Exposure to trauma is certainly not a new phenomena to humankind.  Although not given a formal name until 1980, the disorder now known as PTSD has been recognized throughout the centuries by such varied names as shell shock, battle fatigue, accident neurosis, and post-rape syndrome (American Psychiatric Association [APA], 1997).  Trimble (1985) has noted that many literary heroes and heroines, including Shakespeare's Henry IV, seem to meet many of the diagnostic criteria for PTSD.

Although it had been well known that the stresses of combat could produce long-lasting psychological effects, not until 1980 did the American Psychiatric Association add PTSD to the third edition of its Diagnostic and Statistical Manual of Mental Disorders (DSM-III) nosologic classification system (Davison & Neale, 1998).  Although a somewhat controversial diagnosis at first, PTSD has become important to psychiatric theory and concept.  This is chiefly because the PTSD diagnosis stipulates that the etiological agent was outside the individual (i.e., the traumatic event) rather than a personal weakness or flaw (i.e., neurosis) (Friedman, 1996).  This emphasis on the etiological agent makes PTSD unique among other psychiatric diagnoses.  In fact, PTSD cannot be diagnosed without the known presence of a traumatic event within the patient's history  (See “Diagnosis”).

In the DSM-III (1980), a traumatic event was described as a catastrophic stressor that was outside the range of usual human experience.  Accordingly, stress reactions from “normal” daily events such as divorce, failure, rejection, etc., would have been characterized as adjustment disorders rather than PTSD  (Friedman, 1996).

Slight revisions were made to the DSM-III diagnostic criteria in DSM-III-R (1987) and DSM-IV (1994).  Most notably, the definition of what constitutes a traumatic event was altered to include events not outside the range of usual human experience, such as automobile accidents (Davison & Neale, 1998).  Also, the DSM-IV specifies that the patient needs to have an intense emotional reaction to the traumatic event, such as panic, terror, grief, or disgust.

A very similar syndrome is classified by the World Health Organization in the tenth edition of the International Statistical Classification of Diseases, Injuries, and Causes of Death (ICD-10, 1992).

à Link to "Diagnosis",  "ICD-10 Diagnosis", & "Symptoms" for more information.

Questions?  E-mail the author: Gregory Bayse 

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