PTSD's most distinctive feature is its etiological event. With out this event, PTSD symptoms are indistinguishable from symptoms associated with combinations of other psychiatric diagnoses. The DSM definition of PTSD assumes that the relation between the etiological event and its symptoms is equivalent to a cause and effect. In reality, these events are often reasons rather than causes of the syndrome. Where this is true, the syndrome loses its specificity. This paper explains why it is often impossible to distinguish between the reasons and causes of PTSD, and why this difficulty is generally ignored.
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