THE STRESSOR CRITERION AND DIAGNOSING POSTTRAUMATIC-STRESS-DISORDER IN A LEGAL CONTEXT

Bryant (1996) outlined a recent Federal court case where an applicant claimed to be suffering from posttraumatic stress disorder (PTSD) foll owing exposure to atomic testing in Maralinga. In his paper, Bryant (1 996) discusses the legal definition of a stressor, highlighting the am biguity which remains in the DSM-IV definition of the stressor criteri on (American Psychiatric Association, 1994). In this comment, our aim is not to question Bryant's argument concerning the ambiguity of the s tressor criterion, but to question the view that there might be some w ay of objectifying the definition of a stressor in the diagnosis of PT SD, thereby standardising the diagnosis. Our perspective on the PTSD d iagnosis is necessarily biased by our experience as clinicians and res earchers in the field of war-related trauma. Although PTSD has been co nceptualised as an anxiety reaction that follows in the wake of exposu re to an extreme event, there may not be a discrete class of stressors that cause PTSD. In supporting this view, we argue that the etiology of PTSD is multidimensional. It follows that PTSD cannot be understood in terms of a cause-effect type relationship between the stressor and symptoms, as is required for the assessment of compensation/litigatio n claims in the courtroom setting.