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Depress Anxiety. 2014 Feb;31(2):97-106. doi: 10.1002/da.22133. Epub 2013 Jun 12.

Understanding heterogeneity in PTSD: fear, dysphoria, and distress.

Author information

1
Department of Psychology, University of Washington, Seattle, Washington.

Abstract

Fear, dysphoria, and distress are prominent components in the conceptualization of posttraumatic stress disorder (PTSD). However, because our diagnostic categories are open concepts, relying on observed patterns of symptoms for classification, it is unclear whether these components represent core or auxiliary features of the disorder. Convergence across multiple indices is critical for this understanding. In this paper, we examine these components of PTSD across observed symptom patterns, broader theoretical conceptualizations, underlying information processing mechanisms of attention and memory, and underlying learning and neurobiological mechanisms. For each, evidence for similarity or distinctiveness of PTSD with other anxiety disorders and depression is examined. Throughout the review, key points of similarity to the anxiety disorders and divergence with depression argue for a distinction between core fear symptoms and auxiliary dysphoria and distress symptoms. Implications are discussed, noting that, as heterogeneity increases, core characteristics will become more diffused and ancillary constructs will gain an inflated degree of importance.

KEYWORDS:

Anxious-Misery; Depression; Distress; Dysphoria; Fear; PTSD

PMID:
23761021
PMCID:
PMC3900595
DOI:
10.1002/da.22133
[Indexed for MEDLINE]
Free PMC Article

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