Diagnostic alterations for post-traumatic stress disorder: examining data from the National Comorbidity Survey Replication and National Survey of Adolescents.
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.


METHODS
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.
Elhai
Jon D
JD
Disaster Mental Health Institute, University of South Dakota, Vermillion, SD 57069-2390, USA. jonelhai@gmail.com
Ford
Julian D
JD
Ruggiero
Kenneth J
KJ
Christopher Frueh
B
B
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000437:Alcoholism / Q000145:classification / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D001008:Anxiety Disorders / Q000145:classification / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003865:Major Depressive Disorder / Q000145:classification / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D006306:Health Surveys; D006801:Humans; D008016:Life Change Events; D008960:Models, Psychological; D010698:Phobic Disorders / Q000145:classification / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D011594:Psychometrics / Q000706:statistics & numerical data; D015203:Reproducibility of Results; D012959:Socioeconomic Factors; D013313:Stress Disorders, Post-Traumatic / Q000145:classification / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D014481:United States; D055815:Young Adult