Does COVID-19 count?: Defining Criterion A trauma for diagnosing PTSD during a global crisis

• Type of Material: Article
• Authors: Seth Norrholm, Emory University; Alyson Zalta, University of California Irvine; Lori Zoellner, University of Washington; Abigail Lott, Emory University; Matthew T. Tull, University of Toledo; Christopher Reist, VA Long Beach Healthcare System; Paula P. Schnurr, Department of Veterans Affairs; Frank Weathers, Auburn University; Matthew J. Friedman, Department of Veterans Affairs
• Language: English
• Date: 2021-09-01
• Publisher: Wiley
• Publication Version: Final Published Version
• Copyright Statement: © 2021 The Authors. Depression and Anxiety published by Wiley Periodicals LLC
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1002/da.23209
• Title of Journal or Parent Work: Depression and Anxiety
• Volume: 38
• Issue: 9
• Start Page: 882
• End Page: 885
• Keywords: Diagnostic and Statistical Manual of Mental Disorders; SARS-CoV-2; COVID-19; peritraumatic reactions; Pandemics; PTSD phenomenology; anxiety; Stress Disorders, Post-Traumatic; diagnosis; Humans; DSM; etiology
• Research Categories: Psychology, Behavioral; Sociology, Public and Social Welfare; Biology, Virology

Abstract

Introduction: The ongoing coronavirus disease 2019 (COVID-19) pandemic is a globally significant crisis with a rapid spread worldwide, high rates of illness and mortality, a high degree of uncertainty, and a disruption of daily life across the sociodemographic spectrum. The clinically relevant psychological consequences of this catastrophe will be long-lasting and far-reaching. There is an emerging body of empirical literature related to the mental health aspects of this pandemic and this body will likely expand exponentially. The COVID-19 pandemic is an example of a historic catastrophe from which we can learn much and from which the field will need to archive, interpret, and synthesize a multitude of clinical and research observations. Methods: In this commentary, we discuss situations and contexts in which a diagnosis of posttraumatic stress disorder (PTSD) may or may not apply within the context of diagnostic and statistical manual of mental disorders, fifth edition (DSM-5) criteria. Results: Our consensus is that a COVID-related event cannot be considered traumatic unless key aspects of DSM-5's PTSD Criterion A have been established for a specific type of COVID-19 event (e.g., acute, life-threatening, and catastrophic). Conclusion: The application of a more liberal interpretation of Criterion A will dilute the PTSD diagnosis, increase heterogeneity, confound case–control research, and create an overall sample pool with varying degrees of risk and vulnerability factors.