Examining the diagnostic utility of the
            <i>DSM‐5</i>
            PTSD symptoms among male and female returning veterans

Green, Jonathan D.; Annunziata, Anthony; Kleiman, Sarah E.; Bovin, Michelle J.; Harwell, Aaron; Fox, Annie M.L.; Black, Shimrit K.; Schnurr, Paula P.; Holowka, Darren W.; Rosen, Raymond C.; Keane, Terence M.; Marx, Brian P.

doi:10.1002/da.22667

Cited by 9 publications

(5 citation statements)

References 36 publications

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“…To calculate interrater agreement, an independent rater randomly selected, reviewed, and coded 100 interviews using the same SCID-5 criteria as the original assessor. We then compared the assessment results of the original and independent assessors, which demonstrated good interrater agreement (κ = .82; Green et al, 2017; Mitchell et al, 2017).…”

Section: Methodsmentioning

confidence: 99%

The role of PTSD symptom clusters and criterion in predicting future high-risk drug and alcohol use among returning veteran men and women.

Livingston¹,

Farmer²,

Mahoney³

et al. 2022

Psychological Services

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The prevalence of co-occurring posttraumatic stress disorder (PTSD) and substance use disorder (SUD) remains exceptionally high among returning veterans, with numerous studies linking PTSD, but not specific PTSD symptoms, to future SUD risk. Further explication of PTSD symptom effects on future SUD risk will likely promote intervention development and refinement while offsetting SUD risk. Accordingly, In this study we explored the prospective associations between PTSD symptom clusters, symptoms, and future SUD risk and use of specific drug classes. Returning veterans (N = 1,295; M age = 42.3, SD = 9.89; 51% female; 66.8% White) completed structured diagnostic interviews to assess PTSD symptoms and self-report measures of substance use 14-36 months later (M = 24.59, SD = 2.97). Hyperarousal and reckless/selfdestructive symptoms specifically predicted future high-risk drug use and binge drinking behavior, and avoidance of internal stimuli (i.e., of trauma memories, thoughts, and feelings) differentiated individuals classified as high-risk for alcohol use based on their AUDIT total score. Further, negative alterations in cognition and mood predicted future opioid (i.e., nightmares) and stimulant use (i.e., flashbacks), whereas concentration difficulties were inversely associated with future binge drinking. This longitudinal study identified prospective and enduring associations between specific PTSD symptom clusters, symptoms, and future high-risk substance use patterns among returning veterans. Accordingly, careful assessment of specific PTSD criteria and differential motivations for substance use is warranted, along with tailored interventions to offset risk for opioid, stimulant, and alcohol use among returning veterans. Impact StatementWe found that PTSD clusters predicted future high-risk substance use among returning veterans, as well as specific patterns of substance use longitudinally (e.g., opioid use). In addition to identifying future research directions, study findings highlight specific PTSD symptoms to consider in assessment and treatment in order to offset risk for hazardous substance use.

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Section: Methodsmentioning

confidence: 99%

The role of PTSD symptom clusters and criterion in predicting future high-risk drug and alcohol use among returning veteran men and women.

Livingston¹,

Farmer²,

Mahoney³

et al. 2022

Psychological Services

Self Cite

View full text Add to dashboard Cite

show abstract

“…This was done to obtain comprehensive symptom assessment for each participant. Interrater agreement was excellent (κ = .82) among a randomly selected subset of 100 interviews that were rated by a second assessor who separately listened to a digital recording of the interview and provided independent symptom and diagnosis ratings (Green et al, 2017).…”

Section: Methodsmentioning

confidence: 99%

Toward Reduced Burden in Evidence-Based Assessment of PTSD: A Machine Learning Study

et al. 2020

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Structured diagnostic interviews involve significant respondent burden and clinician administration time. This study examined whether we can maintain diagnostic accuracy using fewer posttraumatic stress disorder (PTSD) assessment questions. Our study included 1,265 U.S. veterans of the Afghanistan and Iraq conflicts who were assessed for PTSD using the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (SCID-5). We used random forests to assess the importance of each diagnostic item in predicting a SCID-5 PTSD diagnosis. We used variable importance to rank each item and removed the lowest ranking items while maintaining ≥90% accuracy (i.e., efficiency), sensitivity, and other metrics. We eliminated six diagnostic items among the overall sample, four items among male veterans, and six items among female veterans. Our findings demonstrate that we may shorten the SCID-5 PTSD module while maintaining excellent diagnostic performance. These findings have implications for potentially reducing patient and provider burden of PTSD diagnostic assessment.

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“…In the first type, a comparison was conducted only between PTSD cases of each ICD/DSM diagnosis (e.g. ICD-11 and DSM-5) (Green et al, 2017;Hyland et al, 2016;O'Donnell et al, 2014). In the second type of studies, a comparison was conducted also between 'unique' cases of PTSD, meaning cases who only fulfilled either ICD or DSM diagnostic criteria of PTSD but not both (La Greca, Danzi, & Chan, 2017;Morina, van Emmerik, Andrews, & Brewin, 2014;Shevlin et al, 2018;Stammel, Abbing, Heeke, & Knaevelsrud, 2015;Wisco et al, 2017Wisco et al, , 2016.…”

Section: Introductionmentioning

confidence: 99%

Prevalence and comorbidity of the ICD-11 and DSM-5 for PTSD caseness with previous diagnostic manuals among the Japanese population

Ito

Takebayashi

et al. 2020

European Journal of Psychotraumatology

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Background: The diagnostic criteria for posttraumatic stress disorder (PTSD) differ between DSM-5 and ICD-11, which may affect the estimation of prevalence. Objective: To investigate the concordance of ICD-11 and DSM-5, as compared to ICD-10 and DSM-IV, regarding PTSD caseness among Japanese people who had experienced different potentially traumatic events. In addition, we estimated the comorbidity with major depressive disorder and generalized anxiety disorder according to these four diagnostic manuals. Method: A web-based survey (n = 6,180) was conducted from November 2016 to March 2017. Participants completed the PTSD Checklist for DSM-5, and other standardized measures of PTSD, depression, and anxiety. Results: The prevalence of PTSD caseness according to ICD-11 was significantly lower as compared to DSM-IV, DSM-5, and ICD-10. Cohen's kappa between DSM-5 and ICD-11 was 0.79, indicating substantial agreement. Comorbidity with depression was significantly higher in unique DSM-5 cases than in unique ICD-11 cases. Unique DSM-5 PTSD cases were significantly stronger functionally impaired than unique ICD-11 PTSD cases. Conclusions: Although requiring fewer items, the ICD-11 showed substantial agreement with DSM-5 regarding PTSD caseness. The lower comorbidity rates in unique cases may support the concept of the ICD-11 which intends to reduce comorbidity by identifying the core elements of PTSD.

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Examining the diagnostic utility of the DSM‐5 PTSD symptoms among male and female returning veterans

Abstract: ICD-11 PTSD criteria demonstrate neither greater diagnostic specificity nor reduced rates of comorbidity relative to DSM-5 criteria and, as such, do not perform as intended. Modifications to existing symptoms or new symptoms may improve differential diagnosis.

Cited by 9 publications

References 36 publications

The role of PTSD symptom clusters and criterion in predicting future high-risk drug and alcohol use among returning veteran men and women.

The role of PTSD symptom clusters and criterion in predicting future high-risk drug and alcohol use among returning veteran men and women.

Toward Reduced Burden in Evidence-Based Assessment of PTSD: A Machine Learning Study

Prevalence and comorbidity of the ICD-11 and DSM-5 for PTSD caseness with previous diagnostic manuals among the Japanese population

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