Post-traumatic stress disorder: Does it exist?

Facing the inevitable, psychiatry formally acquired PTSD as a diagnostic entity in 1980. It then discovered that PTSD had a bevy of nasty laylegal relatives (e.g., disability and personal injury claims). In response, psychiatrists have been continuously trying to refine PTSD criteria. There have even been cogent arguments that psychiatrists should take their own forensic medicine and formally address legally relevant behavior in the DSM. In the meantime, prosecutors, defense attorneys, and adjudicators sometimes stretch and pull the DSM-III-R PTSD diagnosis beyond justifiable limits to try to fit square pegs of psychiatric testimony into round holes of legal rules. Ultimately, however, lawyers cannot be blamed for misusing the PTSD diagnosis because only clinicians can make it. Casual diagnosticians may fail to apply the requisite symptomatic criteria or do so only superficially. In their haste to eliminate bogus stress claims, clinicians should not throw out the baby (authentic PTSD) with the bathwater (idiosyncratic 'stress' disorders and careless PTSD diagnoses).