Gender differences in DSM-5 versus DSM-IV-TR PTSD prevalence and criteria comparison among 512 survivors to the L'Aquila earthquake.
BACKGROUND
Post-traumatic Stress Disorder (PTSD) has demonstrated gender-specific prevalence and expressions across the different DSM definitions, since its first introduction in DSM-III. The DSM-5 recently introduced important revisions to PTSD symptomatological criteria. Aim of the present study is to explore whether gender moderates rates of DSM-5 PTSD expression in a non-clinical sample of survivors to a massive earthquake in Italy.


METHODS
512 survivors of the L'Aquila 2009 earthquake, previously investigated for the presence DSM-IV-TR PTSD, were reassessed according to DSM-5 criteria in order to explore gender differences. All subjects completed the Trauma and Loss Spectrum-Self Report (TALS-SR).


RESULTS
Females showed significantly higher DSM-5 PTSD rates and rates of endorsement of almost all DSM-5 PTSD criteria. Significant gender differences emerged in almost half of PTSD symptomatological criteria with women reporting higher rates in 8 of them, while men in only one (a new symptom in DSM-5: reckless or self-destructive behavior). Considering the impact of the three new DSM-5 symptoms on the diagnosis, significant gender differences emerged with these being crucial in almost half of the PTSD diagnoses in males but in about one-fourth in females. By using ROC curves, DSM-5 criteria E and D showed the highest AUC values in males (.876) and females (.837), respectively.


CONCLUSIONS
The use of self-report instrument; no information on comorbidity; homogeneity of study sample; lack of assessment on functional impairment.


CONCLUSIONS
This study provides a contribution to the ongoing need for reassessment on how gender moderates rates of expression of particular disorders such as PTSD.
Section of Psychiatry, Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 65, 56100 Pisa, Italy. Electronic address: ccarmassi@gmail.com.
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Carmassi
International Mood Center, University of California at San Diego, La Jolla, CA, USA.
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Akiskal
International Mood Center, University of California at San Diego, La Jolla, CA, USA.
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Bessonov
Section of Psychiatry, Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 65, 56100 Pisa, Italy.
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Massimetti
Section of Psychiatry, Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 65, 56100 Pisa, Italy.
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Calderani
Section of Psychiatry, Department of Experimental Medicine, University of L׳Aquila, L׳Aquila, Italy.
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Stratta
Section of Psychiatry, Department of Experimental Medicine, University of L׳Aquila, L׳Aquila, Italy.
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Rossi
Section of Psychiatry, Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 65, 56100 Pisa, Italy.
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Dell'Osso
D000293:Adolescent; D039721:Diagnostic and Statistical Manual of Mental Disorders; D004190:Disasters; D055866:Earthquakes; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D015995:Prevalence; D017678:Sex Distribution; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D017741:Survivors / Q000523:psychology* / Q000706:statistics & numerical data
DSM-5; Earthquake; Gender; PTSD; Post-traumatic stress symptoms