Article

This review examines the question of whether there should be a cluster of
disorders, including the adjustment disorders (ADs), acute stress disorder
(ASD), posttraumatic stress disorder (PTSD), and the dissociative disorders
(DDs), in a section devoted to abnormal responses to stress and trauma in the
DSM-5. Environmental risk factors, including the individual's developmental
experience, would thus become a major diagnostic consideration. The relationship
of these disorders to one another is examined and also their relationship to
other anxiety disorders to determine whether they are better grouped with
anxiety disorders or a new specific grouping of trauma and stressor-related
disorders. First how stress responses have been classified since DSM-III is
reviewed. The major focus is on PTSD because it has received the most
attention, regarding its proper placement among the psychiatric diagnoses. It is
discussed whether PTSD should be considered an anxiety disorder, a stressinduced
fear circuitry disorder, an internalizing disorder, or a trauma and
stressor-related disorder. Then, ASD, AD, and DD are considered from a
similar perspective. Evidence is examined pro and con, and a conclsion is offered
recommending inclusion of this cluster of disorders in a section entitled
''Trauma and Stressor-Related Disorders.''
The recommendation to shift ASD
and PTSD out of the anxiety disorders section reflects increased recognition of
trauma as a precipitant, emphasizing common etiology over common
phenomenology. Similar considerations are addressed with regard to AD and DD.

Langue : ANGLAIS