title: APPROXIMATING A DSM-5 DIAGNOSIS OF PTSD USING DSM-IV CRITERIA.
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.
authors.affiliation: Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts.
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: Rosellini
authors.affiliation: Department of Psychiatry, University of California San Diego, La Jolla, California.|Department of Family and Preventive Medicine, University of California San Diego, La Jolla, California.|VA San Diego Healthcare System, San Diego, California.
authors.forename: Murray B
authors.initials: MB
authors.lastname: Stein
authors.affiliation: National Institute of Mental Health, Bethesda, Maryland.
authors.forename: Lisa J
authors.initials: LJ
authors.lastname: Colpe
authors.affiliation: Institute for Social Research, University of Michigan, Ann Arbor, Michigan.
authors.forename: Steven G
authors.initials: SG
authors.lastname: Heeringa
authors.affiliation: Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts.
authors.forename: Maria V
authors.initials: MV
authors.lastname: Petukhova
authors.affiliation: Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts.
authors.forename: Nancy A
authors.initials: NA
authors.lastname: Sampson
authors.affiliation: National Institute of Mental Health, Bethesda, Maryland.
authors.forename: Michael
authors.initials: M
authors.lastname: Schoenbaum
authors.affiliation: Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University School of Medicine, Bethesda, Maryland.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Ursano
authors.affiliation: Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts.
authors.forename: Ronald C
authors.initials: RC
authors.lastname: Kessler
mesh_terms: D000328:Adult; D057189:Checklist / Q000592:standards; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008889:Military Personnel / Q000523:psychology* / Q000706:statistics & numerical data; D015995:Prevalence; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis* / Q000453:epidemiology; D014481:United States / Q000453:epidemiology
keywords: PTSD/posttraumatic stress disorder; anxiety/anxiety disorders; assessment/diagnosis; measurement/psychometrics; trauma
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