The ambiguous DSM-IV/-TR term “threat to physical integrity” (p.
The DSM-5 has clarified and narrowed the types of events that qualify as “traumatic”. Stressful events not involving an immediate threat to life or physical injury such as psychosocial stressors (e.g., divorce or job loss) are not considered trauma in this definition. The DSM-5 definition of trauma requires “actual or threatened death, serious injury, or sexual violence” (p. Criterion A was retained in the DSM-5, but it was modified to restrict its inclusiveness. Some authors questioned the value of criterion A altogether, even suggesting that it should be abolished. Some trauma experts criticized criterion A in the DSM-IV as too inclusive and warned that this change had the potential to promote “conceptual bracket creep” or “criterion creep”. Criterion A is not only the most fundamental part of the nosology of PTSD, but also its most controversial aspect. PTSD begins with criterion A, which requires exposure to a traumatic event.
This is the only diagnostic category in the DSM -5 that is not grouped conceptually by the types of symptoms characteristic of the disorders in it. Other disorders included in this diagnostic category are adjustment disorder, reactive attachment disorder, disinhibited social engagement disorder, and acute stress disorder. This diagnostic category is distinctive among psychiatric disorders in the requirement of exposure to a stressful event as a precondition. In the DSM-5, PTSD was placed in a new diagnostic category named “Trauma and Stressor-related Disorders” indicating a common focus of the disorders in it as relating to adverse events. Considerable research has demonstrated that PTSD entails multiple emotions (e.g., guilt, shame, anger) outside of the fear/anxiety spectrum, thus providing evidence inconsistent with inclusion of PTSD with the anxiety disorders. Perhaps the most substantial conceptual change in the DSM-5 for PTSD was the removal of the disorder from the anxiety disorders category. Specifically, it will critically examine the DSM-5 diagnostic criteria for PTSD, review changes in the criteria made in the DSM-5, and consider how the criteria shape current conceptualizations of PTSD. This article will explore the nosology of the current diagnosis of PTSD. Regardless, the changes in the diagnostic criteria for PTSD from DSM-IV/-TR to DSM-5 were substantial. 548), with the appreciation that because important clinical and scientific consequences could result from any modifications to the diagnostic criteria, the work group needed to have very strong evidence before making any changes. This was described as a “very conservative approach” (p.
DSM 5 APA CITATION PROFESSIONAL
The revision efforts included an extensive review of literature, secondary analyses, professional presentations and town halls, vigorous debates among trauma experts and nosologists, and rounds of public and professional reviews of the proposed criteria.
The fifth edition ( DSM-5) of the criteria required seven years of planning, six years of actual work group activity, and a year to finalize the materials for publication and obtain the approval of the APA Assembly and Board of Trustees. Therefore, this article will refer to these two versions together as DSM-IV/-TR.
DSM 5 APA CITATION MANUAL
Although the subsequent DSM-IV text revision edition of the manual ( DSM-IV-TR) revised the text accompanying the criteria, the diagnostic criteria for PTSD did not change in this version.
The literature accumulating during this time presented various polemical arguments concerning the definition of trauma and even questioning the need for it in the definition of PTSD, which and how many symptoms to include in the PTSD criteria and how they should be grouped, and even whether PTSD is a valid diagnosis at all. Following publication of the fourth edition of the DSM ( DSM-IV) in 1994, PTSD experts criticized the criteria extensively, proposing myriad ways to address the problems they identified. With each revision of the DSM, the criteria for PTSD have changed substantially. Posttraumatic stress disorder (PTSD) has attracted controversy since its introduction as a psychiatric disorder in the third edition of the American Psychiatric Association’s (APA) Diagnostic and Statistical Manual of Mental Disorders ( DSM-III) in 1980.
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