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Evolution of PTSD Diagnosis in the DSM

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Future Directions in Post-Traumatic Stress Disorder

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Abstract

This chapter summarizes the historical developments in the conceptualization of PTSD, discusses the significant current issues regarding the diagnosis of PTSD, and describes the changes that are in the DSM-5. The themes running through this narrative include war as a catalyst for understanding the impact of trauma, psychological and physiological conceptualizations of the syndrome, the pendulum of internal and external causality, application of PTSD to civilian traumas, and developmental perspectives in the diagnosis of PTSD.

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References

  • American Counseling Association. (2011). An open letter to the American Psychiatric Association and DSM-5 Task Force. Retrieved from http://www.counseling.org/

  • American Psychiatric Association. (1952). Diagnostic and statistical manual of mental disorders. Washington, DC: Author.

    Google Scholar 

  • American Psychiatric Association. (1968). Diagnostic and statistical manual of mental disorders (2nd ed.). Washington, DC: Author.

    Google Scholar 

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

    Google Scholar 

  • American Psychiatric Association. (1987). Diagnostic and statistical manual of mental disorders (3rd ed., rev.). Washington, DC: Author.

    Google Scholar 

  • American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.

    Google Scholar 

  • American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text rev.). Washington, DC: Author.

    Google Scholar 

  • American Psychiatric Association. (2007). APA names DSM-5 task force members: Leading experts to revise handbook for diagnosing mental disorders. Retrieved from http://www.dsm5.org

  • American Psychiatric Association. (2012). Army in midst of PTSD diagnosis controversy. Retrieved from http://alert.psychiatricnews.org/2012/02/army-in-midst-of-ptsd-diagnosis.html

  • American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

    Book  Google Scholar 

  • Andraesen, N. C. (1980). Post-traumatic stress disorder. In H. Kaplan, A. Freedman, & B. Sadock (Eds.), Comprehensive textbook of psychiatry (3rd ed., pp. 1517–1525). Baltimore, MD: Williams & Wilkins.

    Google Scholar 

  • Andraesen, N. C. (2010). Posttraumatic stress disorder: A history and a critique. Annals of the New York Academy of Sciences, 1208, 67–71. doi:10.1111/j.1749-6632.2010.05699.x.

    Article  Google Scholar 

  • Andrews, B., Brewin, C. R., Philpott, R., & Stewart, L. (2007). Delayed-onset posttraumatic stress disorder: A systematic review of the evidence. American Journal of Psychiatry, 164, 1319–1326. doi:10.1176/appi.ajp.2007.06091491.

    Article  PubMed  Google Scholar 

  • Appel, J. W., & Beebe, G. W. (1946). Preventive psychiatry: An epidemiological approach. Journal of the American Medical Association, 131, 1468–1471.

    Article  Google Scholar 

  • Asmundson, G. J. G., 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.

    Article  PubMed  Google Scholar 

  • Atkinson, R. M., Henderson, R. G., Sparr, L. F., & Deale, S. (1982). Assessment of Vietnam veterans for post-traumatic stress disorder in Veterans Administration disability claims. American Journal of Psychiatry, 139, 1118–1121.

    Article  PubMed  Google Scholar 

  • Boone, K. N. (2011). The paradox of PTSD. Wilson Quarterly, 35(4), 18–22.

    Google Scholar 

  • Bovin, M. J., & Marx, B. P. (2011). The importance of the peritraumatic experience in defining traumatic stress. Psychological Bulletin, 137, 47–67. doi:10.1037/a0021353.

    Article  PubMed  Google Scholar 

  • Breslau, N., & Kessler, R. C. (2001). The stressor criterion in DSM-IV posttraumatic stress disorder: An empirical investigation. Biological Psychiatry, 50(9), 699–704.

    Article  PubMed  Google Scholar 

  • Brewin, C. R., Lanius, R. A., Novac, A., Schnyder, U., & Galea, S. (2009). Reformulating PTSD for DSM-5: Life after Criterion A. Journal of Traumatic Stress, 22, 366–373. doi:10.1002/jts.20443.

    Article  PubMed  Google Scholar 

  • Brill, N. Q., & Beeb, G. (1955). A follow-up study of war neuroses. Washington, DC: Government Printing Office.

    Book  Google Scholar 

  • Classen, C., Koopman, C., Hales, R., & Spiegel, D. (1998). Acute stress disorder as a predictor of posttraumatic stress symptoms. American Journal of Psychiatry, 155(5), 620–624.

