Rosen Gerald M, Lilienfeld Scott O
University of Washington, Seattle, Washington, USA.
Clin Psychol Rev. 2008 Jun;28(5):837-68. doi: 10.1016/j.cpr.2007.12.002. Epub 2007 Dec 23.
The diagnosis of posttraumatic stress disorder (PTSD) rests on several core assumptions, particularly the premise that a distinct class of traumatic events is linked to a distinct clinical syndrome. This core assumption of specific etiology ostensibly distinguishes the PTSD diagnosis from virtually all other psychiatric disorders. Additional attempts to distinguish PTSD from extant conditions have included searches for distinctive markers (e.g., biological and laboratory findings) and hypothesized underlying mechanisms (e.g., fragmentation of traumatic memory). We review the literature on PTSD's core assumptions and various attempts to validate the construct within a nomological network of distinctive correlates. We find that virtually all core assumptions and hypothesized mechanisms lack compelling or consistent empirical support. We consider the implications of these findings for conceptualizing PTSD in the forthcoming edition of the American Psychiatric Association's diagnostic manual.
创伤后应激障碍（PTSD）的诊断基于若干核心假设，尤其是这样一个前提，即一类独特的创伤事件与一种独特的临床综合征相关联。这种特定病因的核心假设表面上使PTSD的诊断与几乎所有其他精神障碍区分开来。将PTSD与现有病症区分开来的其他尝试包括寻找独特的标志物（如生物学和实验室检查结果）以及假设的潜在机制（如创伤记忆的碎片化）。我们回顾了关于PTSD核心假设的文献，以及在一个由独特相关因素构成的法理网络内验证该概念的各种尝试。我们发现，几乎所有的核心假设和假设机制都缺乏令人信服或一致的实证支持。我们考虑了这些发现对在美国精神病学协会即将出版的诊断手册中对PTSD进行概念化的影响。
