The 2013 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) includes some changes to the diagnosis of Posttraumatic Stress Disorder (PTSD). The changes are noted on the website for the DSM-5 and they are also currently conducting trials in the field in order to determine what implications of such changes will mean for patients.
The first change to the posttraumatic stress disorder diagnosis is that it will no longer be considered as an anxiety disorder and instead will be considered as one of the ‘Trauma-and-Stressor-Related-Disorders’. This is a new section that has been created to classify disorders that have been brought on by specific traumas in the patient’s life rather than just general anxiety.
The criteria for categorizing the meaning of a traumatic event known as Criterion A1 has been reworded to be explained as exposure to death or sexual violence or threats of death or sexual violence. The possibilities for the individual being considered having Criterion A1 are that the individual directly experienced the situation, had it happen to a family member or friend or that the individual was a witness to the event occurring to a third party.
A second set of criteria known as Criterion A2 which refers to how the individual deals with the effects of being involved in the traumatic event and as a result ended up developing posttraumatic stress disorder will be removed from the diagnostic criteria. The reason for this change is that is has been documented through research that the posttraumatic stress disorder patients reacted to the traumatic event in various ways. For example, patients did not respond immediately to the event by feeling fear, a feeling of helplessness or a feeling of shock. This response was especially common with regard to military personel.
Another change that has been made in the DSM-5 is that symptoms of posttraumatic stress disorder are split into groups instead of being considered all as plausible symptoms of posttraumatic stress disorder in a single individual. The DSM-5 splits them into two groups. One of the sets of symptoms deals with avoidance issues with regard to dealing with the trauma.
There will be new symptoms of the disorder to be introduced in the DSM-5 that include details about being numb to the traumatic event (i.e. being unable to remember details of the event, lack of interest in previously enjoyed activities and feeling detached). A few additional changes have been made that will also impact the diagnosis of posttraumatic stress disorder.
The data has not yet been published as to how the new definitions of what constitutes Posttraumatic Stress Disorder will impact how common the disorder is in various populations because the changes are likely to significantly impact the way that the disorder is categorized in patients. The field trials however once they are published will provide greater inside into exactly how the rates will change with the changes to the DSM-5.