The DOI matches its Crossref record; 67 of the 67 references it cites were found in a registry or an index.
636,120 Ways to Have Posttraumatic Stress Disorder
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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In the citing paper
“Variation in results may reflect heterogeneity of the causes, symptoms (120), and underlying reward mechanisms (121) of posttraumatic stress.”
From A transdiagnostic perspective on social anhedonia (2019) · cites this paper as [120]
In the citing paper
“Patients with the same diagnosis may show different symptom profiles [1], which may also vary over time.”
From Using person-specific networks in psychotherapy: challenges, limitations, and how we could use them anyway (2020) · cites this paper as [1]
In the citing paper
“A further argument is that, when using the DSM-5 definition of PTSD, there are 636,120 permutations of how the disorder may present 169 , which may impair the identification of meaningful biomarkers.”
From Post‐traumatic stress disorder: a state‐of‐the‐art review of evidence and challenges (2019) · cites this paper as [169]
Citations
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Cited by
Sorted by citations
Moving Forward: Challenges and Directions for Psychopathological Network Theory and Methodology
Fried, E. I., & Cramer, A. O. J. (2017) · Perspectives on Psychological Science · doi:10.1177/1745691617705892 · Cited by 1,015
Transdiagnostic approaches to mental health problems: Current status and future directions.
Dalgleish, T., Black, M., Johnston, D., & Bevan, A. (2020) · Journal of Consulting and Clinical Psychology · doi:10.1037/ccp0000482 · Cited by 883
Galatzer-Levy, I. R., Huang, S. H., & Bonanno, G. A. (2018) · Clinical Psychology Review · doi:10.1016/j.cpr.2018.05.008 · Cited by 878
Self-citationClark, L. A., Cuthbert, B., Lewis-Fernández, R., Narrow, W. E., & Reed, G. M. (2017) · Psychological Science in the Public Interest · doi:10.1177/1529100617727266 · Cited by 688
A review of current evidence regarding the ICD-11 proposals for diagnosing PTSD and complex PTSD
Brewin, C. R., Cloitre, M., Hyland, P., Shevlin, M., Maercker, A., Bryant, R. A., Humayun, A., Jones, L. M., Kagee, A., Rousseau, C., et al. (2017) · Clinical Psychology Review · doi:10.1016/j.cpr.2017.09.001 · Cited by 678
Self-citation
Metadata
- 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
- 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
- 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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