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The Diagnostic Spectrum of Trauma-Related Disorders

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Evidence Based Treatments for Trauma-Related Psychological Disorders

Abstract

Classifying mental disorders, including traumatic stress disorders, in psychiatry has often been difficult because of the need to discriminate between normal and abnormal states. This situation is particularly difficult in the context of posttraumatic presentations because stress responses are common, and it raises issues of where a line should be drawn between normative reaction and disorder. This chapter reviews the current status of diagnostic systems for describing posttraumatic stress conditions. There has been much activity in this space in recent years because the major diagnostic systems have been undergoing significant reviews and modifications. In this context, this chapter reviews the current status of the major conditions, including posttraumatic stress disorder (PTSD), complex PTSD, acute stress disorder (ASD), acute stress reaction (ASR) and prolonged grief disorder.

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References

  • American Psychiatric Association. (1952). Diagnostic and Statistical Manual of Mental Disorders (DSM I). Washington, DC: American Psychiatric Association.

    Google Scholar 

  • American Psychiatric Association. (1968). Diagnostic and statistical manual of mental disorders (2nd ed.). Washington, DC: American Psychiatric Association.

    Google Scholar 

  • American Psychiatric Association. (1980). Diagnostic and statistical manual of mental disorders (3rd ed.). Washington, DC: American Psychiatric Association.

    Google Scholar 

  • American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: American Psychiatric Association.

    Google Scholar 

  • American Psychiatric Association. (2013). Diagnostic and statistical manual for mental disorders (5th ed.). Washington, DC: American Psychiatric Association.

    Book  Google Scholar 

  • Andrews, G., Charney, D. S., Sirovatka, P. J., & Regier, D. A. (Eds.). (2009). Stress-induced and fear circuitry disorders: Refining the research agenda for DSM-V. Arlington: American Psychiatric Association.

    Google Scholar 

  • Asmundson, G. J., Frombach, I., McQuaid, J., Pedrelli, P., Lenox, R., & Stein, M. B. (2000). Dimensionality of posttraumatic stress symptoms: A confirmatory factor analysis of DSM-IV symptom clusters and other symptom models. Behaviour Research and Therapy, 38(2), 203–214.

    Article  CAS  PubMed  Google Scholar 

  • Blanchard, E. B., & Penk, W. E. (1998). Posttraumatic stress disorder and comorbid major depression: Is the correlation an illusion? Journal of Anxiety Disorders, 12(1), 21–37.

    Article  CAS  PubMed  Google Scholar 

  • Boelen, P. A., & Prigerson, H. G. (2007). The influence of symptoms of prolonged grief disorder, depression, and anxiety on quality of life among bereaved adults: A prospective study. European Archives of Psychiatry and Clinical Neuroscience, 257(8), 444–452.

    Article  PubMed  Google Scholar 

  • Boelen, P. A., & van den Bout, J. (2005). Complicated grief, depression, and anxiety as distinct post loss syndromes: A confirmatory factor analysis study. American Journal of Psychiatry, 162(11), 2175–2177.

    Article  PubMed  Google Scholar 

  • Bonanno, G. A., Neria, Y., Mancini, A., Coifman, K. G., Litz, B., & Insel, B. (2007). Is there more to complicated grief than depression and posttraumatic stress disorder? A test of incremental validity. Journal of Abnormal Psychology, 116(2), 342–351.

    Article  PubMed  Google Scholar 

  • Brewin, C. R., Andrews, B., & Rose, S. (2000). Fear, helplessness, and horror in posttraumatic stress disorder: Investigating DSM-IV criterion A2 in victims of violent crime. Journal of Traumatic Stress, 13(3), 499–509.

    Article  CAS  PubMed  Google Scholar 

  • Brewin, C. R., Gregory, J. D., Lipton, M., & Burgess, N. (2010). Intrusive images in psychological disorders: Characteristics, neural mechanisms, and treatment implications. Psychological Review, 117(1), 210–232.

