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Can J Psychiatry. 1999 Feb;44(1):21-33.

Individual differences in posttraumatic distress: problems with the DSM-IV model.

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  • 1Department of Psychology, Simon Fraser University, Burnaby, British Columbia. bowman@sfu.ca

Abstract

OBJECTIVE:

To evaluate the evidence concerning the role of threatening life events in accounting for clinically significant posttraumatic stress responses.

METHOD:

Research was examined to review the epidemiology, evidence of dose-response relations, and individual difference factors in accounting for variations in conditions, including posttraumatic stress disorder, after exposure to threatening events.

RESULTS:

The evidence is significantly discrepant from the clinical Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) model. Greater distress arises from individual differences than from event characteristics. Important individual differences that interact with threat exposures include trait negative affectivity (neuroticism); beliefs about emotions, the self, the world, and the sources and consequences of danger; and prevent acts, disorders, and intelligence. Reasons for the discrepancies between the evidence and the current model of posttraumatic distress are proposed.

CONCLUSION:

In accounting for responses to threatening life events, the relatively minor contribution of event qualities compared with individual differences has significant treatment implications. Treatment approaches assuming that toxic event exposure creates a posttraumatic disorder fail to consider individual differences that could improve treatment efficacy.

Comment in

PMID:
10076738
[PubMed - indexed for MEDLINE]
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