The inclusion of drone pilots in DSM criteria for PTSD: a critical review

This critical narrative review examines how drone pilots became incorporated into the DSM-5-TR diagnostic criteria for posttraumatic stress disorder (PTSD), despite limited and conflicting empirical evidence. Drawing on a purposive review of psychiatric and related literature, the article traces the evolution of PTSD criteria from DSM-IV-TR to DSM-5, evaluates seven studies of PTSD among drone pilots, and applies social constructionism to interpret changes in psychiatric classification. Studies using clinical diagnostic assessments generally found no elevated PTSD risk among drone pilots, while screening-based studies identified associations with occupational factors, including prolonged work hours. The review argues that DSM-5-TR's inclusion of drone operators reflects the expansion of ideas about trauma through indirect, mediatized exposure rather than definitive epidemiological evidence. These findings underscore the need for rigorous research into remote warfare and traumatic stress while inviting critical reflection on the cultural, social, and political processes shaping psychiatric knowledge and classification.