Skip to main content
SpringerLink
Log in

Critical Issues in the Evolving Diagnosis of PTSD

  • Chapter
  • First Online:
Handbook of Forensic Sociology and Psychology

  • 2519 Accesses

Abstract

The diagnosis specificity of posttraumatic Stress disorder (PTSD) continues to evolve, and there are critical issues for forensic experts and mental health experts to consider in the proper use and understanding of this important diagnosis. PTSD has long been a poorly defined diagnosis. Recent empirical findings in the PTSD literature have led researchers to propose that the diagnostic criteria for this disorder do not appropriately rule out other disorders of extreme stress that are distinct from PTSD. The diagnostic criteria for PTSD have not covered the full range of posttraumatic impairments, such as emotional dysregulation or dysregulation of consciousness, which can be used to distinguish simple PTSD from more complex forms (Herman, 1992; Courtois & Ford, 2009). Research on stress disorders has revealed distinct symptomatic nuances that differentiate these disorders not only from PTSD but also from each other. Therefore, as the approaches to creating diagnostic criteria and conceptualizing stress disorders continue to evolve, the most efficient way to clinically assess these disorders should advance simultaneously. This chapter will provide a focused review of recent literature on stress disorders and will present an approach to assessment using repeated application of therapist evaluation and empirically supported measures based on the stage and type of the presenting stress disorder. Further directions for future research in this area are suggested.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 119.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 159.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • American Psychiatric Association DSM-III. (1980). Diagnostic and statistical manual of mental disorders (3rd ed.). Washington, DC: Author.

    Google Scholar 

  • American Psychiatric Association DSM-III-R. (1987). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author

    Google Scholar 

  • American Psychiatric Association (2007). DSM-IV TR, Diagnostic and Statistical Manual of Mental Disorders. Washington, D.C.

    Google Scholar 

  • American Psychiatric Association DSM-V Development. (2012). http://www.dsm5.org/ProposedRevisions/Pages/proposedrevision.aspx?rid=165.

  • Berwin, 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(5), 366–373.

    Google Scholar 

  • Benight, C. (2012). Understanding human adaptation to traumatic stress exposure: Beyond the medical model. Psychologial Trauma: Theory, Research, Practice, and Policy, 4(1), 1–8.

    Google Scholar 

  • Blake, D. D., Weathers, F. W., Nagy, L. M., Kaloupek, D. G., Gusman, F. D., Charney, D. S., et al. (1995). The development of a clinician-administered PTSD scale. Journal of Traumatic Stress, 8(1), 75–90.

    Article  PubMed  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • Bonanno, G., Pat-Horenczyk, R., & Noll, J. (2011). Coping, flexibility and trauma: The perceived ability to cope with trauma (PACT) Scale. Psychological Trauma: Theory, Research, Practice, and Policy, 3(2), 117–129.

    Article  Google Scholar 

  • Briere, J. (2004). Psychological assessment of adult posttraumatic states: Phenomenology, diagnosis, and measurement (2nd. ed.). Washington, DC: American Psychological Association.

    Google Scholar 

  • Briere, J., & Scott, C. (2006). Principles of trauma therapy: A guide to symptoms, evaluation, and treatment. Thousand Oaks, CA: Sage.

    Google Scholar 

  • Briere, J., & Spinazzola, J. (2009). Assessment of the sequelae of complex trauma: Evidence-based measures. In C. A. Courtois & J. D. Ford (Eds.), Treating Complex Traumatic Stress Disorders, pp. 104–124. New York, NY: Guilford Press.

    Google Scholar 

  • Brown, D. (2009). Assessment of attachment and abuse history, and adult attachment style. In C. A. Courtois & J. D. Ford (Eds.), Treating complex traumatic stress disorders: An evidence-based guide (pp. 124–144). New York, NY: Guilford Press.

    Google Scholar 

  • Bryant, R. A., Harvey, A. G., Gordon, E., & Barry, R. J. (1995). Eye movement and elecrtrodermal responses to threat stimuli in post traumatic stress disorder. International Journal of Psychophysiology, 20(3), 2009–213. PubMed: 87888223.

    Article  Google Scholar 

  • Chalton, L. D., & McMillan, T. M. (2009). Can “partial” PTSD explain differences in diagnosis of PTSD by questionnaire self-report and interview after head injury? Brain Injury, 23(2), 77–82.

