Resick, P. A. (2005). Resolution of trauma-related guilt following treatment of PTSD in female rape victims: a result of cognitive processing therapy targeting comorbid depression? Journal of Affective Disorders, 86, 259–265. doi:10.1016/j.jad.2005.02.013
Nixon, R. D., Bryant, R. A., Moulds, M. L., Felmingham, K. L., & Mastrodomenico, J. A. (2005). Physiological arousal and dissociation in acute trauma victims during trauma narratives. Journal of Traumatic Stress, 18, 107–113. doi:10.1002/jts.20019
Olde, E., van der Hart, O., Kleber, R., & van Son, M. (2006). Posttraumatic stress following childbirth: a review. Clinical Psychology Review, 26, 1–16. doi:10.1016/j.cpr.2005.07.002
Olff, M., Koeter, M. W., van Haaften, E. H., Kersten, P. H., & Gersons, B. P. (2005). Impact of a foot and mouth disease crisis on post-traumatic stress symptoms in farmers. The British Journal of Psychiatry, 186, 165–166. doi:10.1192/bjp.186.2.165
Palmieri, P. A., & Fitzgerald, L. F. (2005). Confirmatory factor analysis of posttraumatic stress symptoms in sexually harassed women. Journal of Traumatic Stress, 18, 657–666. doi:10.1002/jts.20074
Palmieri, P. A., Marshall, G. N., & Schell, T. L. (2007a). Confirmatory factor analysis of posttraumatic stress symptoms in Cambodian refugees. Journal of Traumatic Stress, 20, 207–216. doi:10.1002/jts.20196
Palmieri, P. A., Weathers, F. W., Difede, J., & King, D. W. (2007b). Confirmatory factor analysis of the PTSD checklist and the clinician-administered PTSD Scale in disaster workers exposed to the World Trade Center Ground Zero. Journal of Abnormal Psychology, 116, 329–341. doi:10.1037/0021-843X.116.2.329
Panagioti, M., Gooding, P., Taylor, P. T., & Tarrier, N. (2013). A model of suicidal behavior in posttraumatic stress disorder (PTSD): the mediating role of defeat and entrapment. Psychiatry Research, 209, 55–59. doi:10.1016/j.psychres.2013.02.018
Pietrzak, R. H., Goldstein, R. B., Southwick, S. M., & Grant, B. F. (2011). Personality disorders associated with full and partial posttraumatic stress disorder in the US population: results from wave 2 of the national epidemiologic survey on alcohol and related conditions. Journal of Psychiatric Research, 45, 678–686. doi:10.1016/j.jpsychires.2010.09.013
Regier, D. A., Narrow, W. E., Clarke, D. E., Kraemer, H. C., Kuramoto, S. J., Kuhl, E. A., & Kupfer, D. J. (2013). DSM-5 field trials in the United States and Canada, part II: test–retest reliability of selected categorical diagnoses. The American Journal of Psychiatry, 170, 59–70. doi:10.1176/appi.ajp.2012.12070999
Resick, P. A., Suvak, M. K., Johnides, B. D., Mitchell, K. S., & Iverson, K. M. (2012). The impact of dissociation on PTSD treatment with cognitive processing therapy. Depression and Anxiety, 29, 718–730. doi:10.1002/da.21938
Robertson, N., Davies, G., & Nettleingham, A. (2009). Vicarious traumatisation as a consequence of jury service. The Howard Journal of Criminal Justice, 48(1), 1–12. doi:10.1111/j.1468-2311.2008.00539.x
Rosen, G. (1996). Posttraumatic stress disorder, pulp fiction, and the press. The Bulletin of the American Academy of Psychiatry and the Law, 24, 267–269.
