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The most controversial of all psychiatric diagnoses just won’t lie down: and giving the problem to a committee just didn’t help.

309.81
Posttraumatic Stress Disorder
====================================

Updated August-20-2010

Posttraumatic Stress Disorder *  

 

A. The person was exposed to one or more of the following event(s): death or threatened death, actual or threatened serious injury, or actual or threatened sexual violation, in one or more of the following ways: **

  1. Experiencing the event(s) him/herself

  2. Witnessing, in person, the event(s) as they occurred to others

  3. Learning that the event(s) occurred to a close relative or closefriend; in such cases, the actual or threatened death must have been violent or accidental

  4. Experiencing repeated or extreme exposure to aversive details of the event(s)(e.g., first responders collecting body parts; police officers repeatedly exposed to details of child abuse); this does not apply to exposure through electronic media, television, movies, or pictures, unless this exposure is work related.

via dsm5.org

This is the first part of the latest version of the revised criteria for PTSD in DSM-V, from just a couple of weeks ago. There has been the hottest of debates ever since the second world war. For me the most compelling argument is that this criterion A should be abolished altogether. There are insurmountable problems with defining the event criterion, and if you can’t have the symptoms without the event, why make the event a criterion? And if you *can* have the symptoms without the event, also, why make it a criterion?

This A criterion is surely more complex than any individual would have wished. And the rest of the symptom criteria look like something written by a committee, which they were - there are twenty different symptoms to consider and combine.

I think this is an example of where the consensus reached by a committee is worse than any of the suggestions the individuals involved would have made.

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