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Considering PTSD for DSM-5.

Publication ,  Journal Article
Friedman, MJ; Resick, PA; Bryant, RA; Brewin, CR
Published in: Depress Anxiety
September 2011

This is a review of the relevant empirical literature concerning the DSM-IV-TR diagnostic criteria for PTSD. Most of this work has focused on Criteria A1 and A2, the two components of the A (Stressor) Criterion. With regard to A1, the review considers: (a) whether A1 is etiologically or temporally related to the PTSD symptoms; (b) whether it is possible to distinguish "traumatic" from "non-traumatic" stressors; and (c) whether A1 should be eliminated from DSM-5. Empirical literature regarding the utility of the A2 criterion indicates that there is little support for keeping the A2 criterion in DSM-5. The B (reexperiencing), C (avoidance/numbing) and D (hyperarousal) criteria are also reviewed. Confirmatory factor analyses suggest that the latent structure of PTSD appears to consist of four distinct symptom clusters rather than the three-cluster structure found in DSM-IV. It has also been shown that in addition to the fear-based symptoms emphasized in DSM-IV, traumatic exposure is also followed by dysphoric, anhedonic symptoms, aggressive/externalizing symptoms, guilt/shame symptoms, dissociative symptoms, and negative appraisals about oneself and the world. A new set of diagnostic criteria is proposed for DSM-5 that: (a) attempts to sharpen the A1 criterion; (b) eliminates the A2 criterion; (c) proposes four rather than three symptom clusters; and (d) expands the scope of the B-E criteria beyond a fear-based context. The final sections of this review consider: (a) partial/subsyndromal PTSD; (b) disorders of extreme stress not otherwise specified (DESNOS)/complex PTSD; (c) cross- cultural factors; (d) developmental factors; and (e) subtypes of PTSD.

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Published In

Depress Anxiety

DOI

EISSN

1520-6394

Publication Date

September 2011

Volume

28

Issue

9

Start / End Page

750 / 769

Location

United States

Related Subject Headings

  • Stress Disorders, Post-Traumatic
  • Reproducibility of Results
  • Psychometrics
  • Psychiatry
  • Life Change Events
  • Humans
  • Dissociative Disorders
  • Diagnostic and Statistical Manual of Mental Disorders
  • Diagnosis, Differential
  • Cross-Cultural Comparison
 

Citation

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Friedman, M. J., Resick, P. A., Bryant, R. A., & Brewin, C. R. (2011). Considering PTSD for DSM-5. Depress Anxiety, 28(9), 750–769. https://doi.org/10.1002/da.20767
Friedman, Matthew J., Patricia A. Resick, Richard A. Bryant, and Chris R. Brewin. “Considering PTSD for DSM-5.Depress Anxiety 28, no. 9 (September 2011): 750–69. https://doi.org/10.1002/da.20767.
Friedman MJ, Resick PA, Bryant RA, Brewin CR. Considering PTSD for DSM-5. Depress Anxiety. 2011 Sep;28(9):750–69.
Friedman, Matthew J., et al. “Considering PTSD for DSM-5.Depress Anxiety, vol. 28, no. 9, Sept. 2011, pp. 750–69. Pubmed, doi:10.1002/da.20767.
Friedman MJ, Resick PA, Bryant RA, Brewin CR. Considering PTSD for DSM-5. Depress Anxiety. 2011 Sep;28(9):750–769.
Journal cover image

Published In

Depress Anxiety

DOI

EISSN

1520-6394

Publication Date

September 2011

Volume

28

Issue

9

Start / End Page

750 / 769

Location

United States

Related Subject Headings

  • Stress Disorders, Post-Traumatic
  • Reproducibility of Results
  • Psychometrics
  • Psychiatry
  • Life Change Events
  • Humans
  • Dissociative Disorders
  • Diagnostic and Statistical Manual of Mental Disorders
  • Diagnosis, Differential
  • Cross-Cultural Comparison