The DSM-5 exclusion of media exposure to traumatic events: A critical reexamination in light of the October 7, 2023, attacks.

Abstract

The issue: Criterion A, the event criterion in the posttraumatic stress disorder (PTSD) diagnosis, has been the subject of continuous debate over the years. The publication of the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5), has marked a significant change in the definition of potentially traumatic events. Most notably, secondary traumatization and indirect exposure are now an integral part of the PTSD diagnosis. However, the Manual includes one exclusion, noting that exposure through electronic media, television, movies, or pictures should not be considered as potentially traumatic, unless it is work-related.

Recommendations: In this article, we wish to strongly challenge this exclusion, using the events of October 7, 2023, in Israel as a unique case example. The events of that day included the killing of more than a thousand civilians and the abduction of more than 250 civilians and soldiers. During these events, millions worldwide were exposed to horrific, uncensored footage of killings and kidnapping. These were broadcast on social media and other informal media outlets (e.g., Telegram), which during the war have become a major source of information. Due to the lack of formal censorship or regulation, the materials shown were often very graphic. This represents a radical shift from traditional forms of media, to which we believe the DSM-5 referred in the first place. We would like to strongly argue that such coverage has a significant traumatic potential, as we already witness in large parts of Israeli society today. We therefore argue for the removal of the Criterion A4 exclusion from the DSM-5. Implications for clinical work and media policy are also discussed. (PsycInfo Database Record (c) 2025 APA, all rights reserved).