Is helplessness still helpful in diagnosing posttraumatic stress disorder?

Ekaterina Pivovarova, Gen Tanaka, Michael Tang, Harold J. Bursztajn, Michael B. First

Research output: Contribution to journalArticlepeer-review

6 Scopus citations


Criteria A2, experience of helplessness, fear, or horror at the time of the traumatic event, was removed from the posttraumatic stress disorder diagnosis in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. We argue that there is empirical support for retention of A2, a criterion that has clinical value and may improve diagnostic accuracy. Specifically, we demonstrate that A2 has high negative predictive power, AIDS in the prediction of symptom severity, and can be indispensible to detecting the disorder in children. We examine how augmenting A2 with other peritramautic emotions could improve clinical and diagnostic utility. In our opinion, rather than being eliminated, A2 needs to be reconstructed and included as one criterion of PTSD.

Original languageEnglish (US)
Pages (from-to)3-8
Number of pages6
JournalJournal of Nervous and Mental Disease
Issue number1
StatePublished - 2016
Externally publishedYes


  • DSM-5
  • Diagnostic accuracy
  • Diagnostic utility
  • PTSD
  • Trauma

ASJC Scopus subject areas

  • Psychiatry and Mental health


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