In Reply In his letter, Guina acknowledges many positive aspects of the DSM-5, while reiterating concerns about the potential impact of these revisions. We completely agree that functional impairment and dysfunction are critically important, that posttraumatic stress disorder (PTSD) is best understood as a dimensional as well as a categorical construct,1 and that a primary goal of any diagnosis should be to identify individuals with significant distress or functional impairment who can benefit from treatment and other services. However, we take exception to other parts of his letter.