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Letters to the Editor
Sep 2011

Posttraumatic Stress Disorder Subtypes Invalid—Reply

Author Affiliations

Author Affiliations: Max-Planck Institute of Psychiatry, Munich, Germany (Drs Binder, Mehta, and Holsboer); Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine (Drs Binder and Ressler), and Yerkes National Primate Research Center (Dr Ressler), Atlanta, Georgia; and Howard Hughes Medical Institute, Chevy Chase, Maryland (Dr Ressler)

Arch Gen Psychiatry. 2011;68(9):978-980. doi:10.1001/archgenpsychiatry.2011.94

In reply

Thank you for the opportunity to respond to Dr Carroll's concerns. We appreciate his questions and concerns.

First, we must disagree that“this report suffers from serious deficiencies in design and in critical interpretation” and that“the evidence does not support the conclusions.” Although Dr Carroll's concerns are understandable, we have responded to each of them.

1.“A statistically significant triple interaction among allele carrier status, PTSD status, and baseline serum cortisol concentration or change in cortisol concentration with dexamethasone administration does not identify a specific dysfunction or a PTSD subtype. Further to the fictive status of these proposals, operational definitions of the supposed subtypes of PTSD were not given.”

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