title: The effect of draft DSM-V criteria on posttraumatic stress disorder prevalence.
abstract: BACKGROUND
  This study was designed to examine the concordance of proposed DSM-V posttraumatic stress disorder (PTSD) criteria with DSM-IV classification rules and examine the impact of the proposed DSM-V PTSD criteria on prevalence.
  
  
  METHODS
  The sample (N = 185) included participants who were recruited for studies focused on trauma and health conducted at an academic medical center and VA medical center in the southeastern United States. The prevalence and concordance between DSM-IV and the proposed DSM-V classifications were calculated based on results from structured clinical interviews. Prevalence rates and diagnostic efficiency indices including sensitivity, specificity, area under the curve (AUC), and Kappa were calculated for each of the possible ways to define DSM-V PTSD.
  
  
  RESULTS
  Ninety-five percent of the sample reported an event that met both DSM-IV PTSD Criterion A1 and A2, but only 89% reported a trauma that met Criterion A on DSM-V. Results examining concordance between DSM-IV and DSM-V algorithms indicated that several of the algorithms had AUCs above 0.90. The requirement of two symptoms from both Clusters D and E provided strong concordance to DSM-IV (AUC = 0.93; Kappa = 0.86) and a greater balance between sensitivity and specificity than requiring three symptoms in both Clusters D and E.
  
  
  CONCLUSIONS
  Despite several significant changes to the diagnostic criteria for PTSD for DSM-V, several possible classification rules provided good concordance with DSM-IV. The magnitude of the impact of DSM-V decision rules on prevalence will be largely affected by the DSM-IV PTSD base rate in the population of interest.
authors.affiliation: VISN-6 Mental Illness Research & Education Center, Durham, NC 27705, USA. patrick.calhoun2@va.gov
authors.forename: Patrick S
authors.initials: PS
authors.lastname: Calhoun
authors.forename: Jeffrey S
authors.initials: JS
authors.lastname: Hertzberg
authors.forename: Angela C
authors.initials: AC
authors.lastname: Kirby
authors.forename: Michelle F
authors.initials: MF
authors.lastname: Dennis
authors.forename: Lauren P
authors.initials: LP
authors.lastname: Hair
authors.forename: Eric A
authors.initials: EA
authors.lastname: Dedert
authors.forename: Jean C
authors.initials: JC
authors.lastname: Beckham
mesh_terms: D000328:Adult; D019540:Area Under Curve; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D008297:Male; D015995:Prevalence; D012680:Sensitivity and Specificity; D015144:Southeastern United States / Q000453:epidemiology; D013313:Stress Disorders, Post-Traumatic / Q000145:classification / Q000175:diagnosis* / Q000453:epidemiology