The overall highly successful review article is incomplete with regard to one issue that is crucial for all those who are not experts in psychotrauma. The incompletely listed criteria for relevant trauma (A criterion) may create the impression in non-specialist readers that only “… life-threatening or potentially life-threatening external events and those associated with serious injury, …” allow a diagnosis of PTSD according to DSM-IV.
This would mean that post-traumatic stress disorder (PTSD) according to DSM-IV cannot be diagnosed in a patient who has been raped but where the rape took place without intention to kill and did not result in serious physical injury, or in a child who experienced a serious physical attack on its mother, even if all other criteria are met.
Obviously the diagnosis in both cases is PTSD, because the complete text in the DSM-IV says:
- The person has been exposed to a traumatic event in which both of the following have been present:
– “The person experienced, witnessed, or was confronted with an event or events that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others (2).”
– “[...] the person's response involved intense fear, helplessness, or horror. Note: In children, this may be expressed instead by disorganized or agitated behavior.”
Dr. med. Roland Ebner
Kinder- und Jugendpsychiatrie am Klinikum Deggendorf
Außenstelle des BKH Landshut
Perlasberger Straße 41, Deggendorf
Conflict of interest statement
The author declares that no conflict of interest exists.
|1.||American Psychiatric Association: Diagnostic and statistical manual of mental disorders. DSM-IV-TR. 4th edition, Text Revision. Washington DC; American Psychiatric Association 2000.|
|2.||Frommberger U, Angenendt J, Berger M: Post-traumatic stress disorder—a diagnostic and therapeutic challenge. Dtsch Arztebl Int 2014; 111: 59–65. VOLLTEXT|