    Article  PubMed  Google Scholar 

  • Contractor, A. A., Durham, T. A., Brennan, J. A., Armour, C., Wutrick, H. R., Frueh, B. C., et al. (2013). DSM-5 PTSD’s symptom dimensions and relations with major depression’s symptom dimensions in a primary care sample. Psychiatry Research, 215(1), 146–153. Retrieved from http://dx.doi.org/10.1016/j.psychres.2013.10.015.

    Article  PubMed  Google Scholar 

  • Cosgrove, L., & Krimsky, S. (2012). A comparison of DSM-IV and DSM-5 panel members’ financial associations with industry: A pernicious problem exists. PLoS Medicine, 9(3), 1–4.

    Article  Google Scholar 

  • Coyne, J. C., & Thompson, R. (2007). Posttraumatic stress syndromes: Useful or negative heuristics? Journal of Anxiety Disorders, 21(2), 223–229. doi:10.1016/j.janxdis.2006.09.008.

    Article  PubMed  Google Scholar 

  • De Jong, J. T., Komproe, I. H., Van Ommeren, M., El Masri, M., Araya, M., et al. (2001). Lifetime events and posttraumatic stress disorder in 4 postconflict settings. Journal of the American Medical Association, 286(5), 555–562. doi:10.1001/jama.286.5.555.

    Article  PubMed  Google Scholar 

  • Dean, E. T. (1992). The myth of the troubled and scorned Vietnam veteran. Journal of American Studies, 26, 59–74.

    Article  Google Scholar 

  • Elhai, J. D., Miller, M. E., Ford, J. D., Biehn, T. L., Palmieri, P. A., & Frueh, B. C. (2012). Posttraumatic stress disorder in DSM-5: Estimates of prevalence and symptom structure in a nonclinical sample of college students. Journal of Anxiety Disorders, 26, 58–64.

    Article  PubMed  Google Scholar 

  • Elhai, J. D., & Palmieri, P. A. (2011). The factor structure of posttraumatic stress disorder: A literature update, critique of methodology, and agenda for future research. Journal of Anxiety Disorders, 25, 849–854. doi:10.1016/j.janxdis.2011.04.007.

    Article  PubMed  Google Scholar 

  • Freud, S. (1892). On the theory of hysterical attacks. In J. Strachey (Ed. & Trans.), The standard edition of the complete psychological works of Sigmund Freud (Vol. 1., pp. 151–154). London: Hogarth Press.

    Google Scholar 

  • Freud, S. (1920). Beyond the pleasure principle. In J. Strachey (Ed. & Trans.), The standard edition of the complete psychological works of Sigmund Freud (Vol. 18, pp. 7–64). London: Hogarth Press.

    Google Scholar 

  • Friedman, M. J. (2005). Veterans’ mental health in the wake of war. New England Journal of Medicine, 352(13), 1287–1290. doi:10.111/j.1525-1497.2006.00367.x.

    Article  PubMed  Google Scholar 

  • Friedman, M. J., & Fuller, R. B. (1985). War veterans’ post-traumatic stress disorder and the U.S. congress. In W. Kelley (Ed.), Post-traumatic stress disorder and the war veteran patient (pp. 3–11). New York, NY: Brunner/Mazel.

    Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • Frueh, B. C., Elhai, J. D., & Acierno, R. (2010). The future of posttraumatic stress disorder in the DSM. Psychological Injury and Law, 3, 260–270. doi:10.1007/s12207-010-9088-6.

    Article  Google Scholar 

  • Frueh, B. C., Grubaugh, A. L., Yeager, D. E., & Magruder, K. M. (2009). Delayed-onset posttraumatic stress disorder among war veterans in primary care clinics. British Journal of Psychiatry, 194, 515–520. doi:10.1192/bjp.bp.108.054700.

    Article  PubMed Central  PubMed  Google Scholar 

  • Galatzer-Levy, I. R., & Bryant, R. A. (2013). 636,120 ways to have posttraumatic stress disorder. Perspectives on Psychological Science, 8(6), 651–662. doi:10.1177/1745691613504115.

    Article  Google Scholar 

  • Galea, S., Ahern, J., Resnick, H., Kilpatrick, D., Bucuvalis, M., Gold, J., et al. (2002). Psychological sequelae of the Sept 11 terrorist attacks in New York City. New England Journal of Medicine, 346, 982–987.

