PTSD: A problematic diagnostic category

Research output: Contribution to journalReview articlepeer-review

134 Scopus citations


Since the publication of Diagnostic and Statistical Manual of Mental Disorders (DSM)-III, posttraumatic stress disorder (PTSD) has become a remarkably dominant theme in mental health discourse and diagnostic practice. This development has been encouraged by the diagnosis being officially presumed to exist in acute, chronic, delayed, complex, subdromal, and even "masked" forms. Here, we present an historical and clinical review that indicates how, since 1980, the term PTSD (along with its dubious embellishments) replaced established views on mental responses to trauma to the detriment of patient care and psychiatric investigation. From this historical perspective, we review and evaluate the natural course of emotional and behavioral reactions to traumatic experiences, and as well their assessment, formulation, and therapeutic management in both civilian and military situations. From this we conclude that the concept of PTSD has moved the mental health field away from, rather than towards a better understanding of the natural psychological responses to trauma. A return to prior standards of diagnostic practice and therapeutic planning would greatly benefit patient care, rehabilitative services to veterans, and epidemiologic research.

Original languageEnglish (US)
Pages (from-to)211-222
Number of pages12
JournalJournal of Anxiety Disorders
Issue number2
StatePublished - 2007


  • Accident neurosis
  • Battle fatigue
  • DSM
  • Dissociation
  • PTSD
  • Psychiatric diagnosis
  • Stress
  • Trauma
  • Vietnam war
  • War neurosis

ASJC Scopus subject areas

  • Clinical Psychology
  • Psychiatry and Mental health


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