    Article  PubMed Central  PubMed  Google Scholar 

  • Bryant, R. A. (2011). Acute stress disorder as a predictor of posttraumatic stress disorder: A systematic review. Journal of Clinical Psychiatry, 72, 233–239.

    Article  PubMed  Google Scholar 

  • Bryant, R. A. (2012). Grief as a psychiatric disorder. British Journal of Psychiatry, 201, 9–10.

    Article  PubMed  Google Scholar 

  • Bryant, R. A., & Harvey, A. G. (1997). Acute stress disorder: A critical review of diagnostic issues. Clinical Psychology Review, 17(7), 757–773.

    Article  CAS  PubMed  Google Scholar 

  • Bryant, R. A., Creamer, M., O’Donnell, M. L., Silove, D., & McFarlane, A. C. (2008). A multisite study of the capacity of acute stress disorder diagnosis to predict posttraumatic stress disorder. Journal of Clinical Psychiatry, 69(6), 923–929.

    Article  PubMed  Google Scholar 

  • Bryant, R. A., Creamer, M., O’Donnell, M., Silove, D., & McFarlane, A. C. (2011a). Heart rate after trauma and the specificity of fear circuitry disorders. Psychological Medicine, 41, 2573–2580.

    Google Scholar 

  • Bryant, R. A., Friedman, M. J., Spiegel, D., Ursano, R., & Strain, J. (2011b). A review of acute stress disorder in DSM-5. Depression and Anxiety, 28(9), 802–817.

    Article  PubMed  Google Scholar 

  • Bryant, R. A., O’Donnell, M. L., Creamer, M., McFarlane, A. C., & Silove, D. (2011c). Posttraumatic intrusive symptoms across psychiatric disorders. Journal of Psychiatric Research, 45(6), 842–847.

    Article  PubMed  Google Scholar 

  • Bryant, R. A., Creamer, M., O’Donnell, M., Silove, D., McFarlane, A.C., & Forbes, D. (in press). A comparison of the capacity of DSM-IV and DSM-5 acute stress disorder definitions to predict posttraumatic stress disorder. Journal of Clinical Psychiatry.

    Google Scholar 

  • Cannistraro, P. A., Wright, C. I., Wedig, M. M., Martis, B., Shin, L. M., Wilhelm, S., & Rauch, S. L. (2004). Amygdala responses to human faces in obsessive-compulsive disorder. Biological Psychiatry, 56(12), 916–920.

    Article  PubMed  Google Scholar 

  • Cloitre, M., Courtois, C. A., Charuvastra, A., Carapezza, R., Stolbach, B. C., & Green, B. L. (2011). Treatment of complex PTSD: Results of the ISTSS expert clinician survey on best practices. Journal of Traumatic Stress, 24(6), 615–627.

    Article  PubMed  Google Scholar 

  • Cloitre, M., Garvert, D., Brewin, C.R., Bryatn, R.A., & Maercker, A. (2013). Evidence for ICD-11 PTSD and complex PTSD: A latent profile analysis. European Journal of Psychotraumatology, 4, 20706. http://dx.doi.org/10.3402/ejpt.v4i0.20706

  • Dalgleish, T., Meiser-Stedman, R., Kassam-Adams, N., Ehlers, A., Winston, F., Smith, P., et al. (2008). Predictive validity of acute stress disorder in children and adolescents. British Journal of Psychiatry, 192(5), 392–393.

    Article  PubMed  Google Scholar 

  • Ehring, T., Ehlers, A., & Glucksman, E. (2008). Do cognitive models help in predicting the severity of posttraumatic stress disorder, phobia, and depression after motor vehicle accidents? A prospective longitudinal study. Journal of Consulting and Clinical Psychology, 76(2), 219–230.

