The Historical Evolution of PTSD Diagnostic Criteria

Abstract

In the last quarter of this century, there has been a rapid proliferation of interest in traumatic stress syndromes, especially in post-traumatic stress disorder (PTSD) as a diagnostic category of the Diagnostic and Statistical Manual of Mental Disorders, Third Edition-Revised (DSM-III-R) (American Psychiatric Association, 1987). Viewed from a historical perspective, the emergence of widespread interest in PTSD by the medical and behavioral sciences as well as in legal arenas of litigation is quite understandable perhaps, expectable when examined by a retrospective look at some major events of the 20th century: two world wars, the atomic bombing of Hiroshima, scores of nationalistic and colonial wars, widespread civil violence, mass genocide, catastrophic disasters of human and natural origin, the growing awareness of domestic violence and childhood sexual abuse, technological disasters, famine, widespread diseases such as acquired immune deficiency syndrome (AIDS), and many more forms of catastrophic stress. When it is considered that hundreds of millions of human lives have been adversely effected by such traumatic events, it only stands to reason that sooner or later scientific inquiry would begin examining the multifaceted aspects of what traumatization means and its potential long-term impact to human lives of such events. Today there is a convergence of interest in PTSD. Such seemingly odd bedfellows as the neurosciences, experimental psychology, clinical psychiatry, and sociology are probing new areas of traumatic impact and discovering the complex psychobiological processes that control reaction patterns, symptom manifestation, and other aspects of coping and adaptation following a traumatic event (Wilson, 1989; Wilson & Raphael, 1993).