Posttraumatic Stress Disorder and Dissociative Disorders

Abstract This chapter has two major sections, one on posttraumatic stress disorder (PTSD) and the other on dissociative disorders. In addition to reviewing the nosological history of these syndromes and their epidemiology, the chapter covers landmark studies and recent research, especially work concerning the cognitive (attention, memory) and biological (genetic, neuroscientific, psychophysiological) aspects of these disorders. Although clinicians have long recognized that traumatic events can produce psychiatric symptoms in previously well-adjusted individuals, prevailing opinion held that stress-induced symptoms were transient and that persistent symptoms implied the presence of another neurotic or characterological disturbance. The psychiatric sequelae of the Vietnam War altered this view. Many veterans reported chronic symptoms, often long after reentering civilian life. Instead of viewing these men as suffering from preexisting conditions worsened by the war, clinicians concluded that combat itself could cause lasting psychiatric disability. The author then discusses certain controversies that have embroiled both syndromes over the years.