    Article  PubMed Central  PubMed  Google Scholar 

  • Elkit, A., Hyland, P. Shevlin, M. (2014). Evidence of symptom profiles consistent with posttraumatic stress disorder and complex posttraumatic stress disorder in different trauma samples. European Journal of Psychotraumatology, 5, 24221. http://dx.doi.org/10.3402/ejpt.v5.24221

  • Faravelli, C. (1985). Life events preceding the onset of panic disorder. Journal of Affective Disorders, 9(1), 103–105.

    Article  CAS  PubMed  Google Scholar 

  • Fear, N. T., Iversen, A. C., Chatterjee, A., Jones, M., Greenberg, N., Hull, L., et al. (2008). Risky driving among regular armed forces personnel from the United Kingdom. American Journal of Preventative Medicine, 35(3), 230–236.

    Article  Google Scholar 

  • Feiring, C., & Cleland, C. (2007). Childhood sexual abuse and abuse-specific attributions of blame over 6 years following discovery. Child Abuse and Neglect, 31(11–12), 1169–1186.

    Article  PubMed Central  PubMed  Google Scholar 

  • Felmingham, K., Kemp, A. H., Williams, L., Falconer, E., Olivieri, G., Peduto, A., et al. (2008). Dissociative responses to conscious and non-conscious fear impact underlying brain function in post-traumatic stress disorder. Psychological Medicine, 38(12), 1771–1780.

    Article  CAS  PubMed  Google Scholar 

  • Friedman, M. J., Resick, P. A., Bryant, R. A., & Brewin, C. R. (2011). Considering PTSD for DSM-5. Depression and Anxiety, 28, 750–769.

    Article  PubMed  Google Scholar 

  • Fujisawa, D., Miyashita, M., Nakajima, S., Ito, M., Kato, M., & Kim, Y. (2010). Prevalence and determinants of complicated grief in general population. Journal of Affective Disorders, 127(1–3), 352–358.

    Article  PubMed  Google Scholar 

  • Galatzer-Levy, I., & Bryant, R. A. (2013). 636,120 ways to have posttraumatic stress disorder: The relative merits of categorical and dimensional approaches to posttraumatic stress. Perspectives in Psychological Science, 8, 651–662.

    Article  Google Scholar 

  • Golden, A.-M., & Dalgleish, T. (2010). Is prolonged grief distinct from bereavement-related posttraumatic stress? Psychiatry Research, 178, 336–341.

    Article  PubMed  Google Scholar 

  • Griffin, M. G., Resick, P. A., & Mechanic, M. B. (1997). Objective assessment of peritraumatic dissociation: Psychophysiological indicators. American Journal of Psychiatry, 154(8), 1081–1088.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  • Harvey, A. G., & Bryant, R. A. (2002). Acute stress disorder: A synthesis and critique. Psychological Bulletin, 128(6), 886–902.

    Article  PubMed  Google Scholar 

  • Herman, J. L. (1992). Complex PTSD: A syndrome in survivors of prolonged and repeated trauma. Journal of Traumatic Stress, 5(3), 377–391.

    Article  Google Scholar 

  • Horowitz, M. J. (2007). Understanding and ameliorating revenge fantasies in psychotherapy. American Journal of Psychiatry, 164(1), 24–27.

    Article  PubMed  Google Scholar 

  • Isserlin, L., Zerach, G., & Solomon, Z. (2008). Acute stress responses: A review and synthesis of ASD, ASR, and CSR. American Journal of Orthopsychiatry, 78(4), 423–429.

    Article  PubMed  Google Scholar 

  • Jakupcak, M., Conybeare, D., Phelps, L., Hunt, S., Holmes, H. A., Felker, B., et al. (2007). Anger, hostility, and aggression among Iraq and Afghanistan war veterans reporting PTSD and subthreshold PTSD. Journal of Traumatic Stress, 20(6), 945–954.

