The stressor criterion in DSM-IV posttraumatic stress disorder: An empirical investigation
The stressor criterion in DSM-IV posttraumatic stress disorder: An empirical investigation
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DOI：
10.1016/s0006-3223(01)01167-2
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发表时间：
2001-11-01
影响因子：
10.6
通讯作者：
Kessler, RC
中科院分区：
文献类型：
--
作者：
Breslau, N;Kessler, RC
背景：DSM-IV对创伤后应激障碍(PTSD)的两部分定义拓宽了应激源(A1)的种类，并增加了主观成分(A2)。方法：对密歇根州东南部2181名具有代表性的人群进行了创伤事件和创伤后应激障碍的终生历史访谈。对修订后的两部分定义的评估是基于随机选择的代表社区经历的创伤事件总数的事件样本。结果：A1中扩大的压力源定义使可用于诊断创伤后应激障碍的事件总数增加了59%。大部分A1事件(76.6%)涉及A2的情绪反应。女性比男性更倾向于支持A2(调整后的优势比=2.66；95%可信区间1.92，3.71)。在由具有代表性的事件样本导致的所有创伤后应激障碍病例中，38%可归因于A1中符合资格的事件的扩大。A2对导致创伤后应激障碍的识别没有实质性的改善；然而，不涉及A2的事件很少导致创伤后应激障碍。结论：与以前的定义相比，A1中更广泛的应激源显著增加了可用于诊断创伤后应激障碍的社区经历事件的数量。此外，A2作为一个单独的标准可能是有用的，这是出现创伤后应激障碍所必需的急性反应，并可能作为一种早期筛查，以确定几乎没有创伤后应激障碍风险的最近暴露者的子集。A2作为筛查的效用必须进行前瞻性测试。(C)2001年生物精神病学学会。
Background: The DSM-IV two-part definition of posttraumatic stress disorder (PTSD) widened the variety of stressors (Al) and added a subjective component (A2). The effects of the revised stressor criterion on estimates Of exposure and PTSD in a community sample are evaluated.Methods: A representative sample of 2181 persons in southeast Michigan were interviewed about lifetime history of traumatic events and PTSD. The evaluation of the revised two-part definition is based on a randomly selected sample of events that represents the total pool of traumatic events experienced in the community.Results: The enlarged definition of stressors in A1 increased the total number of events that can be used to diagnose PTSD by 59%. The majority of A1 events (76.6%) involved the emotional response in A2. Females were more likely than males to endorse A2 (adjusted odds ratio = 2.66; 95% con fidence interval 1.92, 3.71). Of all PTSD cases resulting from the representative sample of events, 38% were attributable to the expansion of qualifying events in A1. The identification of exposures that lead to PTSD were not improved materially by A2; however, events that did not involve A2 rarely resulted in PTSD.Conclusions: Compared to previous definitions, the wider variety of stressors in A1 markedly increased the number of events experienced in the community that can be used to diagnose PTSD. Furthermore, A2 might be useful as a separate criterion, an acute response necessary for the emergence of PTSD, and might serve as an early screen for identifying a subset of recently exposed persons at virtually no risk for PTSD. The utility of A2 as a screen must be tested prospectively. (C) 2001 Society of Biological Psychiatry.