title: Examining potential overlap of DSM-5 PTSD criteria D and E.
abstract: The Diagnostic and Statistical Manual, Fifth Edition-5 (DSM-5) has adopted a four-factor symptom model for Posttraumatic Stress Disorder (PTSD) that includes new symptom additions in criterion D (D2, D3, D4), negative alterations in cognition and mood. This article examines potential overlapping endorsement of these symptoms amongst one another and with the behavioral symptoms within PTSD criterion E (E1 and E3; alterations in arousal and reactivity), through the lenses of cognitive-behavioral theory. Responses of veteran participants (N=320) completing the PTSD Checklist-5 were used to determine overlap in symptom reporting. We conducted a series of direct logistic regressions to determine the predictive ability of meeting the criterion D or E symptoms based on endorsement of the target D symptoms (D2, D3, D4). Results suggest that the new cognitive and emotional symptoms of criterion D have significant overlapping content, and that thought-related symptoms are often endorsed in conjunction with their behavioral counterpoint (D2/E3; D4/E1). Our results suggest that DSM-5 criterion D symptoms may not be central to the diagnostic structure of PTSD. These symptoms add complexity and difficulty to diagnosing PTSD without adding much unique content.
authors.affiliation: Southeast Louisiana Veterans Health Care System, 3500 Canal Street, New Orleans, LA 70119, USA; Tulane University School of Medicine, Department of Psychiatry and Behavioral Sciences, 1430 Tulane Avenue, New Orleans, LA 70112, USA; South Central VA MIRECC, 3500 Canal Street, New Orleans, LA 70119, USA. Electronic address: laurel.franklin@va.gov.
authors.forename: C Laurel
authors.initials: CL
authors.lastname: Franklin
authors.affiliation: Southeast Louisiana Veterans Health Care System, 3500 Canal Street, New Orleans, LA 70119, USA; South Central VA MIRECC, 3500 Canal Street, New Orleans, LA 70119, USA.
authors.forename: Jessica L
authors.initials: JL
authors.lastname: Walton
authors.affiliation: Southeast Louisiana Veterans Health Care System, 3500 Canal Street, New Orleans, LA 70119, USA; South Central VA MIRECC, 3500 Canal Street, New Orleans, LA 70119, USA.
authors.forename: Lisa-Ann
authors.initials: LA
authors.lastname: Cuccurullo
authors.affiliation: Southeast Louisiana Veterans Health Care System, 3500 Canal Street, New Orleans, LA 70119, USA; South Central VA MIRECC, 3500 Canal Street, New Orleans, LA 70119, USA.
authors.forename: Amanda
authors.initials: A
authors.lastname: Raines
authors.affiliation: Southeast Louisiana Veterans Health Care System, 3500 Canal Street, New Orleans, LA 70119, USA.
authors.forename: Jaqueline
authors.initials: J
authors.lastname: Ball
authors.affiliation: Southeast Louisiana Veterans Health Care System, 3500 Canal Street, New Orleans, LA 70119, USA.
authors.forename: Amanda
authors.initials: A
authors.lastname: Vaught
authors.affiliation: Southeast Louisiana Veterans Health Care System, 3500 Canal Street, New Orleans, LA 70119, USA.
authors.forename: Jessica L
authors.initials: JL
authors.lastname: Chambliss
authors.affiliation: Edward Hines Jr. VA Hospital, 5000 S. Fifth Street, Hines, IL 60141, USA.
authors.forename: Kelly P
authors.initials: KP
authors.lastname: Maieritsch
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D057189:Checklist / Q000706:statistics & numerical data; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data*; D013313:Stress Disorders, Post-Traumatic / Q000145:classification / Q000175:diagnosis*; D014728:Veterans / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: PTSD checklist; Posttraumatic Stress Disorder; Trauma; Veterans