    Article  PubMed  Google Scholar 

  • Kaufman, M. L., Kimble, M. O., Kaloupek, D. G., McTeague, L. M., Bachrach, P., Forti, A. M., et al. (2002). Peritraumatic dissociation and physiological response to trauma-relevant stimuli in Vietnam combat veterans with posttraumatic stress disorder. The Journal of Nervous and Mental Disease, 190(3), 167–174.

    Article  PubMed  Google Scholar 

  • King, D. W., Leskin, G. A., King, L. A., & Weathers, F. W. (1998). Confirmatory factor analysis of the clinician-administered PTSD Scale: Evidence for the dimensionality of posttraumatic stress disorder. Psychological Assessment, 10(2), 90–96.

    Article  Google Scholar 

  • Knefel, M., & Lueger-Schuster, B. (2013). An evaluation of ICD-11 PTSD and complex PTSD criteria in a sample of adult survivors of childhood institutional abuse. European Journal of Psychotraumatology, 4, 22608. http://dx.doi.org/10.3402/ejpt.v4i0.22608

  • Lanius, R. A., Brand, B., Vermetten, E., Frewen, P. A., & Spiegel, D. (2012). The dissociative subtype of posttraumatic stress disorder: Rationale, clinical and neurobiological evidence, and implications. Depression and Anxiety, 29(8), 701–708.

    Article  PubMed  Google Scholar 

  • Leskela, J., Dieperink, M., & Thuras, P. (2002). Shame and posttraumatic stress disorder. Journal of Traumatic Stress, 15(3), 223–226.

    Article  PubMed  Google Scholar 

  • Maercker, A., Brewin, C. R., Bryant, R. A., Cloitre, M., Reed, G. M., van Ommeren, M., et al. (2013a). Proposals for mental disorders specifically associated with stress in the International Classification of Diseases-11. Lancet, 381(9878), 1683–1685.

    Article  PubMed  Google Scholar 

  • Maercker, A., Brewin, C. R., Bryant, R. A., Cloitre, M., van Ommeren, M., Jones, L. M., et al. (2013b). Diagnosis and classification of disorders specifically associated with stress: Proposals for ICD-11. World Psychiatry, 12(3), 198–206.

    Article  PubMed Central  PubMed  Google Scholar 

  • Manfro, G. G., Otto, M. W., McArdle, E. T., Worthington, J. J., 3rd, Rosenbaum, J. F., & Pollack, M. H. (1996). Relationship of antecedent stressful life events to childhood and family history of anxiety and the course of panic disorder. Journal of Affective Disorders, 41(2), 135–139.

    Article  CAS  PubMed  Google Scholar 

  • Marshall, G. N. (2004). Posttraumatic stress disorder symptom checklist: Factor structure and English-Spanish measurement invariance. Journal of Traumatic Stress, 17(3), 223–230.

    Article  PubMed  Google Scholar 

  • McCabe, R. E., Antony, M. M., Summerfeldt, L. J., Liss, A., & Swinson, R. P. (2003). Preliminary examination of the relationship between anxiety disorders in adults and self-reported history of teasing or bullying experiences. Cognitive Behavior Therapy, 32(4), 187–193.

    Article  Google Scholar 

  • Melhem, N. M., Porta, G., Shamseddeen, W., Payne, M. W., & Brent, D. A. (2011). Grief in children and adolescents bereaved by sudden parental death. Archives of General Psychiatry, 68, 911–919.

    Article  PubMed Central  PubMed  Google Scholar 

  • Milad, M. R., Rauch, S. L., Pitman, R. K., & Quirk, G. J. (2006). Fear extinction in rats: Implications for human brain imaging and anxiety disorders. Biological Psychology, 73(1), 61–71.

    Article  PubMed  Google Scholar 

  • Morina, N., Rudari, V., Bleichhardt, G., & Prigerson, H. G. (2010). Prolonged grief disorder, depression, and posttraumatic stress disorder among bereaved Kosovar civilian war survivors: A preliminary investigation. International Journal of Social Psychiatry, 56(3), 288–297.

