Post-traumatic stress disorder without the trauma

Br J Clin Psychol. 1994 Feb;33(1):71-4. doi: 10.1111/j.2044-8260.1994.tb01095.x.


Examples are reported of PTSD cases showing full symptomatology (intrusive imagery, avoidance behaviour, disordered arousal) in the absence of a single, acute, dramatic trauma of the kind required by the current DSM-III-R definition. Such trauma is thus not a necessary condition for PTSD, and other evidence shows it to be not a sufficient condition. It is suggested that the DSM-III-R Axis IV distinction between acute and enduring psychosocial stressors be incorporated into the definition to distinguish two pathways to stress disorder, post-traumatic (PTSD) and prolonged duress (PDSD). Differential treatment implications of the two routes are noted.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anxiety Disorders / classification
  • Anxiety Disorders / diagnosis
  • Anxiety Disorders / psychology
  • Arousal
  • Comorbidity
  • Depressive Disorder / classification
  • Depressive Disorder / diagnosis
  • Depressive Disorder / psychology
  • Diagnosis, Differential
  • Female
  • Humans
  • Male
  • Middle Aged
  • Occupational Diseases / classification
  • Occupational Diseases / diagnosis*
  • Occupational Diseases / psychology
  • Psychiatric Status Rating Scales
  • Stress Disorders, Post-Traumatic / classification
  • Stress Disorders, Post-Traumatic / diagnosis*
  • Stress Disorders, Post-Traumatic / psychology
  • Stress, Psychological / complications*