Testing a <i>DSM‐5</i> reformulation of posttraumatic stress disorder: Impact on prevalence and comorbidity among treatment‐seeking civilian trauma survivors

Emmerik, Arnold A. P. van; Kamphuis, Jan H.

doi:10.1002/jts.20630

Cited by 27 publications

(28 citation statements)

References 12 publications

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“…[38–41] Based on these findings, we suggest that broadly defined PTSD may be a particularly useful additional construct in future epidemiological studies of PTSD.…”

Section: Discussionmentioning

confidence: 94%

DSM-5 and Icd-11 Definitions of Posttraumatic Stress Disorder: Investigating “Narrow” and “Broad” Approaches

et al. 2014

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Background The development of the Diagnostic and Statistical Manual of Mental Disorders 5th edition (DSM-5) and ICD-11 has led to reconsideration of diagnostic criteria for posttraumatic stress disorder (PTSD). The World Mental Health (WMH) Surveys allow investigation of the implications of the changing criteria compared to DSM-IV and ICD-10. Methods WMH Surveys in 13 countries asked respondents to enumerate all their lifetime traumatic events (TEs) and randomly selected one TE per respondent for PTSD assessment. DSMIV and ICD-10 PTSD were assessed for the 23,936 respondents who reported lifetime TEs in these surveys with the fully structured Composite International Diagnostic Interview (CIDI). DSM-5 and proposed ICD-11 criteria were approximated. Associations of the different criteria sets with indicators of clinical severity (distress-impairment, suicidality, comorbid fear-distress disorders, PTSD symptom duration) were examined to investigate the implications of using the different systems. Results A total of 5.6% of respondents met criteria for “broadly defined” PTSD (i.e., full criteria in at least one diagnostic system), with prevalence ranging from 3.0% with DSM-5 to 4.4% with ICD-10. Only one-third of broadly defined cases met criteria in all four systems and another one third in only one system (narrowly defined cases). Between-system differences in indicators of clinical severity suggest that ICD-10 criteria are least strict and DSM-IV criteria most strict. The more striking result, though, is that significantly elevated indicators of clinical significance were found even for narrowly defined cases for each of the four diagnostic systems. Conclusions These results argue for a broad definition of PTSD defined by any one of the different systems to capture all clinically significant cases of PTSD in future studies.

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“…[38–41] Based on these findings, we suggest that broadly defined PTSD may be a particularly useful additional construct in future epidemiological studies of PTSD.…”

Section: Discussionmentioning

confidence: 94%

DSM-5 and Icd-11 Definitions of Posttraumatic Stress Disorder: Investigating “Narrow” and “Broad” Approaches

et al. 2014

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“…Comparing the proposed ICD-11 to DSM-IV criteria, Stammel, Abbing, Heeke, and Knaevelsrud (2015) reported reduced PTSD prevalence according to the proposed ICD-11 criteria. In contrast, van Emmerik and Kamphuis (2011) as well as Morina, Emmerik, Andrews, and Brewin (2014) found no differences. To our knowledge, only two studies to date have systematically compared all four diagnostic systems, again yielding inconsistent results.…”

Section: Introductionmentioning

confidence: 85%

“…Of special concern for this study was the concordance when self-rated questionnaires were scored following the diagnostic rules of DSM-IV, DSM-5, ICD-10, and proposed ICD-11 criteria for PTSD. It is of note that most earlier studies in this area used clinician-administered interviews to check for a positive diagnosis of PTSD (Elhai et al, 2009; Forbes et al, 2011; Gentes et al, 2014; Morina et al, 2014; O’Donnell et al, 2014; Stein et al, 2014; van Emmerik & Kamphuis, 2011; Wisco et al, 2016). While this is without doubt the gold standard for clinical research, clinical practice often heavily relies on self-administered instruments, underlining the importance of investigating the consistency when self-rating instruments for PTSD are provided.…”

Section: Introductionmentioning

confidence: 99%

Comparison of DSM-5 and proposed ICD-11 criteria for PTSD with DSM-IV and ICD-10: changes in PTSD prevalence in military personnel

