Does Post-Traumatic Stress Disorder Require Trauma?

"...Not only is trauma insufficient to trigger PTSD symptoms, it is also not necessary. Although by definition clinicians cannot diagnose PTSD in the absence of trauma, recent work suggests that the disorder’s telltale symptom pattern can emerge from stressors that do not involve bodily peril. In 2008 psychologist Gerald M. Rosen of the University of Washington and one of us (Lilienfeld) reviewed data demonstrating that significant PTSD symptoms can follow emotional upheavals resulting from divorce, significant employment difficulties or loss of a close friendship. In a 2005 study of 454 undergraduates, psychologist Sari Gold of Temple University and her colleagues revealed that students who had experienced nontraumatic stressors, such as serious illness in a loved one, divorce of their parents, relationship problems or imprisonment of someone close to them, reported even higher rates of PTSD symptoms than did students who had lived through bona fide trauma. Taken together, these findings call into question the long-standing belief that these symptoms are tied only to physical threat.

In light of these and other data, some authors have suggested that the PTSD diagnosis be extended to include anxiety reactions to events that are stressful but not terrifying. Yet such a change could lead to what Harvard University psychologist Richard J. McNally calls “criterion creep”—expanding the boundaries of the diagnosis beyond recognition. This and other controversies aside, recent results raise the possibility that PTSD is a less distinctive affliction than originally thought and that its symptoms may arise in response to a plethora of intense stressors that are part and parcel of the human condition...." http://www.scientificamerican.com/article.cfm?id=when-coping-fails