Conflict between current knowledge about posttraumatic stress disorder and its original conceptual basis.
OBJECTIVE
The author's goal was to explore the historical, political, and social forces that have played a major role in the acceptance of the idea of trauma as a cause of the specific symptoms of posttraumatic stress disorder (PTSD) and to discuss the impact that current research findings have had on some of the initial conceptualizations of the disorder.


METHODS
The conceptual origins of PTSD are described, and the literature on the prevalence, longitudinal course, phenomenology, and neurobiology of PTSD is reviewed.


RESULTS
Paradoxically, there are a series of findings that support the idea that PTSD is a distinct diagnostic entity, but these are different from those originally developed from psychosocial theory and stress research.


CONCLUSIONS
PTSD has been a controversial diagnosis and is again at a vulnerable point. It is imperative that the field address how current findings challenge the original conceptualizations of this disorder so that the next generation of conceptual issues can be formulated.
Department of Psychiatry, Mount Sinai School of Medicine, New York, N.Y., USA.
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Yehuda
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McFarlane
D000223:Adaptation, Psychological; D015897:Comorbidity; D006801:Humans; D008016:Life Change Events; D008137:Longitudinal Studies; D008960:Models, Psychological; D015995:Prevalence; D012307:Risk Factors; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology; D013315:Stress, Psychological / Q000150:complications / Q000175:diagnosis / Q000523:psychology