Diagnostic criteria for posttraumatic stress disorder are lacking

The relevancy of an individual's subjective experience in determining what constitutes a traumatic event has been a source of debate among PTSD specialists for years. The study concludes that both objective and subjective factors are relevant and that current PTSD criteria are missing several reactions that many trauma survivors experience.

The study's authors conducted a comprehensive literature review of the research on peritraumatic experiences and the types of reactions that trauma survivors often demonstrate. They found that individuals adapt to extreme experiences in a highly complex and coordinated manner.

"A person's response is multifaceted and may include appraisals and other thoughts, a variety of felt emotions and behaviors. It's not enough to rely on the objective qualities of an experience to determine whether it should be considered traumatic or not," said co-author Brian P. Marx, PhD, an associate professor of psychiatry at Boston University School of Medicine and psychologist at the VA National Center for PTSD. "Trauma should be defined as the interaction between the individual and his or her environment and all parts of an individual's response should be considered."

PTSD is believed to be the result of exposure to trauma, so understanding what defines a traumatic experience is critical. Current criteria for PTSD in the Diagnostic and Statistical Manual include few distinct subjective emotions. The authors suggest that researchers investigate and add more appropriate examples to these criteria in order to more accurately categorize traumatic events.

"Knowing exactly what trauma is can help us to better know who is a trauma survivor and who is not," said Marx. "It is critical that we know this for the purposes of understanding the disorder as well as being better able to help those who are survivors of trauma."

These findings currently appear in Psychological Bulletin online.