    Article  PubMed  Google Scholar 

  • Gawande, A. (2004). Casualties of war—military care for the wounded from Iraq and Afghanistan. New England Journal of Medicine, 351, 2471–2475.

    Article  PubMed  Google Scholar 

  • Grinker, R. R., & Spiegel, J. P. (1945). Men under stress. Philadelphia, PA: Blakiston.

    Book  Google Scholar 

  • Hargreaves, G., Wittkower, E., & Wilson, A. T. M. (1940). Psychiatric organisation in the services. In E. Miller (Ed.), The neurosis of war (pp. 163–179). London: Macmillan.

    Google Scholar 

  • Herman, J. L. (1997). Trauma and recovery. New York, NY: Basic.

    Google Scholar 

  • Hoge, C. W., McGurk, D., Thomas, J. L., Cox, A. L., Engel, C. C., & Castro, C. A. (2008). Mild traumatic brain injury in U.S. soldiers returning from Iraq. New England Journal of Medicine, 358, 453–463.

    Article  PubMed  Google Scholar 

  • Institute of Medicine. (2006). Posttraumatic stress disorder: Diagnosis and assessment. Washington, DC: Author.

    Google Scholar 

  • Institute of Medicine. (2007). PTSD compensation and military service. Washington, DC: Author.

    Google Scholar 

  • Kardiner, A. (1941). The traumatic neuroses of war. Washington, DC: National Research Council.

    Book  Google Scholar 

  • Kardiner, A. (1959). Traumatic neuroses of war. In S. Arieti (Ed.), American handbook of psychiatry (pp. 245–257). New York, NY: Basic.

    Google Scholar 

  • Katz, I. R., & Karlin, B. (2009). A veteran’s guide to mental health services in the VA. In P. P. Driscoll & C. Straus (Eds.), Hidden battles on unseen fronts: Stories of American soldiers with traumatic brain injury and PTSD. Drexel Hill, PA: CASEMATE.

    Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • Kulka, R. A., Schlenger, W. E., Fairbank, J. A., Hough, R. L., Jordan, B. K., Marmar, C. R., et al. (1990). Trauma and the Vietnam War generation: Report of findings from the National Vietnam Veterans Readjustment Study. New York, NY: Brunner/Mazel.

    Google Scholar 

  • Long, M. E., & Elhai, J. D. (2009). Posttraumatic stress disorder’s traumatic stress or criterion: History, controversy, clinical and legal implications. Psychological Injury and Law, 2, 167–178. doi:10.1007/s12207-009-9043-6.

    Article  Google Scholar 

  • McHugh, P. R., & Treisman, G. (2007). PTSD: A problematic diagnostic category. Journal of Anxiety Disorders, 21, 211–222. doi:10.1016/j.janxdis.2006.09.003.

    Article  PubMed  Google Scholar 

  • McNally, R. J. (2009). Can we fix PTSD in DSM-5? Depression and Anxiety, 26, 597–600. doi:10.1002/da.20586.

    Article  PubMed  Google Scholar 

  • Miller, L. N., Chard, K. M., Schumm, J. A., & O’Brien, C. (2011). The impact of endorsing Spitzer’s proposed criteria for PTSD in the forthcoming DSM-5 on male and female veterans. Journal of Anxiety Disorders, 25(5), 639–644. doi:10.1016/j.janxdis.2011.02.004.

    Article  PubMed  Google Scholar 

  • Miller, M. W., Resick, P. A., & Keane, T. M. (2009). DSM-5: Should PTSD be in a class of its own? British Journal of Psychiatry, 194(1), 90. doi:10.1192/bjp.194.1.90.

    Article  PubMed  Google Scholar 

  • Moran, M. (2007). Developmental trauma mertis DSM diagnosis, experts say. Psychiatry News, 42(3), 20.

    Article  Google Scholar 

  • Mott, F. W. (1917). The microscopic examination of the brains of two men dead of commotion cerebri (shell shock) without visible injury. British Medical Journal, 2, 612–615.

    Article  PubMed Central  PubMed  Google Scholar 

  • Myers, C. S. (1940). Shellshock in France 1914-18: Based on a war diary. Cambridge: Cambridge University Press.

