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A critical evaluation of the complex PTSD literature: Implications for DSM-5

Authors

  • Patricia A. Resick,

    Corresponding author
    1. National Center for Posttraumatic Stress Disorder, VA Boston Healthcare System, Boston, Massachusetts, USA
    2. Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts, USA
    • Women's Health Sciences Division (116B-3), National Center for PTSD, VA Boston Healthcare System, 150 South Huntington Avenue, Boston, MA 02130.
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  • Michelle J. Bovin,

    1. National Center for Posttraumatic Stress Disorder, VA Boston Healthcare System, Boston, Massachusetts, USA
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  • Amber L. Calloway,

    1. National Center for Posttraumatic Stress Disorder, VA Boston Healthcare System, Boston, Massachusetts, USA
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  • Alexandra M. Dick,

    1. National Center for Posttraumatic Stress Disorder, VA Boston Healthcare System, Boston, Massachusetts, USA
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  • Matthew W. King,

    1. National Center for Posttraumatic Stress Disorder, VA Boston Healthcare System, Boston, Massachusetts, USA
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  • Karen S. Mitchell,

    1. National Center for Posttraumatic Stress Disorder, VA Boston Healthcare System, Boston, Massachusetts, USA
    2. Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts, USA
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  • Michael K. Suvak,

    1. National Center for Posttraumatic Stress Disorder, VA Boston Healthcare System, Boston, Massachusetts, USA
    2. Department of Psychology, Suffolk University, Boston, Massachusetts, USA
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  • Stephanie Y. Wells,

    1. National Center for Posttraumatic Stress Disorder, VA Boston Healthcare System, Boston, Massachusetts, USA
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  • Shannon Wiltsey Stirman,

    1. National Center for Posttraumatic Stress Disorder, VA Boston Healthcare System, Boston, Massachusetts, USA
    2. Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts, USA
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  • Erika J. Wolf

    1. National Center for Posttraumatic Stress Disorder, VA Boston Healthcare System, Boston, Massachusetts, USA
    2. Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts, USA
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  • After Patricia Resick, all authors are listed alphabetically.

Abstract

Complex posttraumatic stress disorder (CPTSD) has been proposed as a diagnosis for capturing the diverse clusters of symptoms observed in survivors of prolonged trauma that are outside the current definition of PTSD. Introducing a new diagnosis requires a high standard of evidence, including a clear definition of the disorder, reliable and valid assessment measures, support for convergent and discriminant validity, and incremental validity with respect to implications for treatment planning and outcome. In this article, the extant literature on CPTSD is reviewed within the framework of construct validity to evaluate the proposed diagnosis on these criteria. Although the efforts in support of CPTSD have brought much needed attention to limitations in the trauma literature, we conclude that available evidence does not support a new diagnostic category at this time. Some directions for future research are suggested.

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