Criteria A criticism

Question 1

Criticism 1 (Pathologizes)

Answer 1

Claims distress is ‘normal’ response and that symptoms will resolve itself;

• Reactions to extreme stress are time-limited
• Symptoms of PTSD are ubiquitous reactions to stressful events
• Said its not distinguishable from normal distress

This is untrue;
- PTSD symptoms are often chronic
- Nothing but ‘normal’stress? what is normal and where is the line
- Neuro-image studies show unique patterns in PTSD

Question 2

Criticism 2 (Inadequacy)

Answer 2

Suposedly too broad/too narrow;
- Other disorders linked to it
- insufficient specificity; trauma of others
- excessive specificity

But:
- traumatic events increase risk for PTSD but not other dis.
- too complex, can be influcenced by other indicators
- PTSD without report of intense fear/horror

Question 3

Criticism 3 (symptom overlap)

Answer 3

Overlap w despression/anxiety

• Flashbacks/nightmares are distinctive to PTSD

Question 4

Improvement of diagnosis

Answer 4

Proposed by Brewin:
- Focus on set of core symptom io criteria A
- emphasizing reexperiencing/intrusive memories and feeling of horror, recurrent distressing dreams related to events now percceived as threatened.
- Reducing core symptoms from 17 to 6, focus on most predictive of PTSD

Thereby improving diagnostic accuracy while maintaining distinctiveness

Question 5

Avoidance according to Brewin

Answer 5

Should be present in past month, either;

• Effort to avoid thoughts, feelings, convo’s or internal reminders associated with the reexperienced events

or

• Efforts to avoid activities, places, people or external reminders associated w reexperienced events

Question 6

Arousal according to Brewin

Answer 6

Hyperarousal should be present most days, either

• hypervigilance
• exaggerated startle response

Question 7

6 proposed criteria

Answer 7

Trauma:

Reexperiencing
Avoidance
hyperArousal
duration
Impairment

Question 8

Emperical findings, comparing Brewin to DSM

Answer 8

13% lost the diagnosis and 13% gained the diagnosis. Those that lost it did still have a disorder, but were classified as depression/anxiety.

The comorbidity remained the same

In another study the prev. was the same, but the comorbidity with depression was a lot less (14%)