In the present study, the second major factor in discrepancy of cases meeting the DSM-IV but not DSM-5 criteria was failure to have at least one active avoidance symptom as required to meet DSM-5 Criterion C. As noted, concern has been raised about cases that might be missed due to this requirement. However, some argue that presence of active avoidance may increase distinctiveness of PTSD from some other disorders such as major depression (Forbes et al., 2011). The separation of active avoidance from other DSM-IV Criterion C items is also consistent with results of multiple-factor-analytic studies and role of avoidance in conceptualizations of PTSD (Friedman et al., 2011). In short, most would agree that avoidance is a key part of the PTSD construct and clinical picture, and most would agree that PTSD without active avoidance is not PTSD as we know it.
