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Cited by 629Posttraumatic Stress Disorder ResearchPersonality Disorders and PsychopathologyAnxiety, Depression, Psychometrics, Treatment, Cognitive Processes

Considering PTSD for DSM-5

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Friedman, Matthew J., Resick, Patricia A., Bryant, Richard A., Brewin, Chris R.·2011·Depression and Anxiety
DOI 10.1002/da.20767
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Abstract

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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  • Other disorders are thought to be associated with or worsened by trauma, but usually do not depend on trauma for their occurrence.

    “These other disorders are thought to be associated with or exacerbated by a trauma, but are not dependent on an experience of trauma in most cases (Friedman, Resick, Bryant, & Brewin., 2011).”

    From Sexual assault victimization and psychopathology: A review and meta-analysis (2017) · cites this paper as Friedman, Resick, Bryant, & Brewin., 2011

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References 176 · Cited by 629

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Authors
Friedman, M. J., Resick, P. A., Bryant, R. A., & Brewin, C. R.
Affiliations
  • Dartmouth College (US)
  • Boston University (US)
  • UNSW Sydney (AU)
  • University College London (GB)
Corresponding author
Friedman, Matthew J.
ORCID
Venue
Depression and Anxiety
Publisher
Wiley
Published
2010-12-13
Volume
28
Issue
9
Pages
750-769
ISSN
1091-4269 (ISSN-L)
DOI
10.1002/da.20767
OpenAlex
W2125763983
Cited by
629
References
176
Citations by year
2026: 24 · 2025: 27 · 2024: 24 · 2023: 22 · 2022: 33 · 2021: 31 · 2020: 39 · 2019: 31 · 2018: 51 · 2017: 48 · 2016: 44 · 2015: 45 · 2014: 89 · 2013: 70 · 2012: 39
FWCI
41.92
Type
journal article
Language
en
Open access
Licence
doi.wiley.com/10.1002/tdm_license_1.1 (tdm, 1723 d)
Locations
  • Depression and Anxiety (publishedVersion)
  • PubMed (publishedVersion)
  • UCL Discovery (University College London) (submittedVersion)
  • Zenodo (CERN European Organization for Nuclear Research) (submittedVersion, public-domain)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
  • Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Keywords
post-traumatic stress disorder, DSM-5 diagnostic criteria, DSM-IV-TR, re-experiencing symptoms, avoidance and numbing, hyperarousal, symptom clusters, guilt and shame, dissociative symptoms, negative appraisals, subsyndromal PTSD, complex PTSD, cross-cultural factors, developmental factors, PTSD subtypes
MeSH terms
Arousal, Cross-Cultural Comparison, Diagnosis, Differential, Dissociative Disorders, Humans, Life Change Events, Psychometrics, Stress Disorders, Post-Traumatic, Reproducibility of Results, Diagnostic and Statistical Manual of Mental Disorders

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