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The Ontology of Posttraumatic Stress Disorder: Natural Kind, Social Construction, or Causal System?


Address correspondence to Richard J. McNally, Department of Psychology, Harvard University, 1230 William James Hall, 33 Kirkland Street, Cambridge, MA 02138. E-mail:


The ontological status of posttraumatic stress disorder (PTSD) has long been a focus of intense controversy. Is PTSD a natural kind discovered recently by astute clinicians, but present throughout history and across diverse cultures? Or is it a socially constructed artifact arising in the wake of the Vietnam War? In addition to covering issues relevant to this debate, I describe another interpretation of PTSD orthogonal to the natural versus artifactual dichotomy. Inspired by the causal systems approach to mental disorders pioneered by Borsboom and his colleagues, I suggest a causal system interpretation of PTSD is a scientifically more profitable approach than either the social constructionist or natural kind interpretations of this disorder.

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