by Sergio Silva, M.D.

Created on: August 20, 2009

Understanding PTSD (Post-Traumatic Stress Disorder)

The term "PTSD" (Post-Traumatic Stress Disorder) has entered the popular vernacular, such that it is a term that is bandied about fairly commonly, and often incorrectly. Many times what people mean when they say "PTSD" is actually what psychiatrists classify as an Acute Stress Disorder (308.3), or an Adjustment Disorder with Anxiety (309.24), according to the Diagnostic and Statistical Manual of Mental Disorders, fourth edition, text revision (DSM-IV-TR), the publication that mental health scientists use to operationally define psychiatric syndromes for the purposes of carrying out research.

In psychiatry there are no diagnostic blood tests or definitive biopsy samples; instead, diagnoses are arrived at by considering the presentation, history, and serial mental status examinations and by ruling out other medical conditions for which more objective laboratory tests and diagnostic procedures are available. Because mental health diagnosis is therefore inherently more subjective, in order to ensure that researchers were talking about the same clinical phenomenon it became necessary to devise a convenient method of classifying the various psychiatric disorders according to certain diagnostic criteria. This article briefly outlines the DSM-IV-TR diagnostic criteria for PTSD, so you can understand what doctors mean when they use the term and to improve communication between you and your healthcare provider, if you feel that you may be suffering from this disorder.

Before enumerating the established diagnostic criteria, it's worth emphasizing again that all DSM criteria were developed, by consensus, among panel members of the American Psychiatric Association for the purpose of improving communication among researchers and ensuring the cross-validity of their studies. The DSM is chiefly followed to make sure that one group of researchers studying "PTSD" is actually studying the same disorder as another group studying "PTSD," so that meaningful conclusions can be drawn and comparisons can be made.

Clinicians-practitioners seeing patients in a treatment, as opposed to a research, setting-are generally encouraged to follow the same guidelines, but the difference is that in the clinic we are less concerned with statistics and more concerned with patient outcome. Accordingly, if the DSM indicates that "4 out of 5 of the following criteria must be met for a diagnosis" of this or that disorder to be

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