Cited by 778Posttraumatic Stress Disorder ResearchPersonality Disorders and PsychopathologyAnxiety, Depression, Psychometrics, Treatment, Cognitive Processes

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636,120 Ways to Have Posttraumatic Stress Disorder

Galatzer-Levy, Isaac R., Bryant, Richard A.·2013·Perspectives on Psychological Science

DOI 10.1177/1745691613504115

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Abstract

In an attempt to capture the variety of symptoms that emerge following traumatic stress, the revision of posttraumatic stress disorder (PTSD) criteria in the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders ( DSM–5) has expanded to include additional symptom presentations. One consequence of this expansion is that it increases the amorphous nature of the classification. Using a binomial equation to elucidate possible symptom combinations, we demonstrate that the DSM–IV criteria listed for PTSD have a high level of symptom profile heterogeneity (79,794 combinations); the changes result in an eightfold expansion in the DSM–5, to 636,120 combinations. In this article, we use the example of PTSD to discuss the limitations of DSM-based diagnostic entities for classification in research by elucidating inherent flaws that are either specific artifacts from the history of the DSM or intrinsic to the underlying logic of the DSM’s method of classification. We discuss new directions in research that can provide better information regarding both clinical and nonclinical behavioral heterogeneity in response to potentially traumatic and common stressful life events. These empirical alternatives to an a priori classification system hold promise for answering questions about why diversity occurs in response to stressors.

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Authors: Galatzer-Levy, I. R., & Bryant, R. A.
Affiliations: New York University School of Medicine
UNSW Sydney (AU)
ORCID: Bryant, Richard A.
Venue: Perspectives on Psychological Science
Publisher: SAGE Publications
Published: 2013-11
Volume: 8
Issue: 6
Pages: 651-662
ISSN: 1745-6916 (ISSN-L)
1745-6924
DOI: 10.1177/1745691613504115
OpenAlex: W1985730575
Cited by: 778
References: 64
Citations by year: 2026: 47 · 2025: 70 · 2024: 92 · 2023: 78 · 2022: 88 · 2021: 71 · 2020: 79 · 2019: 59 · 2018: 58 · 2017: 46 · 2016: 40 · 2015: 32 · 2014: 16 · 2013: 1
FWCI: 32.97
Type: journal article
Language: en
Open access: closed
Licence: journals.sagepub.com/page/policies/text-and-data-mining-license (tdm)
Locations: Perspectives on Psychological Science (publishedVersion)
PubMed (publishedVersion)
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, DSM-IV, diagnostic criteria, symptom combinations, psychiatric classification, binomial model, potentially traumatic events

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