Date of Conferral

2017

Degree

Ph.D.

School

Psychology

Advisor

Susana Verdinelli

Abstract

The fifth and most recent edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), has presented revised diagnostic criteria for posttraumatic stress disorder (PTSD). The impact of the new diagnostic criteria upon the day-to-day experiences of mental health professionals, including diagnosis, treatment, and insurance billing has remained unclear. Using the adaptive information processing model as a theoretical framework, this multiple case study explored how licensed clinicians experienced utilization of the revised diagnostic criteria for PTSD. Fifteen mental health practitioners who had experience in the treatment of clients presenting PTSD symptoms were interviewed. Data from participant interviews were analyzed and themes developed. Participants agreed with the removal of Criterion A2 (in which the individual must experience intense fear, helplessness, or horror at the time of the event), the addition of a dissociative subtype, and separate criteria for PTSD in children. However, clinicians strongly disagreed with the changes to Criterion A, which defines trauma as directly experiencing the event, witness the event as it happens to others, or learning about the event happening to close friends or family. In the case of the event happening to close friends or family, the event must be violent or accidental. Additionally, an individual may experience repeated extreme or repeated exposure to aversive details of the event (for example, first responders). Results of this study uncovered gaps between the DSM-5 criteria and the experiences of clinicians in the diagnosis of PTSD. This contributes to the ongoing debate about the appropriate definition of trauma in the DSM-5 and supports the need for continuing research.

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