Does COVID‐19 count?: Defining Criterion A trauma for diagnosing PTSD during a global crisis

• Published in: Depression and anxiety Vol. 38; no. 9; pp. 882 - 885
• Main Authors: Norrholm, Seth D., Zalta, Alyson, Zoellner, Lori, Powers, Abigail, Tull, Matthew T., Reist, Christopher, Schnurr, Paula P., Weathers, Frank, Friedman, Matthew J.
• Format: Journal Article
• Language: English
• Published: Hoboken Hindawi Limited 01-09-2021; John Wiley and Sons Inc
• Subjects: Anxiety; Coronaviruses; COVID-19; Diagnosis; DSM; etiology; Medical diagnosis; Mental disorders; Pandemics; peritraumatic reactions; Post traumatic stress disorder; PTSD phenomenology; Trauma
• ISSN: 1091-4269; 1520-6394
• DOI: 10.1002/da.23209

Introduction
The ongoing coronavirus disease 2019 (COVID‐19) pandemic is a globally significant crisis with a rapid spread worldwide, high rates of illness and mortality, a high degree of uncertainty, and a disruption of daily life across the sociodemographic spectrum. The clinically relevant psychological consequences of this catastrophe will be long‐lasting and far‐reaching. There is an emerging body of empirical literature related to the mental health aspects of this pandemic and this body will likely expand exponentially. The COVID‐19 pandemic is an example of a historic catastrophe from which we can learn much and from which the field will need to archive, interpret, and synthesize a multitude of clinical and research observations.
Methods
In this commentary, we discuss situations and contexts in which a diagnosis of posttraumatic stress disorder (PTSD) may or may not apply within the context of diagnostic and statistical manual of mental disorders, fifth edition (DSM‐5) criteria.
Results
Our consensus is that a COVID‐related event cannot be considered traumatic unless key aspects of DSM‐5's PTSD Criterion A have been established for a specific type of COVID‐19 event (e.g., acute, life‐threatening, and catastrophic).
Conclusion
The application of a more liberal interpretation of Criterion A will dilute the PTSD diagnosis, increase heterogeneity, confound case–control research, and create an overall sample pool with varying degrees of risk and vulnerability factors.