Trauma, criterion A, and posttraumatic stress disorder: Scientific utility and definitional validity.

Research examining the relation between trauma and psychopathology has contributed to the identification of individuals who, following exposure to various potentially traumatic events (e.g., domestic violence, rape), may be at high risk for post-trauma difficulties (e.g., sleep disturbance, heightened displays of hypervigilant behavior). However, the validity of the definitional characteristics of trauma has not adequately been explored. For instance, few studies have targeted the extent to which reports of perceived life threat, injury, or peritraumatic responses of “horror,†“fear,†and “helplessness†are associated with various forms of trauma-relevant responding. Yet, reports of such subjective emotional responses and event characteristics are necessary according to the current Diagnostic and Statistical Manual of Mental Disorders (DSM) for an event to be labeled “traumatic.†The present study examined the validity of various DSM-defined characteristics of trauma, and assessed the predictive utility for post-trauma responding of other event characteristics (e.g., controllability, various peritraumatic responses) that are not included within the DSM criteria. This study also explored the extent to which potentially traumatic events are associated with various characteristics of trauma (e.g., perceived life threat, onset predictability). A total of 418 participants were administered several questionnaires, including a life events checklist, event characteristics questionnaire, and assessments of peritraumatic emotional responses and various forms of psychopathology. Results revealed support for the definitional validity of DSM descriptors associated with criterion A1 and criterion A2. However, statistical analyses identified several DSM-unrelated variables (e.g., peritraumatic “numbingâ€) that contributed significant unique variance in the prediction of reported psychopathology beyond that predicted by DSM-related variables (e.g., peritraumatic “helplessnessâ€). Implications for the utility of the DSM formulation of trauma and posttraumatic stress disorder are discussed, and suggestions for future empirical challenges to these formulations are described