Moving forward with a culturally inclusive PTSD Criterion A: Commentary on Marx et al. (2023)

In response to Marx et al.’s (2023) article, “The PTSD Criterion A debate: A brief history, current status, and recommendations for moving forward,” this commentary offers agreement with the recommendation to conduct population-based studies to inform future Criterion A changes. However, to fully address the debate as to whether Criterion A should be expanded, limited, eliminated, or remain unchanged, it is critical that future population-based research focus on cultural inclusivity and the addition of potentially traumatic experiences that are collective and/or cumulative versus individual and discrete. To further understand the etiology of mental health distress and disorder and the role of adverse life experiences, it is also recommended that adverse event specifiers be added to disorders not currently considered to be event-related. The ability to identify the potential long-term effects of adverse life experiences in relation to disorders other than posttraumatic stress disorder (e.g., major depressive disorder) could help validate experiences, reduce stigma, and further advance research on etiology and interventions.