    Article  PubMed  Google Scholar 

  • Nixon, R. D. V., Bryant, R. A., Moulds, M. L., Felmingham, K. L., & Mastrodomenico, J. A. (2005). Physiological arousal and dissociation in acute trauma victims during trauma narratives. Journal of Traumatic Stress, 18(2), 107–113.

    Article  PubMed  Google Scholar 

  • O’Donnell, M. L., Creamer, M., McFarlane, A., Silove, D., & Bryant, R. A. (2010). Should A2 be a diagnostic requirement for posttraumatic stress disorder in DSM-V? Psychiatry Research, 176, 257–260.

    Article  PubMed  Google Scholar 

  • O’Donnell, M. L., Alkemade, N., Nickerson, A., Creamer, M., McFarlane, A. C., Silove, D., Bryant, R. A., & Forbes, D. (2014). The impact of the diagnostic changes to posttraumatic stress disorder for DSM-5 and the proposed changes to ICD-11. British Journal of Psychiatry, 205, 230–235.

    Article  PubMed  Google Scholar 

  • Orth, U., & Wieland, E. (2006). Anger, hostility, and posttraumatic stress disorder in trauma-exposed adults: A meta-analysis. Journal of Consulting and Clinical Psychology, 74(4), 698–706.

    Article  PubMed  Google Scholar 

  • Peters, L., Slade, T., & Andrews, G. (1999). A comparison of ICD-10 and DSM-IV criteria for posttraumatic stress disorder. Journal of Traumatic Stress, 12(2), 335–343.

    Article  CAS  PubMed  Google Scholar 

  • Prigerson, H. G., Horowitz, M. J., Jacobs, S. C., Parkes, C. M., Aslan, M., Goodkin, K., et al. (2009). Prolonged grief disorder: Psychometric validation of criteria proposed for DSM-V and ICD-11. PLoS Medicine, 6(8), e1000121. doi:10.1371/journal.pmed.1000121.

    Article  PubMed Central  PubMed  Google Scholar 

  • Rapee, R. M., Litwin, E. M., & Barlow, D. H. (1990). Impact of life events on subjects with panic disorder and on comparison subjects. American Journal of Psychiatry, 147(5), 640–644.

    Article  CAS  PubMed  Google Scholar 

  • Rapee, R. M., & Bryant, R. A. (2009). Stress and psychosocial factors in onset of fear circuitry disorders. In G. Andrews, D. S. Charney, P. J. Sirovatka, & D. A. Regier (Eds.), Stress-induced and fear circuitry disorders: Advancing the research agenda for DSM-V (pp. 195–214). Arlington: American Psychiatric Publishing, Inc.

    Google Scholar 

  • Rauch, S. L., & Drevets, W. C. (2009). Neuroimaging and neuroanatomy of stress-induced and fear circuitry disorders. In G. Andrews, D. S. Charney, P. J. Sirovatka, & D. A. Regier (Eds.), Stress-induced and fear circuitry disorders: Refining the research agenda for DSM-V (pp. 215–254). Arlington: American Psychiatric Association.

    Google Scholar 

  • Rauch, S. L., Wedig, M. M., Wright, C. I., Martis, B., McMullin, K. G., Shin, L. M., & Wilhelm, S. (2007). Functional magnetic resonance imaging study of regional brain activation during implicit sequence learning in obsessive-compulsive disorder. Biological Psychiatry, 61(3), 330–336.

    Article  PubMed  Google Scholar 

  • Reed, G. M. (2010). Toward ICD-11: Improving the clinical utility of WHO’s International Classification of Mental Disorders. Professional Psychology: Research and Practice, 41, 457–464.

