Research on PTSD and Other Post-Traumatic Reactions: European Literature (Part II) [open pdf - 244KB]
"This is the second of a two-part series by Drs. Weisæth and Eitinger on the European PTSD [Post-Traumatic Stress Disorder] literature. Our previous issue focused on Norwegian publications, and this issue concludes with a review of publications from other European countries. PTSD is a diagnosis that spans national and cultural boundaries, even though it is strictly defined as such only in the diagnostic manual of the American Psychiatric Association. Change is underway, however, to promote the systematic global use of the term. If the 1990 draft of the proposed ICD-10 (the International Classification of Diseases) is accepted, a diagnosis of post-traumatic stress disorder will be used internationally. In addition, the ICD-10 proposes a diagnosis of 'acute stress reaction.' This must have an immediate onset, defined as developing within one hour of exposure to the exceptional mental or physical stressor. Some of our own prospective studies starting in the immediate aftermath have found a high predictive validity of an acute diagnosis. This lends support to such a diagnostic proposal, which could also eliminate the problem that the DSMIII- R diagnosis of PTSD applies only after one month. In some other studies, for example, one on rape victims (this issue), the acute response was not predictive of PTSD; a combined formula of risk factors was needed for prediction. In addition, the ICD-10 proposes a diagnosis of 'enduring personality change after catastrophic experiences' when the specific personality changes have been present for at least three years. The changes meeting the criteria will often have been preceded by a long-lasting post-traumatic stress disorder. There are extensive ongoing consultations between the ICD10 and DSM-IV committees. Summing up, it will be an exciting challenge for the researcher in traumatic stress over the next few years to determine diagnostic categories that match clinical reality."
National Center for PTSD: http://www.ptsd.va.gov/
PTSD Research Quarterly (Summer 1991), v.2 no.3