New findings on alternative criteria for PTSD in preschool children
New findings on alternative criteria for PTSD in preschool children
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DOI：
10.1097/01.chi.0000046822.95464.14
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发表时间：
2003-05-01
影响因子：
13.3
通讯作者：
Putnam, FW
中科院分区：
文献类型：
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作者：
Scheeringa, M;Zeanah, CH;Putnam, FW
目的：对学龄前儿童创伤后应激障碍（PTSD）的一套替代标准进行效度分析。方法：对62名创伤儿童和63名健康对照儿童进行评估，年龄为20个月至6岁。创伤性经历包括机动车碰撞、意外伤害、虐待和目睹暴力。系统地分析了集群C和D所需的症状数量以及建议症状的效用。结果：没有病例符合DSM-IV的PTSD诊断标准。聚类B的支持率为67.9%。当需要三个症状时，符合聚类C阈值的病例比例为2%，当需要两个症状时为11%，当需要一个症状时为39%。当需要两个症状时，D簇的比率为45%，当需要一个症状时，D簇的比率为73%。四个新的症状并没有实质性地增加诊断的有效性的标准。最佳算法（一个聚类B症状，一个聚类C症状和两个聚类D症状）诊断PTSD的比率为26%。共病症状的措施，同时提供收敛验证，以支持这一修订后的算法。结论：对DSM-IV PTSD标准的修订继续得到支持，以便能够诊断出症状严重的幼儿。
Objective: An alternative set of criteria for posttraumatic stress disorder (PTSD) for preschool children was analyzed for validity. Method: Sixty-two traumatized children and 63 healthy controls, aged 20 months through 6 years, were assessed. The traumatic experiences included motor vehicle collisions, accidental injuries, abuse, and witnessing violence. The number of symptoms required for clusters C and D and the utility of proposed symptoms were systematically analyzed. Results: No cases met the DSM-IV algorithm for PTSD. Cluster B was endorsed 67.9% of the time. The proportion of cases meeting the cluster C threshold was 2% when three symptoms were required, 11% when two symptoms were required, and 39% when one symptom was required. The rate of cluster D was 45% when two symptoms were required and 73% when one symptom was required. Four novel symptoms did not substantially add to the diagnostic validity of the criteria. The optimal algorithm (one cluster B symptom, one cluster C symptom, and two cluster D symptoms) diagnosed PTSD at a rate of 26%. Measures of comorbid symptoms concurrently provided convergent validation to support this revised algorithm. Conclusion: Revisions to the DSM-IV PTSD criteria continue to be supported so that highly symptomatic young children can be diagnosed.