    Article  Google Scholar 

  • Resick, P. A., Bovin, M. J., Calloway, A. L., Dick, A. M., King, M. W., Mitchell, K. S., & Wolf, E. J. (2012). A critical evaluation of the complex PTSD literature: Implications for DSM-5. Journal of Traumatic Stress, 25(3), 241–251.

    Article  PubMed  Google Scholar 

  • Rizvi, S. L., Kaysen, D., Gutner, C. A., Griffin, M. G., & Resick, P. A. (2008). Beyond fear: The role of peritraumatic responses in posttraumatic stress and depressive symptoms among female crime victims. Journal of Interpersonal Violence, 23(6), 853–868.

    Article  PubMed  Google Scholar 

  • Roth, S., Newman, E., Pelcovitz, D., van der Kolk, B., & Mandel, F. S. (1997). Complex PTSD in victims exposed to sexual and physical abuse: Results from the DSM-IV field trial for posttraumatic stress disorder. Journal of Traumatic Stress, 10(4), 539–555.

    CAS  PubMed  Google Scholar 

  • Shear, K., Frank, E., Houck, P. R., & Reynolds, C. F., 3rd. (2005). Treatment of complicated grief: A randomized controlled trial. Journal of the American Medical Association, 293(21), 2601–2608.

    Article  CAS  PubMed  Google Scholar 

  • Shear, M. K., Simon, N., Wall, M., Zisook, S., Neimeyer, R., Duan, N., et al. (2011). Complicated grief and related bereavement issues for DSM-5. Depression and Anxiety, 28(2), 103–117.

    Article  PubMed Central  PubMed  Google Scholar 

  • Shin, L. M., & Liberzon, I. (2010). The neurocircuitry of fear, stress, and anxiety disorders. Neuropsychopharmacology, 35(1), 169–191.

    Article  PubMed Central  PubMed  Google Scholar 

  • Simon, N. M., Shear, K. M., Thompson, E. H., Zalta, A. K., Perlman, C., Reynolds, C. F., et al. (2007). The prevalence and correlates of psychiatric comorbidity in individuals with complicated grief. Comprehensive Psychiatry, 48(5), 395–399.

    Article  PubMed  Google Scholar 

  • Simon, N. M., Wall, M. M., Keshaviah, A., Dryman, M. T., Leblanc, N. J., & Shear, M. K. (2011). Informing the symptom profile of complicated grief. Depression and Anxiety, 28(2), 118–126.

    Article  PubMed Central  PubMed  Google Scholar 

  • Spiegel, D., Koopmen, C., Cardeña, C., & Classen, C. (1996). Dissociative symptoms in the diagnosis of acute stress disorder. In L. K. Michelson & W. J. Ray (Eds.), Handbook of dissociation (pp. 367–380). New York: Plenum Press.

    Chapter  Google Scholar 

  • van der Kolk, B. A., Roth, S., Pelcovitz, D., Sunday, S., & Spinazzola, J. (2005). Disorders of extreme stress: The empirical foundation of a complex adaptation to trauma. Journal of Traumatic Stress, 18(5), 389–399.

    Article  PubMed  Google Scholar 

  • Wakefield, J. C. (2013). The DSM-5 debate over the bereavement exclusion: Psychiatric diagnosis and the future of empirically supported treatment. Clinical Psychology Review, 33(7), 825–845.

    Article  PubMed  Google Scholar 

  • World Health Organization, W. H. (1965). International statistical classification of diseases, injuries, and causes of death (8th ed.). Geneva: World Health Organization.

    Google Scholar 

  • World Health Organization, W. H. (1994). International statistical classification of diseases, injuries, and causes of death (8th ed.). Geneva: World Health Organization.

    Google Scholar 

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Bryant, R.A. (2015). The Diagnostic Spectrum of Trauma-Related Disorders. In: Schnyder, U., Cloitre, M. (eds) Evidence Based Treatments for Trauma-Related Psychological Disorders. Springer, Cham. https://doi.org/10.1007/978-3-319-07109-1_6

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