    Google Scholar 

  • National Public Radio. (2012, March 18). Troops’ mental health: How much is unknown? Retrieved from http://www.npr.org

  • New York Times. (2012, March 22). Post-traumatic stress’s surprisingly positive flip side. Retrieved from http://www.nytimes.com

  • North, C. S., Suris, A. M., Davis, M., & Smith, R. P. (2009). Toward validation of the diagnosis of posttraumatic stress disorder. American Journal of Psychiatry, 166, 34–41. doi:10.1176/appi.ajp.2008.08050644.

    Article  PubMed  Google Scholar 

  • O’Brien, L. S. (1998). Traumatic events and mental health. Cambridge: Cambridge University Press.

    Book  Google Scholar 

  • Perkonigg, A., Pfister, H., Stein, M. B., Hofler, M., Lieb, R., et al. (2005). Longitudinal course of posttraumatic stress disorder and post-traumatic stress disorder symptoms in a community sample of adolescents and young adults. American Journal of Psychiatry, 162(7), 1320–1327. doi:10.11776/appi.ajp.162.7.1320.

    Article  PubMed  Google Scholar 

  • Rado, S. (1941). Pathodynamics and treatment of traumatic war neurosis (traumatophobia). Psychosomatic Medicine, 4, 362–368.

    Article  Google Scholar 

  • Resick, P. A., & Miller, M. W. (2009). Posttraumatic stress disorder: Anxiety of traumatic stress disorder? Journal of Traumatic Stress, 22(5), 384–390. doi:10.1002/jts.20437.

    Article  PubMed  Google Scholar 

  • Resnick, H. S., Kilpatrick, D. G., Dansky, B. S., Saunders, B. E., & Best, C. L. (1993). Prevalence of civilian trauma and posttraumatic stress disorder in a representative national sample of women. Journal of Consulting and Clinical Psychology, 61(6), 984–991.

    Article  PubMed  Google Scholar 

  • Rosen, G. M., Lilienfeld, S. O., Frueh, B. C., McHugh, P. R., & Spitzer, R. L. (2010). Reflections on PTSD’s future in DSM-5. British Journal of Psychiatry, 197, 343–344. doi:10.1192/bjp.bp.110.079699.

    Article  PubMed  Google Scholar 

  • Rosen, G. M., Spitzer, R. L., & McHugh, P. R. (2008). Problems with the post-traumatic stress disorder diagnosis and its future in DSM-5. British Journal of Psychiatry, 192, 3–4. doi:10.1192/bjp.bp.107.043083.

    Article  PubMed  Google Scholar 

  • Rosen, G. M., & Taylor, S. (2007). Pseudo-PTSD. Journal of Anxiety Disorders, 21(2), 201–210. doi:10.1016/j.anxdis.2006.09.011.

    Article  PubMed  Google Scholar 

  • Saigh, P. A., & Bremner, D. (1999). Posttraumatic stress disorder: A comprehensive text. Boston, MA: Allyn & Bacon.

    Google Scholar 

  • Scheeringa, M. S., Myers, L., Putnam, F. W., & Zeanah, C. H. (2012). Diagnosing PTSD in early childhood: an empirical assessment of four approaches. Journal of Traumatic Stress, 25(4), 359–367.

    Article  PubMed  Google Scholar 

  • Scheeringa, M. S., Zeanah, C. H., & Cohen, J. A. (2011). PTSD in children and adolescents: Towards an empirically based algorithm. Depression and Anxiety, 28(9), 770–782. doi:10.1002/da.20736.

    Article  PubMed  Google Scholar 

  • Schlenger, W. E., Caddell, J. M., Ebert, L., Jordan, B. K., Rourke, K. M., et al. (2002). Psychological reactions to terrorist attacks: Findings from the national study of Americans’ reactions to Sept 11. Journal of the American Medical Association, 288(5), 581–588. doi:10.1001/jama.288.5.581.

    Article  PubMed  Google Scholar 

  • Scott, W. (1990). PTSD in DSM-III: A case in the politics of diagnosis and disease. Social Problems, 37(3), 294–310.

    Article  Google Scholar 

  • Schnurr, P. P. (1991). PTSD and combat-related psychiatric symptoms in older veterans. PTSD Research Quarterly, 2, 1–6.

    Google Scholar 

  • Shephard, B. (2004). Risk factors and PTSD. In G. M. Rosen (Ed.) Posttraumatic Stress Disorder (pp. 39–61). Chichester: Wiley.

    Chapter  Google Scholar 

  • Shay, J. (1991). Learning about combat stress from Homer’s Illiad. Journal of Traumatic Stress, 4, 561–579.

