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Am J Psychiatry 1995; 152:1705-1713
Copyright © 1995 by American Psychiatric Association
Conflict between current knowledge about posttraumatic stress disorder and its original conceptual basis
R Yehuda and AC McFarlane
Department of Psychiatry, Mount Sinai School of Medicine, New York, N.Y., USA.
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. METHOD:
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.
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