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The DSM-5 Got PTSD Right: Comment on Friedman (2013)


  • Dean G. Kilpatrick

    Corresponding author
    1. Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
    • Correspondence should be addressed to Dean G. Kilpatrick, 67 President Street, South Building, Suite 200, Charleston, SC 29425. E-mail:

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  • Contents are solely the responsibility of the author and views expressed do not necessarily represent those of the APA or other agencies.


Friedman in his article in this issue describes the posttraumatic stress disorder (PTSD) diagnosis according to the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5) and provides considerable information about the process that resulted in the revisions, as well as how PTSD in the DSM-5 differs from proposals for PTSD in the International Classification of Mental Disorders and Related Health Problems (ICD-11). In this commentary, I argue that (a) the placement of PTSD in the DSM-5 category of Trauma and Stressor-Related Disorders is a major advance because it draws attention to the role of “nurture” when there is an overemphasis on “nature” by some; (b) the broader construct of PTSD in DSM-5 is justified because it includes clinically important problems and can be reliably diagnosed; and (c) the web surveys contributed substantially to the provision of data needed to support proposed changes. Concerns are raised about the proposed ICD-11 approach, and the case is presented that substantial evidence should be required before these proposed changes are made because they differ substantially from a DSM-5 PTSD diagnosis that has demonstrated reliability and validity.

Traditional and Simplified Chinese Abstracts by AsianSTSS

標題 : PTSD : DSM 第五版弄清楚了嗎?

撮要 : 這一期Friedman的文章描述精神疾病診斷及統計手冊第五版(DSM-5;美國精神學會〔APA〕,2013) 中創傷後壓力症(PTSD)的診斷,和提供PTSD在DSM-5內修訂的由來,及PTSD在DSM-5和國際疾病分類(ICD-11)提案的相互差異。本評論指出:(a)PTSD在DSM-5放在「創傷及壓力相關障礙」類別是一個進步,因為除了“天性”方面的影響亦留意到“教養”的角色;(b)PTSD在DSM-5的較寬構築是有必要的,因為包含了臨床重要問題,而且診斷方面更可靠;(c)網絡調查對建議的改變提供充份資料。由於ICD-11建議提案的提議改動對比已證實有可靠性及認可性的 DSM-5 PTSD有着明顯的差異,我們希望能有充份証據支持改動。

标题 : PTSD : DSM 第五版弄清楚了吗?

撮要 : 这一期Friedman的文章描述精神疾病诊断及统计手册第五版(DSM-5;美国精神学会〔APA〕,2013) 中创伤后压力症(PTSD)的诊断,和提供PTSD在DSM-5内修订的始末,及PTSD在DSM-5和国际疾病分类(ICD-11)提案的相互差异。本评论指出:(a)PTSD在DSM-5放在「创伤及压力相关障碍」类别是一个进步,因为除了“天性”方面的影响亦留意到“教养”的角色;(b)PTSD在DSM-5的较宽构筑是有必要的,因为包含了临床重要问题,而且诊断方面更可靠;(c)网络调查对建议的改变提供充份资料。由于ICD-11建议提案的提议改动对比已证实有可靠性及认可性的 DSM-5 PTSD有着明显的差异,我们希望能有充份证据支持改动。