Rude, S. S., Durham-Fowler, J. A., Baum, E. S., Rooney, S. B., & Maestas, K. L. (2010). Self-report and cognitive processing measures of depressive thinking predict subsequent major depressive disorder. Cognitive Therapy and Research, 34, 107–115. doi:10.1007/s10608-009-9237-y
Ruscio, A. M., Ruscio, J., & Keane, T. M. (2002). The latent structure of posttraumatic stress disorder: a taxometric investigation of reactions to extreme stress. Journal of Abnormal Psychology, 111, 290–301. doi:10.1037//0021-843X.111.2.290
Rytwinski, N. K., Scur, M. D., Feeny, N. C., & Youngstrom, E. A. (2013). The co-occurrence of major depressive disorder among individuals with posttraumatic stress disorder: A meta-analysis. Journal of Traumatic Stress, 26, 299–309. doi:10.1002/jts.21814
Sanislow, C. A., Pine, D. S., Quinn, K. J., Kozak, M. J., Garvey, M. A., Heinssen, R. K., ... Cuthbert, B. N. (2010). Developing constructs for psychopathology research: research domain criteria. Journal of Abnormal Psychology, 119, 631–639. doi:10.1037/a0020909
Schinka, J. A., Brown, L. M., Borenstein, A. R., & Mortimer, J. A. (2007). Confirmatory factor analysis of the PTSD Checklist in the elderly. Journal of Traumatic Stress, 20, 281–289. doi:10.1002/jts.20202
Shalev, A. Y., Freedman, S., Peri, T., Brandes, D., Sahar, T., Orr, S. P., & Pitman, R. K. (1998). Prospective study of posttraumatic stress disorder and depression following trauma. American Journal of Psychiatry, 155, 630–637.
Simms, L. J., Watson, D., & Doebbelling, B. N. (2002). Confirmatory factor analyses of posttraumatic stress symptoms in deployed and nondeployed veterans of the Gulf War. Journal of Abnormal Psychology, 111, 637–647. doi:10.1037/0021-843X.111.4.637
Speckens, A. E., Ehlers, A., Hackmann, A., & Clark, D. M. (2006). Changes in intrusive memories associated with imaginal reliving in posttraumatic stress disorder. Journal of Anxiety Disorders, 20, 328–341. doi:10.1016/j.janxdis.2005.02.004
Spitzer, R. L., First, M. B., & Wakefield, J. C. (2007). Saving PTSD from itself in DSM-V. Journal of Anxiety Disorders, 21, 233–241. doi:10.1016/j.janxdis.2006.09.006
Spitzer, R. L., Endicott, J., & Williams, J. B. (2012). Standards for DSM-5 reliability. American Journal of Psychiatry, 169, 537. doi:10.1176/appi.ajp.2012.12010083
Stein, D. J., Koenen, K. C., Friedman, M. J., Hill, E., McLaughlin, K. A., Petukhova, M., & Kessler, R. C. (2013). Dissociation in posttraumatic stress disorder: evidence from the world mental health surveys. Biological Psychiatry, 73, 302–312. doi:10.1016/j.biopsych.2012.08.022
Steuwe, C., Lanius, R. A., & Frewen, P. A. (2012). Evidence for a dissociative subtype of PTSD by latent profile and confirmatory factor analyses in a civilian sample. Depression and Anxiety, 29, 689–700. doi:10.1002/da.21944
Taylor, S., Fedoroff, I. C., Koch, W. J., Thordarson, D. S., Fecteau, G., & Nicki, R. M. (2001). Posttraumatic stress disorder arising after road traffic collisions: patterns of response to cognitive–behavior therapy. Journal of Consulting and Clinical Psychology, 69, 541–551. doi:10.1037//0022-006X.69.3.541
Taylor, S., Frueh, B. C., & Asmundson, G. J. (2007). Detection and management of malingering in people presenting for treatment of posttraumatic stress disorder: methods, obstacles, and recommendations. Journal of Anxiety Disorders, 21, 22–41. doi:10.1016/j.janxdis.2006.03.016
Thomsen, C. J., Stander, V. A., McWhorter, S. K., Rabenhorts, M. M., & Milner, J. S. (2011). Effects of combat deployment on risky and self-destructive behavior among active military personnel. Journal of Psychiatric Research, 45, 1321–1331. doi:10.1016/j.jpsychires.2011.04.003
van der Kolk, B. A., Pelcovitz, D., Roth, S., & Mandel, F. S. (1996). Dissociation, somatization, and affect dysregulation: the complexity of adaption to trauma. The American Journal of Psychiatry, 153, 83–93.
