The slippery slope of stress: An investigation of Criterion A in posttraumatic stress disorder
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Criterion A of posttraumatic stress disorder (PTSD) specifies the nature of the traumatic experience necessary to warrant further assessment of traumatic symptomatology. Because of its gatekeeper function, it is an important part of the PTSD construct. However, relatively little research has focused on Criterion A, and the research that does exist highlights numerous problems. For instance, studies have produced conflicting results regarding the prevalence of different components of Criterion A as well as the relation between Criterion A components and PTSD symptomatology. The present study was designed to fill several gaps in the current literature and clarify the nature of Criterion A. Specifically, this study deconstructed both Criterion A1 (trauma features) and Criterion A2 (emotional responses to the trauma) and explored their relations to various conceptualizations of posttraumatic stress (e.g., specific symptom clusters, comorbid psychological distress) in a sample of 270 trauma-exposed patients. Results indicated that some, but not all, components of Criterion A as well as non-DSM emotional responses consistently predicted both PTSD symptoms and other indices of psychological distress (e.g., depression and anxiety). In addition, results indicated that type of trauma did not generally moderate the impact of Criterion A components on PTSD outcomes.