UNDERSTANDING HETEROGENEITY IN PTSD: FEAR, DYSPHORIA, AND DISTRESS
Version of Record online: 12 JUN 2013
© 2013 Wiley Periodicals, Inc.
Depression and Anxiety
Focus on PTSD
Volume 31, Issue 2, pages 97–106, February 2014
How to Cite
Zoellner, L. A., Pruitt, L. D., Farach, F. J. and Jun, J. J. (2014), UNDERSTANDING HETEROGENEITY IN PTSD: FEAR, DYSPHORIA, AND DISTRESS. Depress. Anxiety, 31: 97–106. doi: 10.1002/da.22133
- Issue online: 27 JAN 2014
- Version of Record online: 12 JUN 2013
- Manuscript Accepted: 27 APR 2013
- Manuscript Revised: 1 FEB 2013
- Manuscript Received: 1 MAY 2012
- Zoellner. Grant Numbers: R34MH087375, R01MH066347
Fear, dysphoria, and distress are prominent components in the conceptualization of posttraumatic stress disorder (PTSD). However, because our diagnostic categories are open concepts, relying on observed patterns of symptoms for classification, it is unclear whether these components represent core or auxiliary features of the disorder. Convergence across multiple indices is critical for this understanding. In this paper, we examine these components of PTSD across observed symptom patterns, broader theoretical conceptualizations, underlying information processing mechanisms of attention and memory, and underlying learning and neurobiological mechanisms. For each, evidence for similarity or distinctiveness of PTSD with other anxiety disorders and depression is examined. Throughout the review, key points of similarity to the anxiety disorders and divergence with depression argue for a distinction between core fear symptoms and auxiliary dysphoria and distress symptoms. Implications are discussed, noting that, as heterogeneity increases, core characteristics will become more diffused and ancillary constructs will gain an inflated degree of importance.