The utility of Criterion A under chronic national terror

According to DSM-IV-TR, both an objective and a subjective exposure component (A1 and A2 criteria, respectively) are required in order to qualify for a Posttraumatic stress Disorder (PTSD) diagnosis. one proposed DSM-5 change is that Criterion A be more explicitly defined and made purely objective. the DSM and the ICD appear to be largely products of the north american and european societies and, therefore, may be culturally-biased. Compared with other societies, the latter are not exposed to chronic national traumatic stress. therefore, the current structure of Criterion A may be especially relevant to single traumatic incidents, rather than to chronic national scale. the current review raises the question of whether the proposed DSM-5 changes to Criterion A are congruent with the reality of nations where exposure to terror is persistent, constant and of national proportions.