Does Requiring Trauma Exposure Affect Rates of ICD-11 PTSD and Complex PTSD? Implications for DSM-5
Does Requiring Trauma Exposure Affect Rates of ICD-11 PTSD and Complex PTSD? Implications for DSM-5
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DOI：
10.1037/tra0000908
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发表时间：
2021-02-01
影响因子：
6.3
通讯作者：
Brewin, Chris R.
中科院分区：
文献类型：
--
作者：
Hyland, Philip;Karatzias, Thanos;Brewin, Chris R.
目的：几乎没有证据表明创伤后应激障碍（PTSD）更可能遵循标准A定义的创伤事件而不是非标准A压力源。标准A事件可能对国际疾病分类（ICD）-11 PTSD具有更大的预测有效性，PTSD是一种由核心特征定义的更狭窄的疾病。我们评估了使用标准A（符合ICD-11指南的扩展创伤定义）和无暴露标准对ICD-11 PTSD和复杂PTSD（CPTSD）发生率的影响。我们还评估了扩展定义中包含的5种心理威胁事件是否与标准标准A事件一样与PTSD和CPTSD密切相关。方法：来自爱尔兰的全国代表性样本（N = 1，020）完成了自我报告措施。结果：根据标准A（82%）和扩展标准（88%），大多数参与者都有创伤暴露。当不使用暴露标准时，13.7%符合PTSD或CPTSD的诊断要求，使用扩展标准时为13.2%，使用标准A时为13.2%。这5起心理威胁事件与PTSD和CPTSD的相关性与标准A事件一样强。在多元分析中。只有心理威胁事件与PTSD（跟踪）和CPTSD（欺凌）显著相关。情感虐待和忽视）。结论：某些涉及极度恐惧和恐怖的非标准A事件应被视为创伤性事件。ICD-11提供临床指导而不是正式定义的方法为当前和以前试图定义创伤暴露的一些问题提供了可行的解决方案。
Objective: There is little evidence that posttraumatic stress disorder (PTSD) is more likely to follow traumatic events defined by Criterion A than non-Criterion A stressors. Criterion A events might have greater predictive validity for International Classification of Diseases (ICD)-11 PTSD, which is a condition more narrowly defined by core features. We evaluated the impact of using Criterion A, an expanded trauma definition in line with ICD-11 guidelines, and no exposure criterion on rates of ICD-11 PTSD and Complex PTSD (CPTSD). We also assessed whether 5 psychologically threatening events included in the expanded definition were as strongly associated with PTSD and CPTSD as standard Criterion A events. Method: A nationally representative sample from Ireland (N = 1,020) completed self-report measures. Results: Most participants were trauma-exposed based on Criterion A (82%) and the expanded (88%) criterion. When no exposure criterion was used, 13.7% met diagnostic requirements for PTSD or CPTSD, 13.2% when the expanded criterion was used, and 13.2% when Criterion A was used. The 5 psychologically threatening events were as strongly associated with PTSD and CPTSD as the Criterion A events. In a multivariate analysis. only the psychologically threatening events were significantly associated with PTSD (stalking) and CPTSD (bullying. emotional abuse, and neglect). Conclusions: Certain non-Criterion A events involving extreme fear and horror should be considered traumatic. The ICD-11 approach of providing clinical guidance rather than a formal definition offers a viable solution to some of the problems associated with the current and previous attempts to define traumatic exposure.