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About the Authors:
Patcho N. Santiago
* E-mail: [email protected]
Affiliation: Uniformed Services University of the Health Sciences, Center for the Study of Traumatic Stress, Bethesda, Maryland, United States of America
Robert J. Ursano
Affiliation: Uniformed Services University of the Health Sciences, Center for the Study of Traumatic Stress, Bethesda, Maryland, United States of America
Christine L. Gray
Affiliation: Uniformed Services University of the Health Sciences, Center for the Study of Traumatic Stress, Bethesda, Maryland, United States of America
Robert S. Pynoos
Affiliation: University of California Los Angeles, Department of Psychiatry and Biobehavioral Sciences, Los Angeles, California, United States of America
David Spiegel
Affiliation: Stanford University School of Medicine, Center on Stress and Health, Stanford, California, United States of America
Roberto Lewis-Fernandez
Affiliation: Columbia University, Department of Psychiatry, and the New York State Psychiatric Institute, New York, New York, United States of America
Matthew J. Friedman
Affiliation: Department of Veterans Affairs, National Center for Posttraumatic Stress Disorder, White River Junction, Vermont, and the Departments of Psychiatry and Pharmacology & Toxicology, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, United States of America
Carol S. Fullerton
Affiliation: Uniformed Services University of the Health Sciences, Center for the Study of Traumatic Stress, Bethesda, Maryland, United States of America
Introduction
Longitudinal studies of responses to traumatic events document the course of illness and recovery in trauma-exposed populations confirming, as the Diagnostic and Statistical Manual (DSM) has written, that posttraumatic stress disorder has a variable course that can be acute or chronic, remitting after only three months, delayed after six months, or lasting for years. Other studies have longitudinally examined the effectiveness of treatment interventions [1], [2], which highlight the advantage of early intervention to shorten the time to remission of symptoms. Data from control groups in these intervention studies often also reveal the natural course of PTSD. Studies using DSM-IV criteria have followed subjects to examine the epidemiology of PTSD after disasters [3], [4], [5], [6], other traumatic events [7], [8], [9], and military deployment [10], [11], again finding substantial variability across different populations, traumatic events and community contexts. Knowing patterns of response after traumatic events can inform health system interventions after a disaster or traumatic event.
The proposed DSM-5 criteria highlight the importance of direct exposure as...