This article traces the history of classification systems for mental illness and then reviews the history of the American diagnostic system for mental disorders. The steps leading up to each publication of the Diagnostic and Statistical Manual (DSM) are described including leaders, timelines, pre-publication meetings, and field trials. Important changes in the purpose of the manuals are described with a focus on events leading to the manual’s third edition (DSM-III), which represented a paradigm shift in how we think about, and use, the classification system for mental illness. For the first time, DSM-III emphasized empirically-based, atheoretical and agnostic diagnostic criteria. New criticisms of the DSM-III and subsequent editions have arisen with a call for a new paradigm shift to replace diagnostic categories with continuous dimensional systems of classification, returning to etiologically-based definitions and incorporating findings from neurobiological science into systems of diagnosis. In the foreseeable future, however, psychiatric diagnosis must continue to be accomplished by taking a history and assessing the currently established criteria. This is necessary for communication about diseases and education of clinicians and scientists in medical fields, as well as advancement of research needed to further advance the diagnostic criteria of psychiatry.

Rates of suicide and posttraumatic stress disorder remain high among United States military personnel and veterans. Building upon prior work, we conducted a systematic review of research published from 2010 to 2018 regarding: (1) the prevalence of suicidal ideation, suicide attempt, and suicide among United States military personnel and veterans diagnosed with posttraumatic stress disorder; (2) whether posttraumatic stress disorder was associated with suicidal ideation, suicide attempt, and suicide among United States military personnel and veterans. 2,106 titles and abstracts were screened, with 48 articles included. Overall risk of bias was generally high for studies on suicidal ideation or suicide attempt and low for studies on suicide. Across studies, rates of suicidal ideation, suicide attempt, and suicide widely varied based on study methodology and assessment approaches. Findings regarding the association between posttraumatic stress disorder diagnosis with suicidal ideation and suicide were generally mixed, and some studies reported that posttraumatic stress disorder was associated with lower risk for suicide. In contrast, most studies reported significant associations between posttraumatic stress disorder and suicide attempt. These findings suggest complex associations between posttraumatic stress disorder and suicidal ideation, suicide attempt, and suicide, which are likely influenced by other factors (e.g., psychiatric comorbidity). In addition, most samples were comprised of veterans, rather than military personnel. Further research is warranted to elucidate associations between posttraumatic stress disorder and suicidal ideation, suicide attempt, and suicide, including identification of moderators and mediators of this relationship. Addressing this among United States military personnel, by gender, and in relation to different trauma types is also necessary.

Although research has identified evidence-based treatments (EBTs) for military sexual trauma (MST)-related posttraumatic stress disorder (PTSD), few studies have examined the effect of such treatments on psychosocial functioning, health or quality of life in individuals with MST-related PTSD. Male and female veterans (N = 45) with MST-related PTSD took part in a randomized clinical trial that included either 12 weeks of an evidence-based psychotherapeutic treatment (cognitive processing therapy; [CPT]) or a standard control condition (present centered therapy) and 6 months of follow-up. To assess quality of life and psychosocial functioning, each participant was administered the Quality of Life Inventory and the Short Form (36) Health Survey. Using a hierarchical linear modeling approach, results demonstrated that participants treated with CPT reported significantly higher physical functioning over time than did participants treated with PCT. Implications are discussed with regard to the role of psychotherapy in improving a patient's psychosocial and health functioning.

Treating post-traumatic stress disorder (PTSD) related to military sexual trauma (MST) continues to be a priority in veteran populations. Because negative cognitions (NCs) contribute to PTSD severity and treatment, further understanding of how PTSD and related NCs can be addressed and changed within an MST sample is important. Our study analyzed 45 participants who received either cognitive processing therapy (n = 32) or present centered therapy (n = 13). Participants who received cognitive processing therapy had significantly lower NCs scores post-treatment and at follow-up sessions than participants in the present centered therapy condition (p < 0.05). In addition, NCs were positively correlated with PTSD severity (p < 0.05). Implications for future research are discussed for both MST-related and non-MST-related PTSD.