Volume 22, Issue 3 (July 1977)
Validity of Psychotraumatic Reactions
The psychiatrist who is called upon to provide an expert court opinion in cases of personal injury or workmen's compensation certainly may expect to be asked, “What is a posttraumatic psychiatric reaction?” There are many designations for this reaction, including the historically classic traumatic neurosis first described by Oppenheim , who regarded organic aspects as important in the origin of the condition; accident and industrial neurosis; stress reactions; compensation neurosis; or neuroses following trauma . There is also the post-accident anxiety syndrome of Modline . A larger list of designations for posttraumatic psychiatric states has been presented by Culpan and Taylor . Keiser  wrote an excellent review of the earlier history of this condition. For reasons which will be presented in a subsequent paper, I have used the term “posttraumatic neurotic reaction” to characterize psychiatric sequelae to injury. The psychiatrist asked to respond to the above question has the additional burden of explanation posed by the absence of any specific designation for this condition in the Diagnostic and Statistical Manual of the American Psychiatric Association , although the concept has been honored in many books and papers and certainly is part of the working diagnosis catalog of the psychiatrist (and physician and surgeon) concerned with this area of medicine. The American Handbook of Psychiatry , an important reference, includes a section of neuroses following trauma. Keiser  presents 299 references in his book; my references are somewhat more extensive, numbering 2500, including the German literature.