Examining New PTSD DSM-5 Diagnosis Criteria
Author: Boston University Medical Center
Published: 2012/09/06 - Updated: 2024/04/24
Publication Type: Research, Study, Analysis
Peer-Reviewed: Yes
Topic: Psychological Disorders - Publications List
Page Content: Synopsis - Introduction - Main
Synopsis: Study indicates proposed changes to the DSM diagnosis of post-traumatic stress disorder will not substantially affect number of people who meet criteria for the disorder.
• The Diagnostic and Statistical Manual of Mental Disorders (DSM), the handbook that defines psychiatric disorders, has been undergoing revisions for the past decade in advance of the publication of its fifth edition (DSM-5).
• The proposed revisions for DSM-5 involve clarification regarding what constitutes a traumatic event, the addition symptoms such as self-destructive behavior and distorted blaming of oneself or others for the traumatic event and a reorganization of the diagnostic decision rules for establishing a diagnosis of PTSD. Critics have raised concerns about the revision process, noting that some of the new symptoms are not unique to PTSD. They believe that the proposed changes could lead to a number of misdiagnoses, which could artificially increase the number of patients with the disorder.
Introduction
Results of a study led by researchers at Boston University School of Medicine (BUSM) and the Veterans Affairs (VA) Boston Healthcare System indicate that the proposed changes to the diagnosis of post-traumatic stress disorder (PTSD) will not substantially affect the number of people who meet criteria for the disorder.
Main Item
Mark W. Miller, PhD, associate professor at BUSM and a clinical research psychologist at the National Center for PTSD at VA Boston Healthcare System served as lead author of the study, which is published online in Psychological Trauma: Theory, Research, Practice and Policy.
The Diagnostic and Statistical Manual of Mental Disorders (DSM), the handbook that defines psychiatric disorders, has been undergoing revisions for the past decade in advance of the publication of its fifth edition (DSM-5). Included in the proposed revisions are the first major changes to the PTSD diagnosis since its initial appearance in DSM-III back in 1980. These include the addition of new symptoms, revision of existing ones and a new set of diagnostic criteria.
According to DSM-IV, the criteria for a diagnosis of PTSD include exposure to a traumatic event, persistent re-experiencing of the traumatic event, avoidance and emotional numbing, and persistent hyperarousal and hyper-vigilance. The proposed revisions for DSM-5 involve clarification regarding what constitutes a traumatic event, the addition symptoms such as self-destructive behavior and distorted blaming of oneself or others for the traumatic event and a reorganization of the diagnostic decision rules for establishing a diagnosis of PTSD.
Critics have raised concerns about the revision process, noting that some of the new symptoms are not unique to PTSD. They believe that the proposed changes could lead to a number of misdiagnoses, which could artificially increase the number of patients with the disorder.
To address this and to collect data to inform final decisions about the PTSD revision, research was initiated by the DSM-5 PTSD work-group to see if these changes would affect the number of people diagnosed with PTSD. The researchers surveyed a nationally representative sample of 2,953 American adults and a second sample of 345 U.S. military veterans. They found that most of the proposed symptom changes were supported by statistical analysis and did not substantially affect the number of people who would meet criteria for the disorder. Based in part on these findings, the work-group responsible for the PTSD revisions are now moving forward with the proposed revisions for DSM-5.
About the Study
This research was funded primarily by the U.S. Department of Veterans Affairs Mental Health Service and the American Psychiatric Association DSM Research Program.
The study was done in collaboration with Medical University of South Carolina, National Center for PTSD at White River Junction VA Medical Center, Dartmouth Medical School and New England Research Institutes.
Other BUSM research collaborators include: Erika J. Wolf, PhD, assistant professor of psychiatry at BUSM and researcher at the National Center for PTSD at VA Boston Healthcare System; Terence Keane, PhD, professor and vice chairman of psychiatry at BUSM and director of the Behavioral Science Division of the National Center for PTSD and associate chief of staff for Research and Development at VA Boston Healthcare System; Brian P. Marx, PhD, professor of psychiatry at BUSM and researcher at the National Center for PTSD at VA Boston Healthcare System; and Darren W. Holowka, PhD, research assistant professor in psychiatry at BUSM and researcher at the National Center for PTSD at VA Boston Healthcare System.
Learn More About PTSD
- List of Notable People With or Had PTSD: Names of famous individuals with post-traumatic stress disorder (PTSD) or who lived with the condition during their lifetime.
- Post-traumatic Stress Disorder (PTSD) and People with Learning Disabilities: The psychological understanding of PTSD is that it represents a failure on the part of an individual to process their experience of fear.
- Symptoms of PTSD That do the Most Damage: To better treat PTSD a study examined which problems associated with PTSD actually correspond to lower quality of life.
- Gaining Insight into Anxiety Disorders, Panic Attacks, and PTSD: Information on anxiety disorders including panic disorder, obsessive compulsive disorder (OCD), and post traumatic stress disorder (PTSD).
- Post-traumatic Stress Disorder Following Orthopaedic Trauma: PTSD can hinder emotional physical and functional recovery following orthopaedic treatment.
- New Theory on Post-traumatic Stress Disorder (PTSD): Context processing problems could explain symptoms and brain imaging findings, and integrate and improve on earlier models.
Attribution/Source(s): This peer reviewed publication was selected for publishing by the editors of Disabled World (DW) due to its relevance to the disability community. Originally authored by Boston University Medical Center and published on 2012/09/06, this content may have been edited for style, clarity, or brevity. For further details or clarifications, Boston University Medical Center can be contacted at bumc.bu.edu NOTE: Disabled World does not provide any warranties or endorsements related to this article.