APPROXIMATING A DSM-5 DIAGNOSIS OF PTSD USING DSM-IV CRITERIA

作者：Rosellini Anthony J; Stein Murray B; Colpe Lisa J; Heeringa Steven G; Petukhova Maria V; Sampson Nancy A; Schoenbaum Michael; Ursano Robert J; Kessler Ronald C^*

来源：Depression and Anxiety, 2015, 32(7): 493-501.

DOI：10.1002/da.22364

• PTSD
• posttraumatic stress disorder
• assessment
• diagnosis
• anxiety
• anxiety disorders
• measurement
• psychometrics
• trauma

BackgroundDiagnostic criteria for DSM-5 posttraumatic stress disorder (PTSD) are in many ways similar to DSM-IV criteria, raising the possibility that it might be possible to closely approximate DSM-5 diagnoses using DSM-IV symptoms. If so, the resulting transformation rules could be used to pool research data based on the two criteria sets.
MethodsThe pre-post deployment study (PPDS) of the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS) administered a blended 30-day DSM-IV and DSM-5 PTSD symptom assessment based on the civilian PTSD Checklist for DSM-IV (PCL-C) and the PTSD Checklist for DSM-5 (PCL-5). This assessment was completed by 9,193 soldiers from three US Army Brigade Combat Teams approximately 3 months after returning from Afghanistan. PCL-C items were used to operationalize conservative and broad approximations of DSM-5 PTSD diagnoses. The operating characteristics of these approximations were examined compared to diagnoses based on actual DSM-5 criteria.
ResultsThe estimated 30-day prevalence of DSM-5 PTSD based on conservative (4.3%) and broad (4.7%) approximations of DSM-5 criteria using DSM-IV symptom assessments were similar to estimates based on actual DSM-5 criteria (4.6%). Both approximations had excellent sensitivity (92.6-95.5%), specificity (99.6-99.9%), total classification accuracy (99.4-99.6%), and area under the receiver operating characteristic curve (0.96-0.98).
ConclusionsDSM-IV symptoms can be used to approximate DSM-5 diagnoses of PTSD among recently deployed soldiers, making it possible to recode symptom-level data from earlier DSM-IV studies to draw inferences about DSM-5 PTSD. However, replication is needed in broader trauma-exposed samples to evaluate the external validity of this finding.

• 出版日期2015-7