This research was supported by grant IIR 09-342 from the Veterans Administration Health Services Research & Development (HSR&D) service (Susan V. Eisen, Principal Investigator). The work was conducted at the Edith Nourse Rogers Memorial Veterans Hospital in Bedford, MA. The views expressed in this article are those of the authors and do not necessarily represent the views of the Department of Veterans Affairs.
Is DSM-IV criterion A2 associated with PTSD diagnosis and symptom severity?†
Article first published online: 17 JUL 2012
Published 2012. This article is a US Government work and is in the public domain in the USA
Journal of Traumatic Stress
Volume 25, Issue 4, pages 368–375, August 2012
How to Cite
Osei-Bonsu, P. E., Spiro, A., Schultz, M. R., Ryabchenko, K. A., Smith, E., Herz, L. and Eisen, S. V. (2012), Is DSM-IV criterion A2 associated with PTSD diagnosis and symptom severity?. J. Traum. Stress, 25: 368–375. doi: 10.1002/jts.21720
- Issue published online: 2 AUG 2012
- Article first published online: 17 JUL 2012
The diagnostic criteria for posttraumatic stress disorder (PTSD) have received significant scrutiny. Several studies have investigated the utility of Criterion A2, the subjective emotional response to a traumatic event. The American Psychiatric Association (APA) has proposed elimination of A2 from the PTSD diagnostic criteria for DSM-5; however, there is mixed support for this recommendation and few studies have examined A2 in samples at high risk for PTSD such as veterans. In the current study of 908 veterans who screened positive for a traumatic event, A2 was not significantly associated with having been told by a doctor that the veteran had PTSD. Those who endorsed A2, however, reported greater PTSD symptom severity in the 3 DSM-IV symptom clusters of reexperiencing (d = 0.45), avoidance (d = 0.61), and hyperarousal (d = 0.44), and A2 was significantly associated with PTSD symptom severity for all 3 clusters (R2 = .25, .25, and .27, respectively) even with trauma exposure in the model. Thus, although A2 may not be a necessary criterion for PTSD diagnosis, its association with PTSD symptom severity warrants further exploration of its utility.