The Social Construction of PTSD's Diagnostic Criteria

(Citations Underlined)

A while ago I read an essay from the psychiatrist Derek Summerfield which challenged my assumption that disorders in the DSM-5 had objective or inherent validity. The essay, 'The invention of post-traumatic stress disorder and the social usefulness of a psychiatric category' was incredibly controversial at the time, totally upending previous literature regarding the subject. Summerfield made the claim that PTSD (and especially complex PTSD) in its current form was a misdiagnosis of generalized distress and other neuroticisms, simply with the added caveat that the patient was aware they had experienced some traumatic event. Summerfield's work was not something disconnected from victims of such trauma, he was intimately close with those who had been diagnosed with PTSD, primarily treating political prisoners, victims of atrocities, and torture victims.

Summerfield's essay proceedes in a chronology; starting with the WWI diagnosis of shell-shock, examining the construction of PTSD as a disorder in the wake of Vietnam, and ending with PTSD in it's current form. His work with refugees comes to the forefront as from his and other professional's experiences; these people either tend to meet the criteria, but overcome it regardless of whether or not they are treated; or they experience what is called complex PTSD (which you may remember as a disorder commonly misdiagnosed as BPD).

The rest of the essay focuses upon diffrential diagnoses of PTSD, observing that it's symptoms lack specificity and thus are too broad to distinguish from other mood, anxiety, or personality disorders. To this end I agree with Summerfield, PTSD in it's current manifestation describes far too many things to retain the most important part of its criteria, that being flashbacks.