PTSD symptoms and dominant emotional response to a traumatic event: an examination of DSM-IV Criterion A2

Abstract

To qualify for a diagnosis of posttraumatic stress disorder (PTSD), the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) requires that individuals report experiencing dominant emotions of fear, helplessness, and horror during the trauma (Criterion A2). Despite this stipulation, traumatic events can elicit a myriad of emotions other than fear, such as anger, guilt or shame, sadness, and numbing. The present study examined which emotional reactions to a stressful event in a college student sample are associated with the highest levels of PTSD symptoms. Our results suggest mixed support for the DSM-IV criteria. Although, participants who experienced a dominant emotion of fear reported relatively high PTSD symptomatology, participants who experienced anger, disgust-related emotions, and sadness reported PTSD symptoms of equivalent severity. Additionally, participants reported dominant emotions of sadness and other emotions (including disgust, guilt, and shame) more frequently than they reported fear. These results question the specifics of diagnostic Criterion A2 and may have diagnostic and treatment implications.

Keywords:

• PTSD
• emotion
• trauma
• diagnostic and statistical manual

Acknowledgements

We would like to thank Darnell Schuettler for her helpful comments on a previous draft of this paper.

Notes

1. A more detailed list of the negative events nominated is included in Boals and Schuettler (in press). Although they used the same data set, the hypotheses tested in the current study are conceptually distinct from those conducted in Boals and Schuettler and thus are reported in separate papers.