Blame, PTSD and DSM-5: An urgent need for clarification

Research output: Contribution to journalComment/Debate


DSM-5 substantially revised the PTSD criteria relating to exposure, redrawing symptom clusters and introducing additional symptom criteria, among them a newly defined criterion of persistent distorted blame of self or others. This commentary argues that there are fundamental problems with the current DSM-5 formulation of the blame criterion for PTSD. Most critically, there is conflation of self-blame and other-blame, which are two distinct phenomena, and there is heterogeneity in the research findings regarding the association between both kinds of blame and PTSD. Secondly, distortion of blame may be complex to determine. Finally, standard assessment tools fail to accurately represent the criteria as currently formulated. Despite the conceptual ambiguity in the diagnostic criteria and the lack of clarity regarding the assessment of this item in commonly-used measures, there is also evidence that blame is associated with other PTSD symptoms, is clinically relevant and may be an important intervention target in therapy. It is crucial, therefore, to clarify the blame criterion, differentiating aspects of self-blame and other-blame and, even more importantly, delineating the boundaries between normal and pathological blame.
Original languageEnglish
Article number1468709
Pages (from-to)1468709
Number of pages1
JournalEuropean Journal of Psychotraumatology
Issue number1
StatePublished - 1 Jan 2018

Bibliographical note

Publisher Copyright:
© 2018, © 2018 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.


  • DSM-5
  • PCL-5
  • PSSI-5
  • PTSD
  • attributions
  • blame
  • diagnostic criteria

ASJC Scopus subject areas

  • Psychiatry and Mental health


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