The realm of mental health diagnoses has expanded with the inclusion of “trauma and stressor-related disorders” in the fifth edition of the Diagnostic and Statistical Manual for Mental Disorders (DSM-5). This category acknowledges external environmental stressors as contributors to various mental illnesses, broadening the scope of factors considered in mental health assessments.
Within this diagnostic framework, post-traumatic stress disorder (PTSD) demands that the stressor involves exposure to or experience with actual or threatened death, serious injury, or sexual violence (Criterion A). On the other hand, adjustment disorder (AD) encompasses stressors within the realm of everyday normal life, such as job loss, the death of a loved one, or divorce. Scholars like Maercker and Lorenz highlight the commonalities between PTSD and AD, linking them to cognitive distortions around safety and trust developed from maladaptive memories of traumatic events. These memories, often coupled with negative appraisals, profoundly shape an individual’s perception of the world and themselves.
Authors have drawn parallels between the emotional, cognitive, and behavioral responses to infidelity and traumatic experiences, akin to PTSD, despite AD being a more fitting diagnostic category. Both infidelity and PTSD exhibit similar psychophysiological symptoms, including heightened anxiety, hyperarousal, rumination, intrusive flashbacks, emotional dissociation, and depression. However, a crucial distinction lies in the diagnostic criteria required for PTSD, particularly Criterion A. Research indicates that individuals experiencing the aftermath of infidelity meet all PTSD criteria except for Criterion A. Victims of romantic betrayal, as observed in studies by Roos et al. and Gordon et al., demonstrate clinical levels of PTSD symptomology, including elevated depressive symptoms and stress. While these victims undergo significant psychological and emotional distress, it is not due to direct exposure to life-threatening circumstances, as mandated by Criterion A for PTSD.
In light of these findings, attachment-based trauma, as manifested in extradyadic affairs, is proposed as a valid traumatic experience. However, it is crucial to recognise the nuanced differences from PTSD trauma. Some clinicians argue that framing infidelity as a form of trauma can enhance emotional recovery for victims, emphasising the importance of validating such distressing events. Conceptualising infidelity as a distinct traumatic experience within the context of AD allows for a more accurate understanding of its impact while drawing attention to potential overdiagnosis and the reliance on the PTSD label. This nuanced approach aims to capture the complexity of emotional responses to infidelity and offers a more tailored framework for therapeutic intervention and support.
Reference:
Rokach A, Chan SH. Love and Infidelity: Causes and Consequences. Int J Environ Res Public Health. 2023 Feb 22;20(5):3904. doi: 10.3390/ijerph20053904. PMID: 36900915; PMCID: PMC10002055.