Defining traumatic events: An examination of the a criteria

The PTSD definition has been continuously readdressed over the years, with the debate on diagnosis criteria beginning during the disorder's infancy in World War I and continuing to present day. Recent debate has focused on which type of events should be considered traumatic events, capable of producing psychopathology. This chapter examines empirical evidence regarding the appropriateness of the DSM-IV A1 and A2 criteria. A number of studies have revealed the A1 criterion is a poor predictor of PTSD symptoms. In addition, events associated with anger or sadness responses are associated with equivalent levels of PTSD symptoms as events associated with fear. Individuals' centralization, perceptions, and emotional reactions to an event appear to play a critical role in the capability of an event to produce PTSD symptoms. A basic mechanisms viewpoint of PTSD is discussed as a way to explain PTSD as a memory-based disorder rather than event-based. Additional considerations are discussed in respect to recent concerns of "bracket creep" and the importance of preserving PTSD as a legitimate psychological disorder. Experiencing a traumatic event can result in a myriad of psychological and physical health problems. However, individuals differ greatly in the extent to which they are affected by traumatic events (see Bonanno, 2005). Some people are highly resilient and within a few days exhibit little to no negative effects of the traumatic event. Others are initially traumatized and experience PTSD symptoms for several weeks, but symptoms slowly extinguish over the course of a month. However, approximately 8% of individuals who experience a traumatic event continue to experience severe PTSD symptoms beyond the course of one month, sometimes lasting years or decades. An important question for trauma researchers is why some people recover relatively quickly, whereas others develop PTSD. Central to this question is the types of events capable of producing PTSD.