    Article  PubMed  Google Scholar 

  • Cloitre, M., Courtois, C., Charuvastra, A., Carapezza, R., Stolback, C., & Green, B. (2011). Treatment of complex PTSD: Results of the ISTSS expert clinician survey on best practices. Trauma: Theory, Research, Practice, and Policy, 24(6), 615–627.

    Google Scholar 

  • Courtois, C. A., & Ford, J. D. (2009). Complex traumatic stress disorders: An evidence-based guide. New York, NY: Guilford Press.

    Google Scholar 

  • Courtois, C. A. (2004). Complex trauma, complex reactions, assessment and treatment. Psychotherapy: Theory, Research, Practice, Training, 41(4), 412–425.

    Google Scholar 

  • Feldman-Summers, S. (2012). http://www.shirleyfeldmansummers.com/blog/forensic

  • Frazier, P., Gavian, M., Hirai, R., Park, C., Tennen, H., Tomich, P., et al. (2011). Prospective predictors of post traumatic stress disorder symptoms: Direct and mediated relations. Psychological Trauma: Theory, Research, Practice, and Policy, 3(1), 27–36.

    Article  Google Scholar 

  • Gold, L. (2005). The role of PTSD in litigation. Psychiatric Times, 23(14).

    Google Scholar 

  • Heilbrun, K., Grisso, T., & Goldstein, A. M. (2009). Foundations of forensic mental health assessment. New York, NY: Oxford University Press.

    Google Scholar 

  • Herman, J. L. (1992). Trauma and recovery. New York, NY: Basic Books.

    PubMed  Google Scholar 

  • Horowitz, M. (2011). Assessment-based treatment of post-traumatic stress disorders. Create Space Independent Publishing Platform.

    Google Scholar 

  • Horowitz, M., Adler, N., & Kegeles, S. (1988). A scale for measuring the occurrence of positive states of mind: A preliminary report. Psychosomatic Medicine, 50(5), 477–483.

    Google Scholar 

  • Horowitz, M., Sonneborn, D., Sugahara, C., & Maercker, A. (1996). Self-regard: A new measure. American Journal of Psychiatry, 153(3), 382–385.

    Google Scholar 

  • Horowitz, M., Wilmer, N., & Alvarez, W. (1979). Impact of event scale: A measure of subjective stress. Psychosomatic Medicine, 41, 209–218.

    PubMed  Google Scholar 

  • Howitt, D. (2012). Introduction to forensic and criminal psychology. Philadelphia, PA: Trans-Atlantic Publications, Inc.

    Google Scholar 

  • Kane, A. W., & Dvoskin, J. A. (2011). Evaluation for personal injury claims. Best practices in forensic mental health assessment. New York, NY: Oxford University Press.

    Google Scholar 

  • Kapitan, L. (2010). Introduction to art therapy research (pp. 38–66). New York, NY: Routledge, Taylor and Francis.

    Google Scholar 

  • Keen, S. M., Kutter, C. J., Niles, B. L., & Krinsley, K. E. (2008). Psychometric properties of PTSD checklist in sample of male veterans. Journal of Rehabilitation Research and Development, 45(3), 465–474.

    Article  PubMed  Google Scholar 

  • Kimble, M. O., Fleming, K., Brandy, C., Kim, J., & Zambetti, A. (2010). Eyetracking and visual attention to threatening stimuli in veterans of the Iraq War. Journal of Anxiety Disorders, 24(3), 293–299.

    Article  PubMed  Google Scholar 

  • Koch, W., Douglas, K. S., Nichols, T., & O’Neill, M. (2006). Psychological injuries: Forensic assessment, treatment, and law (American Psychology-Law Society Series). New York, NY: Oxford University Press.

    Google Scholar 

  • Lilly, M., & Valdez, C. (2011). Interpersonal trauma and PTSD: The roles of gender and a lifespan perspective in predicting risk. Psychological Trauma: Theory, Research, Practice, and Policy, 4(1), 140–144.

    Article  Google Scholar 

  • Macdonald, A., Greene, C. J., Torres, J. G., Frueh, C., & Morland, L. A. (2012). Concordance between clinician-assessed and self-reported symptoms of post-traumatic stress disorder across three ethnoracial groups (pp. 1–8). Psychological Trauma: Theory, Research, Practice, and Policy.

