Traumatic Events, Criterion Creep, and the
Creation of Pretraumatic Stress Disorder
Gerald M. Rosen - University of Washington
Correspondence concerning this article should be addressed to Gerald M. Rosen, 205 Eastlake Center, 2825 Eastlake Ave. East, Seattle, WA 98102. E-mail: firstname.lastname@example.org.
The linkage of a defined class of traumatic events (Criterion A) with a specified set of symptoms (Criteria B through D) is central to the conceptual foundations of posttraumatic stress disorder. Over the years there has been “conceptual bracket creep” (McNally, 2003) in which an ever-widening field of adverse events is subsumed under Criterion A. In a recent demonstration of this point, Avina and O’Donohue (2002) proposed that nontraumatic events can lead to PTSD as a consequence of the expectation of future trauma. This proposal creates the conceptual equivalent of “pretraumatic” stress disorder, and moves one bracket closer toward rendering the construct of PTSD meaningless.