Dr. Monnica T. Williams suggests that proposed changes in the criteria for post-traumatic stress disorder (PTSD) in the fifth edition of the Diagnostic Manual of Mental Disorders (DSM-5) could increase the potential for better recognition of race-based trauma in racial and ethnic minorities.
In a recent article in Psychology Today, Williams, who is a clinical psychologist and the associate director of the University of Louisville's Center for Mental Health Disparities, said that before the release of the DSM-5 Thursday, racism was recognized as a trauma that could potentially cause PTSD, but only in relation to a specific event. There had to be an incident of intense fear, helplessness, or horror for such consideration. For instance, if someone was assaulted in a racially-motivated event, then racism qualified as a sufficient trauma to be categorized as a cause of PTSD.
But now, under the new definition, the requirements for fear, helplessness, and horror have been removed, making room for the more lasting effects of subtle racism to be considered in the discussion of race-based traumas.
In 2011, researchers found that African Americans who reported experiences of racial discrimination had higher odds of suffering from generalized anxiety disorder (GAD). An article on PsychCentral termed the phenomenon as "racial battle fatigue, saying that "exposure to racial discrimination is analogous to the constant pressure soldiers face on the battlefield."
"While the term [racial battle fatigue] is certainly not trying to say that the conditions are exactly what soldiers face on a battlefield, it borrows from the idea that stress is created in chronically unsafe or hostile environments," said Dr. Jose Soto, Ph.D., associate professor of psychology at University of California, Berkeley.
Williams builds on that concept, saying that many minorities experience lasting, cumulative effects of racism that could lead to the development of PTSD. "It was found that in many cases, such as soldiers trained in combat, emotional responses are only felt afterward, once removed from the traumatic setting," she wrote. So, even when experiences aren't immediate and earth-shattering, their effects can have the magnitude to cause long-lasting trauma.
The addition of factors like intrusion symptoms, persistent avoidance, alteration in cognition and mood, and hyperarousal and reactivity to the DSM-5 bode well for the treatment of patients experiencing race-based trauma, according to Williams.
The DSM-5, which is often referred to as the mental health "bible," was released today amid skepticism, including an announcement from the National Institute for Mental Health that it will no longer fund research based on DSM clusters.