    Google Scholar 

  • McCutcheon, V. V., Sartor, C. E., Pommer, N. E., Bucholz, K. K., Nelson, E. C., Madden, P. A., et al. (2010). Age at trauma exposure and PTSD risk in a young adult female sample. Journal of Traumatic Stress, 23(6), 811–814.

    Article  PubMed  Google Scholar 

  • McGuire, J., & Clark, S. (2011) PTSD and the law: An update. PTSD Research Quarterly, 22(1).

    Google Scholar 

  • National Research Council. (2010). Returning home from Iraq and Afghanistan: Preliminary assessment of readjustment needs of veterans, service members, and their families. Washington, DC: The National Academies Press.

    Google Scholar 

  • Nickerson, A., Bryant, R. A., Silove, D., & Steel, A. (2011). A critical review of psychological treatments of posttraumatic stress disorder in refugees. Clinical Psychology Review, 31, 399–417.

    Article  PubMed  Google Scholar 

  • Robins, E., & Guze, S. B. (1970). Establishment of diagnostic validity in psychiatric illness: Its application to schizophrenia. American Journal of Psychiatry, 126(7), 983–987.

    Google Scholar 

  • Rosen, G.M. (1995). The Aleutian Enterprise sinking and Posttraumatic Stress Disorder: Misdiagnosis in clinical and forensic settings. Professional Psychology: Research and Practice, 26, 82–87.

    Google Scholar 

  • Rosen, G. M. (2004). Traumatic events, criterion creep, and the creation of pretraumatic stress disorder. Science Review Mental Health Practice, 3, 46–7.

    Google Scholar 

  • Rosen, G. M., Lillenfeld, S. O., Frueh, C., McHugh, P. R., & Spitzer, R. L. (2010). Reflections on PTSD’s future in DSM-V. The British Journal of Psychiatry, 197, 343–344.

    Article  PubMed  Google Scholar 

  • Sar, V. (2011). Developmental trauma, complex PTSD, and the current proposal of DSM 5, European Journal of Psychotraumatology, 2, 5622.

    Article  PubMed  Google Scholar 

  • Sparr, L. F., & Boehnlein, J. K. (1990). Posttraumatic stress disorder in tort actions: Forensic minefield. Bulletin American Academy of Psychiatric Law, 18(3), 283–302.

    Google Scholar 

  • Spitzer, R. L., First, M. B., & Wakefield, J. C. (2007). Saving PTSD from itself in DSM-V. Journal of Anxiety Disorders, 21, 233–241.

    Article  PubMed  Google Scholar 

  • Tolin, D. F., Steenkamp, M. M., Marx, B. P., & Litz, B. T. (2010). Detecting symptom exaggeration in combat veterans using MMPI-2 symptom validity scales: A mixed group validation. Psychological Assessment, 22(4), 729–736.

    Article  PubMed  Google Scholar 

  • Worthen, M. D., & Moering, R. G. (2011). A practical guide to conducting VA compensation and pension exams for PTSD and other mental disorders. Psychological Injury and Law, 4(3–4), 187–216. doi:10.1007/s12207-011-9115-2.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Clinical Psychologist, Lovell Federal Health Care Center, North Chicago, Illinois, USA

    John P. Bair Ph.D.

  2. Rosalind Franklin University of Medicine and Science,, North Chicago, Illinois, USA

    John P. Bair Ph.D. (Assistant Professor)

  3. Doctoral Student in Clinical Psychology, Rosalind Franklin University of Medicine and Science North, Chicago, Illinois, USA

    Kathleen M. Long M.S.

Authors
  1. John P. Bair Ph.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. John P. Bair Ph.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Kathleen M. Long M.S.
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding authors

Correspondence to John P. Bair Ph.D. or John P. Bair Ph.D. .

Editor information

Editors and Affiliations

  1. Nursing and Health Sciences, California State University, East Bay, San Francisco, California, USA

    Stephen J. Morewitz

  2. College of Medicine, University of Illinois, Chicago, Illinois, USA

    Mark L. Goldstein

Rights and permissions

Reprints and permissions

Copyright information

© 2014 Springer Science+Business Media New York

About this chapter

Cite this chapter

Bair, J.P., Bair, J.P., Long, K.M. (2014). Critical Issues in the Evolving Diagnosis of PTSD. In: Morewitz, S., Goldstein, M. (eds) Handbook of Forensic Sociology and Psychology. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-7178-3_14

Download citation

Publish with us

Policies and ethics

Search

Navigation