    Article  Google Scholar 

  • Silver, R. C., Holman, E. A., McIntosh, D. N., Poulin, M., & Gil-Rivas, V. (2002). Nationwide longitudinal study of psychological responses to Sept 11. Journal of the American Medical Association, 288(10), 1235–1244. doi:10.1001/jama.288.10.1235.

    Article  PubMed  Google Scholar 

  • Spitzer, R. L., First, M. B., & Wakefield, J. C. (2007). Saving PTSD from itself in DSM-5. Journal of Anxiety Disorders, 21, 233–241. doi:10.1016/j.janxdis.2006.09.006.

    Article  PubMed  Google Scholar 

  • Stone, M. (1988). Shellshock and the psychologists. In W. F. Bynum, R. Porter, & M. Shepherd (Eds.), The anatomy of madness: Essays in the history of psychiatry. London: Tavistock.

    Google Scholar 

  • Tanielian, T. L., Jaycox, L., & Rand Corporation (Eds.). (2008). Invisible wounds of war: Psychological and cognitive injuries, their consequences, and services to assist recovery. Santa Monica, CA: RAND.

    Google Scholar 

  • Trimble, M. R. (1981). Post-traumatic neurosis: From railway spine to the whiplash. Chichester: Wiley.

    Google Scholar 

  • van der Kolk, B. A. (2007). The history of trauma in psychiatry. In M. J. Friedman, T. M. Keane, & P. A. Resick (Eds.), Handbook of PTSD: Science and practice (pp. 19–36). New York, NY: Guilford.

    Google Scholar 

  • van der Kolk, B. A., & Pynoos, R. (2009). Proposal to include a developmental trauma disorder diagnosis for children and adolescents in DSM-5. Retrieved from http://www.traumacenter.org/announcements/DTD_papers_Oct_09.pdf

  • van der Kolk, B. A., Roth, S., Pelcovitz, D., Sunday, S., & Spinazzola, J. (2005). Disorders of extreme stress: The empirical foundation of a complex adaptation to trauma. Journal of Traumatic Stress, 18(5), 389–399. doi:10.1002/jts.20047.

    Article  PubMed  Google Scholar 

  • Warden, D. (2006). Military TBI during the Iraq and Afghanistan Wars. Journal of Head Trauma Rehabilitation, 5, 398–402.

    Article  Google Scholar 

  • Wittchen, H. U., & Jacobi, F. (2005). Size and burden of mental disorders in European Union. European Neuropsychopharmacology, 15, 357–376.

    Article  PubMed  Google Scholar 

  • Wittchen H. U., Gloster A., Beesdo K., Schoenfeld S., & Perkonigg, A. (2009). Posttraumatic stress disorder: Diagnostic and epidemiological perspectives. CNS Spectrums, 14(1), 5–12.

    PubMed  Google Scholar 

  • Yehuda, R., & Bierer, L. M. (2009). The relevance of epigenetics to PTSD: Implications for the DSM-V. Journal of Traumatic Stress, 22(5), 427–434. doi:10.1002/jts.20448

    Article  PubMed Central  PubMed  Google Scholar 

  • Young, A. (1995). The harmony of illusions: Inventing post-traumatic stress disorder. Princeton, NJ: Princeton University Press.

    Google Scholar 

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Authors and Affiliations

  1. James Madison University, Harrisonburg, VA, 22807, USA

    Lennis G. Echterling, Thomas A. Field & Anne L. Stewart

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  1. Lennis G. Echterling
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  2. Thomas A. Field
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  3. Anne L. Stewart
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Correspondence to Lennis G. Echterling .

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Editors and Affiliations

  1. Department of Psychology, University of Haifa, Haifa, Israel

    Marilyn P. Safir

  2. Department of Psychology, University of Haifa, Haifa, Israel

    Helene S. Wallach

  3. Department of Psychiatry and School of Gerontology, University of Southern California Institute for Creative Technologies, Los Angeles, California, USA

    Albert "Skip" Rizzo

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Echterling, L.G., Field, T.A., Stewart, A.L. (2015). Evolution of PTSD Diagnosis in the DSM . In: Safir, M., Wallach, H., Rizzo, A. (eds) Future Directions in Post-Traumatic Stress Disorder. Springer, Boston, MA. https://doi.org/10.1007/978-1-4899-7522-5_9

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