Bret S. Stetka, MD; Christoph U. Correll, MD


May 21, 2013

In This Article

Posttraumatic Stress Disorder

The Change

Formerly in the "Anxiety Disorders" chapter, in DSM-5 posttraumatic stress disorder (PTSD) is now included in a new chapter titled "Trauma- and Stressor-Related Disorders." Furthermore, a fourth diagnostic cluster (in addition to Criteria B, C, and D) capturing behavioral symptoms has been added. The 6 diagnostic criteria included in DSM-IV were maintained, with minor revisions, and 2 additional criteria have been added: (1) negative alterations in cognition and mood associated with the traumatic event, beginning or worsening after the event, and (2) the disturbance is not attributed to the direct physiologic effects of a substance or another medical condition.

In addition, a new diagnostic subtype has been created to include preschool-aged children with PTSD symptoms. Finally, DSM-5 further defines traumatic events, criteria are more culturally applicable, and the prior distinction between acute and chronic PTSD has been removed.

The Implications

The creation of a separate chapter on trauma- and stressor-related disorders will give PTSD the appropriate attention that it deserves as a condition with associated, traceable causal factors that should be addressed. The highlighting of behavioral aspects of PTSD by the creation of a fourth dimension will also probably help focus clinicians' attention on this important component of the disease. The new criteria will also better characterize PTSD in pediatric populations, who unfortunately are all too often victims of PTSD.