Diagnostic alterations for post-traumatic stress disorder: examining data from the National Comorbidity Survey Replication and National Survey of Adolescents
Diagnostic alterations for post-traumatic stress disorder: examining data from the National Comorbidity Survey Replication and National Survey of Adolescents
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DOI：
10.1017/s0033291709005819
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发表时间：
2009-12-01
影响因子：
6.9
通讯作者：
Frueh, B. Christopher
中科院分区：
文献类型：
--
作者：
Elhai, Jon D.;Ford, Julian D.;Frueh, B. Christopher
背景资料。创伤后应激障碍(PTSD)的两个替代模型似乎比传统的精神疾病诊断和统计手册第四版(DSM-IV)三因素PTSD模型更好地代表了该障碍的潜在结构。本研究考察了在保留DSM-IV创伤后应激障碍的六种症状诊断要求的同时，使用这些结构模型诊断终身性创伤后应激障碍的影响。数据收集自大规模流行病学数据集，包括成人(国家共病调查复制)和青少年(全国青少年调查)。两种可供选择的、经验支持的创伤后应激障碍四因素模型与DSM-IV三因素创伤后应激障碍诊断模型进行了比较。结果表明，诊断改变显著提高了结构效度，下调了创伤后应激障碍的终生患病率(成年人下降了约1个百分点，青少年下降了1-2.5个百分点)，以及相当于精神疾病的共同发病率和社会人口学联系。讨论了在未来的DSM版本中修改创伤后应激障碍诊断标准的意义。
Background. Two alternative models of post-traumatic stress disorder (PTSD) appear to represent the disorder's latent structure better than the traditional Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) three-factor PTSD model. The present study examines the impact of using these structural models for the diagnosis of lifetime PTSD while retaining the DSM-IV PTSD's six-symptom diagnostic requirement.Method. Data were gathered from large-scale, epidemiological datasets collected with adults (National Comorbidity Survey Replication) and adolescents (National Survey of Adolescents). Two alternative, empirically supported four-factor models of PTSD were compared with the DSM-IV three-factor PTSD diagnostic model.Results. Results indicated that the diagnostic alterations resulted in substantially improved structural validity, downward adjustments of PTSD's lifetime prevalence (roughly 1 percentage point decreases in adults, 1-2.5 percentage point decreases in adolescents), and equivalent psychiatric co-morbidity and sociodemographic associations.Conclusions. Implications for modifying PTSD diagnostic criteria in future editions of DSM are discussed.