Waelde, L. C., Silvern, L., & Fairbank, J. A. (2005). A taxometric investigation of dissociation in Vietnam veterans. Journal of Traumatic Stress, 18, 359–369. doi:10.1002/jts.20034
Watson, D. (2009). Differentiating the mood and anxiety disorders: a quadripartite model. Annual Review of Clinical Psychology, 5, 221–247. doi:10.1146/annurev.clinpsy.032408.153510
Weathers, F. W., & Keane, T. M. (2007). The criterion a problem revisited: controversies and challenges in defining and measuring psychological trauma. Journal of Traumatic Stress, 20, 107–121. doi:10.1002/jts.20210
Weidmann, A., & Papsdorf, J. (2010). Witnessing trauma in the newsroom: posttraumatic symptoms in television journalists exposed to violent news clips. The Journal of Nervous and Mental Disease, 198, 264–271. doi:10.1097/NMD.0b013e3181d612bf
Weierich, M. R., & Nock, M. K. (2008). Posttraumatic stress symptoms mediate the relation between childhood sexual abuse and nonsuicidal self-injury. Journal of Consulting and Clinical Psychology, 76, 39–44. doi:10.1037/0022-006X.76.1.39
Wolf, E. J., Miller, M. W., Reardon, A. F., Ryabchenko, K. A., Castillo, D., & Freund, R. (2012a). A latent class analysis of dissociation and PTSD: evidence for a dissociative subtype. Archives of General Psychiatry, 69, 698–705. doi:10.1001/archgenpsychiatry.2011.1574
Wolf, E. J., Lunney, C. A., Miller, M. W., Resick, P. A., Friedman, M. J., & Schnurr, P. P. (2012b). The dissociative subtype of PTSD: a replication and extension. Depression and Anxiety, 29, 679–688. doi:10.1002/da.21946
Yuffik, T., & Simms, L. (2010). A meta-analytic investigation of the structure of posttraumatic stress disorder symptoms. Journal of Abnormal Psychology, 119, 764–776. doi:10.1037/a0020981
Zisook, S., Corruble, E., Duan, N., Iglewicz, A., Karam, E. G., Lanouette, N., & Tal Young, I. (2012). The bereavement exclusion and DSM-V. Depression and Anxiety, 29, 425–443. doi:10.1002/da.21927
Zlotnick, C., Shea, T. M., Rosen, K., Simpson, E., Mulrenin, K., Begin, A., & Pearlstein, T. (1997). An affect-management group for women with posttraumatic stress disorder and histories of childhood sexual abuse. Journal of Traumatic Stress, 10, 425–436. doi:10.1002/jts.2490100308
Zlotnick, C., Johnson, D. M., Yen, S., Battle, C. L., Sanislow, C. A., Skodol, A. E., ... Shea, M. T. (2003). Clinical features and impairment in women with borderline personality disorder (BPD) with posttraumatic stress disorder (PTSD), BPD without PTSD, and other personality disorders with PTSD. Journal of Nervous and Mental Disorders, 191, 706–714. doi:10.1097/01.nmd.0000095122.29476.ff
Zoellner, L. A., Rothbaum, B. O., & Feeny, N. C. (2011). PTSD not an anxiety disorder? DSM committee proposal turns back the hands of time. Depression and Anxiety, 28, 853–856. doi:10.1002/da.20899
Zoellner, L. A., Pruitt, L. D., Farach, F. J., & Jun, J. J. (2013). Understanding heterogeneity in PTSD: fear, dysphoria, and distress. Depression and Anxiety, 00, 1–10. doi:10.1002/da.22133
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Zoellner, L.A., Bedard-Gilligan, M.A., Jun, J.J. et al. The Evolving Construct of Posttraumatic Stress Disorder (PTSD): DSM-5 Criteria Changes and Legal Implications. Psychol. Inj. and Law 6, 277–289 (2013). https://doi.org/10.1007/s12207-013-9175-6
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12207-013-9175-6