Revising and Consolidating the DSM-5 and ICD-11 Post-Traumatic Stress Disorders Into a Dimensional Spectrum-Based Disorder: A Literature Review

Author

Samuel Milton Shatsky, Portland State UniversityFollow

First Advisor

Melissa Thompson

Date of Award

Spring 6-12-2025

Document Type

Thesis

Degree Name

Bachelor of Science (B.S.) in Psychology and University Honors

Department

Psychology

Language

English

Subjects

complex trauma, borderline personality disorder, dsm, icd, trauma spectrum disorder

Abstract

This thesis investigates the clinical, cultural, and theoretical implications of replacing the current DSM-5 and ICD-11 categorical diagnoses of posttraumatic stress disorder (PTSD) and complex posttraumatic stress disorder (CPTSD) with a unified dimensional framework: trauma spectrum disorder (TSD). The proposed TSD model addresses ongoing concerns around diagnostic inflation, treatment misalignment, and clinical confusion stemming from binary trauma categorizations. This thesis explores whether adopting a dimensional diagnostic model to replace DSM-5 and ICD-11's current PTSD and CPTSD designations could lead to improved treatment outcomes and diagnostic clarity.

Methodology consisted of an extensive literature review of the field's current research. Using the Portland State University Library's online research database collection, databases Academic Search Premier, Annual Review of Psychiatry, Psychiatry Online, PubMed, PsycINFO, PTSDPubs, and ScienceDirect were used to find relevant research to my topic using keywords such as PTSD, CPTSD, BPD, personality disorders, ICD-11, ICD-10, DSM-5, DSM-III, three factor model, trauma spectrum, dissociation, trauma, DSO, trauma-informed, trauma therapy, DBT, and IFS.

Key findings support the validity of a three-factor model (PTSD, CPTSD, BPD) and highlight serious shortcomings in both the DSM-5 and ICD-11's current frameworks. Existing literature shows some support for dimensional over categorical diagnostic models, provided cultural sensitivity and clinical nuance are crucially preserved. Based on this, a new diagnostic proposal--TSD--is introduced, offering a scalable, patient-centered model that better aligns with empirical data and lived clinical realities.

Persistent Identifier

https://archives.pdx.edu/ds/psu/43696

Recommended Citation

Shatsky, Samuel Milton, "Revising and Consolidating the DSM-5 and ICD-11 Post-Traumatic Stress Disorders Into a Dimensional Spectrum-Based Disorder: A Literature Review" (2025). University Honors Theses. Paper 1611.