In ordinary speech, and even among physicians and
psychotherapists, the word “trauma” is used to denote
an extremely wide variety of events. In everyday medical
practice a diagnosis of PTSD as a synonym for
stress reactions of any kind is as common as it is incorrect.
The term “trauma” for the diagnosis of PTSD,
however, is strictly defined in psychiatric classification
systems. It includes only exceptional, life-threatening
or potentially life-threatening external events and those
associated with serious injury, which are capable of
causing a psychological shock in practically any individual
to a greater or lesser extent.
The psychological consequences of less serious,
non-life-threatening stresses such as a divorce, job loss,
bullying, or bitter feelings about these are to be
considered adjustment disorders, even if individual
symptoms typical of PTSD occur. Too little account is
taken of the fact that diagnosis has not only criteria
relating to trauma, symptoms, time, and clinical significance
but also therapeutic consequences. Incorrect
diagnoses can lead to incorrect treatment or mistaken
expert judgments.
Problems are caused by diagnosis being applied too
broadly, together with overprotective behavior on the
part of the physician and excessively long sick leave,
without appropriate treatment. This can also lead to an
unrealistic desire for treatment, including regressive
behavior and self-identification as a victim.