Articlebronze2015

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

Anthony Joseph Rosellini · Murray B. Stein · Lisa J. Colpe · Steven G. Heeringa · Maria V. Petukhova · Nancy A. Sampson +3 more

69 citations0/0 files storedDepression and Anxiety

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Posttraumatic Stress Disorder Research Traumatic Brain Injury Research Migration, Health and Trauma

Abstract

BACKGROUND: Diagnostic 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. METHODS: The 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. RESULTS: The 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). CONCLUSIONS: DSM-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.

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References

2013Diagnostic and Statistical Manual of Mental Disorders 2005Lifetime Prevalence and Age-of-Onset Distributions of DSM-IV Disorders in the National Comorbidity Survey Replication 2000Diagnostic and Statistical Manual of Mental Disorders.2013National Estimates of Exposure to Traumatic Events and PTSD Prevalence Using DSM-IV and DSM-5 Criteria 2000Posttraumatic stress disorder: the burden to the individual and to society.2010The diagnostic accuracy of the PTSD Checklist: A critical review 2014The prevalence of post-traumatic stress disorder (PTSD) in US combat soldiers: a head-to-head comparison of DSM-5 versus DSM-IV-TR symptom criteria with the PTSD checklist 2014The Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS)

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