Considerable empirical evidence is now available to show that many psychopathological conditions are influenced by stress and/or traumas. However, the diagnostic manuals of the DSM and ICD sys-tems do not always allow us to establish this relation in a precise and adequate way. Starting from working definitions of stress and trauma, we propose a series of diagnostic specifiers which can be included in the I axis of these diagnostic systems. The proposed specifiers are: 1) stress specifiers: when a disorder is linked to acute stress, chronic stress or trauma and 2) specifiers of factors associ-ated with stress: predisposition, trigger factors or maintenance. The use of these specifiers would im-prove diagnostic accuracy, disclose more information regarding the relations between stress and psy-chopathology and would be beneficial in terms of patient therapy.
En la actualidad poseemos numerosa evidencia empírica que demuestra que muchos cuadros psico-patológicos están influidos por el estrés y/o los traumas. Sin embargo, los manuales de diagnóstico de los sistemas DSM y CIE no siempre permiten establecer esta relación de un modo adecuado y preciso. A partir de una definición operativa de los conceptos de estrés y trauma se proponen una serie de especificadores que podrían ser incluidos en el eje I de estos sistemas diagnósticos. Los especificadores propuestos son: 1) especificadores del estrés: cuando un trastorno se vincula con estrés agudo, crónico, o a un trauma y 2) especificadores de factores asociados al estrés: como factor predisponente, desencadenante o de mantenimiento. El uso de estos especificadores mejoraría la precisión diagnóstica, permitiría disponer de más datos sobre las relaciones entre estrés y psicopato-logía, y resultaría beneficioso para la terapéutica de los pacientes.
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