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Cited by 156Posttraumatic Stress Disorder ResearchChild Abuse and TraumaPsychoanalysis and Psychopathology Research

The importance of the peritraumatic experience in defining traumatic stress.

Bovin, Michelle J., Marx, Brian P.·2011·Psychological Bulletin
DOI 10.1037/a0021353
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Abstract

In the Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev., DSM-IV-TR; American Psychiatric Association, 2000), posttraumatic stress disorder (PTSD) Criterion A2 stipulates that an individual must experience intense fear, helplessness, or horror during an event that threatened the life or physical integrity of oneself or others to be eligible for the PTSD diagnosis. In considering this criterion, we describe its origins, review studies that have examined its predictive validity, and reflect on the intended purpose of the criterion and how it complements the mission of the DSM. We then assert that the predictive validity of Criterion A2 may not be an appropriate metric for evaluating its worth. We also note that the current Criterion A2 may not fully capture all the salient aspects of the traumatic stress response. To support this claim, we review empirical research showing that individuals adapt to extreme environmental events by responding in a complex and coordinated manner. This complex response set involves an individual's appraisal regarding the degree to which the event taxes his or her resources, as well as a range of other cognitions (e.g., dissociation), felt emotions (e.g., fear), physiological reactions (e.g., heart rate increase), and behaviors (e.g., tonic immobility). We provide evidence that these response components may be associated with the subsequent development of PTSD. We then describe the challenges associated with accurately assess…

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  • Peritraumatic dissociation increases the risk of subsequent PTSD.

    “There is evidence that peritraumatic dissociation increases the risk of subsequent PTSD [18, 25–30].”

    From Dissociation and Alterations in Brain Function and Structure: Implications for Borderline Personality Disorder (2017) · cites this paper as [25]

  • The DSM criteria for PTSD have been challenged by several authors and impose limitations not relevant to the theory of SE; most importantly, DSM V requires exposure to a situation threatening to life or body, and limits the range of peri-traumatic emotion acceptable for this diagnosis.

    “The criteria laid out in DSM IV and V for the diagnosis of PTSD have been challenged by several authors (Shin and Handwerger, 2009; Bovin and Marx, 2011; Scaglione and Lockwood, 2014) and impose limitations not relevant to the theory of SE; most importantly, the DSM V requires exposure to a situation which is threatening to life or body, and limits the range of peri-traumatic emotion acceptable”

    From Somatic experiencing: using interoception and proprioception as core elements of trauma therapy (2015) · cites this paper as Bovin and Marx, 2011

  • Recent authors suggest that a unitary diagnosis of PTSD should be replaced by a spectrum of trauma-related disorders.

    “Recent authors have pointed to the diversity of various kinds of trauma, suggesting that a unitary diagnosis of PTSD should be replaced by a spectrum of trauma-related disorders (Bovin and Marx, 2011).”

    From Somatic experiencing: using interoception and proprioception as core elements of trauma therapy (2015) · cites this paper as Bovin and Marx, 2011

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Authors
Bovin, M. J., & Marx, B. P.
Affiliations
VA Boston Healthcare System (US)
ORCID
Venue
Psychological Bulletin
Publisher
American Psychological Association (APA)
Published
2011
Volume
137
Issue
1
Pages
47-67
ISSN
  • 0033-2909 (ISSN-L)
  • 1939-1455
DOI
10.1037/a0021353
OpenAlex
W1969391069
Cited by
156
References
36
Citations by year
2026: 6 · 2025: 12 · 2024: 6 · 2023: 9 · 2022: 8 · 2021: 14 · 2020: 17 · 2019: 7 · 2018: 6 · 2017: 6 · 2016: 10 · 2015: 9 · 2014: 11 · 2013: 12 · 2012: 15
FWCI
12.32
Type
journal article
Language
en
Open access
closed
Locations
  • Psychological Bulletin (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
  • Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
  • Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
Keywords
post-traumatic stress disorder, traumatic stress response, DSM-IV-TR, predictive validity, fear and helplessness, dissociation, tonic immobility, physiological arousal, environmental stressors
MeSH terms
Anger, Cognition, Emotions, Fear, Humans, Life Change Events, Models, Psychological, Stress Disorders, Post-Traumatic, Stress, Psychological, Diagnostic and Statistical Manual of Mental Disorders

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