title: Is Helplessness Still Helpful in Diagnosing Posttraumatic Stress Disorder?
abstract: Criteria A2, experience of helplessness, fear, or horror at the time of the traumatic event, was removed from the posttraumatic stress disorder diagnosis in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. We argue that there is empirical support for retention of A2, a criterion that has clinical value and may improve diagnostic accuracy. Specifically, we demonstrate that A2 has high negative predictive power, aids in the prediction of symptom severity, and can be indispensible to detecting the disorder in children. We examine how augmenting A2 with other peritramautic emotions could improve clinical and diagnostic utility. In our opinion, rather than being eliminated, A2 needs to be reconstructed and included as one criterion of PTSD.
authors.affiliation: *Division of Law and Psychiatry, Department of Psychiatry, University of Massachusetts Medical School, Worcester; †Harvard Medical School, Boston; ‡Veterans Association Boston Healthcare System, Brockton; §Program in Psychiatry and the Law, Beth Israel Deaconess Medical Center, Boston, MA; and ||Columbia University Department of Psychiatry, New York State Psychiatric Institute, New York, NY.
authors.forename: Ekaterina
authors.initials: E
authors.lastname: Pivovarova
authors.forename: Gen
authors.initials: G
authors.lastname: Tanaka
authors.forename: Michael
authors.initials: M
authors.lastname: Tang
authors.forename: Harold J
authors.initials: HJ
authors.lastname: Bursztajn
authors.forename: Michael B
authors.initials: MB
authors.lastname: First
mesh_terms: D000328:Adult; D002648:Child; D039721:Diagnostic and Statistical Manual of Mental Disorders; D006801:Humans; D000067073:Psychological Trauma / Q000150:complications / Q000175:diagnosis*; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis* / Q000209:etiology