Kuester

Köhler²,

Ehring

et al. 2017

European Journal of Psychotraumatology

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Background: Recently, changes have been introduced to the diagnostic criteria for posttraumatic stress disorder (PTSD) according to the Diagnostic and Statistical Manual of Mental Disorders (DSM) and the International Classification of Diseases (ICD). Objectives:This study investigated the effect of the diagnostic changes made from DSM-IV to DSM-5 and from ICD-10 to the proposed ICD-11. The concordance of provisional PTSD prevalence between the diagnostic criteria was examined in a convenience sample of 100 members of the German Armed Forces. Method: Based on questionnaire measurements, provisional PTSD prevalence was assessed according to DSM-IV, DSM-5, ICD-10, and proposed ICD-11 criteria. Consistency of the diagnostic status across the diagnostic systems was statistically evaluated. Results: Provisional PTSD prevalence was the same for DSM-IV and DSM-5 (both 56%) and comparable under DSM-5 versus ICD-11 proposal (48%). Agreement between DSM-IV and DSM-5, and between DSM-5 and the proposed ICD-11, was high (both p < .001). Provisional PTSD prevalence was significantly increased under ICD-11 proposal compared to ICD-10 (30%) which was mainly due to the deletion of the time criterion. Agreement between ICD-10 and the proposed ICD-11 was low (p = .014). Conclusion: This study provides preliminary evidence for a satisfactory concordance between provisional PTSD prevalence based on the diagnostic criteria for PTSD that are defined using DSM-IV, DSM-5, and proposed ICD-11. This supports the assumption of a set of PTSD core symptoms as suggested in the ICD-11 proposal, when at the same time a satisfactory concordance between ICD-11 proposal and DSM was given. The finding of increased provisional PTSD prevalence under ICD-11 proposal in contrast to ICD-10 can be of guidance for future epidemiological research on PTSD prevalence, especially concerning further investigations on the impact, appropriateness, and usefulness of the time criterion included in ICD-10 versus the consequences of its deletion as proposed for ICD-11.

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“…Functional impairment was assessed with the Social Adjustment Scale—Self-Report (SAS-SR; Weissman & Bothwell, 1976). The MPSS-SR provided the reduced PTSD symptom set as they are specified for ICD-11 (see Van Emmerik & Kamphuis, 2011). The complex PTSD construct items were selected from a combination of the MPSS-SR and the BSI, which measures a wide range of psychiatric symptoms.…”

Section: Methodsmentioning

confidence: 99%

Evidence for proposed ICD-11 PTSD and complex PTSD: a latent profile analysis

Cloitre

Garvert

Brewin

et al. 2013

European Journal of Psychotraumatology

551

591

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BackgroundThe WHO International Classification of Diseases, 11th version (ICD-11), has proposed two related diagnoses, posttraumatic stress disorder (PTSD) and complex PTSD within the spectrum of trauma and stress-related disorders.ObjectiveTo use latent profile analysis (LPA) to determine whether there are classes of individuals that are distinguishable according to the PTSD and complex PTSD symptom profiles and to identify potential differences in the type of stressor and severity of impairment associated with each profile.MethodAn LPA and related analyses were conducted on 302 individuals who had sought treatment for interpersonal traumas ranging from chronic trauma (e.g., childhood abuse) to single-incident events (e.g., exposure to 9/11 attacks).ResultsThe LPA revealed three classes of individuals: (1) a complex PTSD class defined by elevated PTSD symptoms as well as disturbances in three domains of self-organization: affective dysregulation, negative self-concept, and interpersonal problems; (2) a PTSD class defined by elevated PTSD symptoms but low scores on the three self-organization symptom domains; and (3) a low symptom class defined by low scores on all symptoms and problems. Chronic trauma was more strongly predictive of complex PTSD than PTSD and, conversely, single-event trauma was more strongly predictive of PTSD. In addition, complex PTSD was associated with greater impairment than PTSD. The LPA analysis was completed both with and without individuals with borderline personality disorder (BPD) yielding identical results, suggesting the stability of these classes regardless of BPD comorbidity.ConclusionPreliminary data support the proposed ICD-11 distinction between PTSD and complex PTSD and support the value of testing the clinical utility of this distinction in field trials. Replication of results is necessary.

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Testing a DSM‐5 reformulation of posttraumatic stress disorder: Impact on prevalence and comorbidity among treatment‐seeking civilian trauma survivors

Cited by 27 publications

References 12 publications

DSM-5 and Icd-11 Definitions of Posttraumatic Stress Disorder: Investigating “Narrow” and “Broad” Approaches

DSM-5 and Icd-11 Definitions of Posttraumatic Stress Disorder: Investigating “Narrow” and “Broad” Approaches

Comparison of DSM-5 and proposed ICD-11 criteria for PTSD with DSM-IV and ICD-10: changes in PTSD prevalence in military personnel

Evidence for proposed ICD-11 PTSD and complex PTSD: a latent profile analysis

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