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A century of controversy surrounding posttraumatic stress stress-spectrum syndromes: the impact on DSM-III & DSM-IV

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The authors describe historical clinical reports that preceded the

development of criteria for posttraumatic stress disorder

(PTSD) and influenced the formation of PTSD in DSM-IV. These

reports were identified from extensive search of 19th- and

20th-century American and European medical literature.

Relevant findings from the most representative reports are

described and discussed. Since the mid-19th century, clinical

syndromes resembling PTSD have been described. However,

understanding of PTSD has been complicated by questions of

nomenclature, etiology, and compensation. Nomenclature placed

PTSD syndromes under existing psychiatric disorders:

traumatic hysteria, traumatic neurasthenia, or traumatic

neurosis. Etiological issues have been concerned often solely

with organic factors, pre-existing personality impairments,

intrapsychiatric conflicts, and social factors. Only after

World War II and the concentration camp experiences did the

role of severe trauma in PTSD become recognized. Even though

controversy remains, much progress in understanding PTSD has

been made. {MCMStrSt}

Kinzie JD, Goetz RR

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