A comparison of ICD-11 and DSM-5 criteria of PTSD among Chinese trauma-exposed adolescent samples

Abstract

This study aimed at comparing the prevalence and comorbidity differences of PTSD according to ICD-11 and DSM-5 definitions across two Chinese adolescent trauma-exposed samples. A total of 1,201 students exposed to earthquake and 559 students from vocational schools exposed to potentially traumatic events were included in this study. The PTSD Checklist for DSM-5 was used to measure PTSD symptoms. The MDD and GAD subscales of the Revised Children’s Anxiety and Depression Scale were used to measure major depression disorder (MDD) and generalized anxiety disorder (GAD) symptoms. No significant PTSD prevalence differences between ICD-11 and DSM-5 were found across the two samples. The differences regarding comorbidities between ICD-11 and DSM-5 definitions were not significant among these two samples. The results revealed that the ICD-11 and DSM-5 provided similar prevalence of PTSD and comorbidity rates with MDD and GAD in Chinese trauma-exposed adolescent samples. This study contributes to the current understanding of the similarities and differences using different PTSD criteria and informs the organization and application of these two globally applied PTSD criteria.

Comparing diagnostic criteria for posttraumatic stress disorder in a diverse sample of trauma‐exposed youth

“…Additionally, most participants who met the criteria for PTSD also met the criteria for MDE or GAD, which is also consistent with past research (Bruckmann et al, 2020;Hyland et al, 2016;Wang et al, 2023). However, in the present study, comorbidity rates were not substantially different across the three PTSD classifications.…”

“…A comparison of these diagnostic systems revealed a moderate overall level of agreement between the two diagnoses, with DSM-5 PTSD more prevalent than ICD-11 PTSD. The study findings are consistent with prior research with higher-risk or clinical samples of trauma-exposed youth that have found a higher prevalence of DSM-5 PTSD compared to ICD-11 PTSD (La Greca et al, 2017;Sachser et al, 2018Sachser et al, , 2022Wang et al, 2023) and that agreement between classification systems varied from low to substantial (Danzi & La Greca, 2016;La Greca et al, 2017;Sachser et al, 2018Sachser et al, , 2022Wang et al, 2023).…”

“…In general, studies comparing the preva-lence of PTSD diagnosed using each set of criteria and agreement between the two diagnostic classifications are difficult to synthesize due to methodological issues, including variability in measurements of PTSD and heterogeneity in the clinical characteristics of the samples. Overall, concordance between ICD-11 and DSM-5 PTSD has ranged from fair to good, and large discrepancies in prevalence between the two diagnoses have not been found in population samples of adults (Stein et al, 2014), disasterexposed youth (Danzi & La Greca, 2016;Wang et al, 2023), or youth in foster care (Bruckmann et al, 2020). However, DSM-5 PTSD has been found to be more prevalent in highrisk groups such as refugees (Heeke et al, 2020), military veterans (Wisco et al, 2017), adult survivors of childhood sexual abuse (Hyland et al, 2016), and clinic-referred youth (Sachser et al, 2018).…”

“…Prior to the publication of the DSM-5, studies found that the removal of overlapping symptoms decreased psychiatric comorbidity rates among adolescents (Ford et al, 2009), but not adults (Elhai et al, 2008). However, since the publication of the DSM-5, differences between the two diagnoses have not been found in terms of their comorbidity with depressive or anxiety disorders in youth (Bruckmann et al, 2020;Wang et al, 2023) or adults (Hyland et al, 2016), raising doubts about claims that DSM-5's NACM cluster and additional symptoms AR cluster inflate overall PTSD prevalence or comorbidity rates.…”