New Study Examines Revisions to PTSD Diagnosis Criteria

There are several criteria that must be met for an individual to receive a clinical diagnosis of post-traumatic stress (PTSD). According to the current version of the Diagnostic and Statistical Manual for Mental Disorders (DSM-IV), an individual must have experienced or witnessed a threat of death or injury to himself/herself or someone else, and this event must elicit responses of helplessness, intense fear, or horror. The DSM-V intends to remove these criteria based on evidence that these reactions to the described events do not necessarily predict the development of PTSD. However, some researchers and mental health professionals believe that the reactions of helplessness, fear, and horror are more predictive of PTSD than the traumatic experience itself.

To determine how each of these criteria influence PTSD, Patricia K. Kerig of the Department of Psychology at the University of Utah recently conducted a study that examined all of these symptoms in 555 juvenile offenders who had been exposed to trauma. The adolescents were evaluated for symptom severity and the presence of the three criteria. Kerig found that there was a direct relationship between feelings of helplessness and PTSD. She also discovered that confusion and disorganized behavior, often seen as peritraumatic symptoms, were more strongly associated with PTSD than the symptoms of fear and horror.

The study also identified a distinction between how the female survivors expressed peritraumatic symptoms when compared to the male survivors. With respect to numbing, the male participants demonstrated numbing reactions through helplessness, while the female participants used dissociation as a method of numbing. Kerig believes that because women often experience trauma at the hands of family members, dissociation could be their way of protecting their attachment to their abuser. This study shows that there are a number of ways in which individuals express PTSD and that these manifestations can vary by age, gender and experience. “Therefore, these results suggest the importance of continuing to develop developmentally sensitive and empirically based indices of PTSD in young people,” Kerig said.

Kerig, P. K., Bennett, D. C. (2012). Beyond fear, helplessness, and horror: Peritraumatic reactions associated with posttraumatic stress symptoms among traumatized delinquent youth. Psychological Trauma: Theory, Research, Practice, and Policy. Advance online publication. doi: 10.1037/a0029609

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  • Paul


    September 8th, 2012 at 5:12 AM

    I have noticed that it seems there will be many changes in diagnosis criteria for certian mental illnesses within the next diagnosis manual. Why all the changes if there is still serious disagreement over what actually constitutes the symptoms? Whom makes the decisions about what actually goes to print and if the majority of providers don’t like it, do you expect a huge uproar?

  • jose


    September 8th, 2012 at 9:41 AM

    well,Paul, there will always be revisions as we get to know more and more of the disorder and also as we understand its implications better.what may trigger ptsd in one person does not have to be present in everybody else to label the,m as having ptsd, you know.Different things could cause trauma in different individuals and as broad a definition we have the better it will be to identify potential at-risk clients.

  • Holli


    September 9th, 2012 at 5:13 AM

    I am no expert but wouldn’t the very term PTSD indicate that there at least has to have been some kind of traumatic stress to bring on those feelings?

  • Jesse


    September 9th, 2012 at 1:38 PM

    Its best to base the diagnostic criteria on research,studies like these,and also real world cases.that’s cause there is no concrete list that can be told to be definitive for any disorder its just the way we are built!

  • Reese


    September 10th, 2012 at 4:04 AM

    if this opens up the diagnosis to be more inclusive and therefore get more people help, how could that be bad?



    September 10th, 2012 at 12:28 PM

    I am extremely sure these new revisions would help>Even as a lay person I can tell that trauma is not cause only due to witnessing a traumatic event.why,it could strike just by hearing some horrible news you know!the shock factor is what matters more in this case for trauma.and witnessing an event is not necessary at all.

  • Rudy


    September 12th, 2012 at 4:44 AM

    As long as patients continue to receive proper diagnosis and care, then I think that continual revisions and updates can be important.

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