Changes in diagnostic criteria of PTSD: implications from two prospective longitudinal studies.

This study assesses differences in PTSD rates according to different sets of diagnostic criteria. Two samples have been studied: one comprised of 286 combat stress reaction (CSR) casualties and 218 non-CSR veterans from the Lebanon war (Study 1); the other of 95 ex-POWs and 101 non-POWs from the Yom Kipur war (Study 2). Participants were administered two versions of the PTSD inventory based on different Diagnostic and Statistical Manual of Mental Disorders (DSM) editions: DSM-III and DSM-IV in Study 1 and DSM-III-R and DSM-IV in Study 2. PTSD rates declined when criteria of more recent DSM editions were applied. In addition, findings clearly demonstrate the importance of the dysfunction criterion (F) in PTSD. The highly complex nature of the PTSD diagnosis is discussed, as well as the important role of dysfunction and distress.