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

Psychol Med. 2009 Dec;39(12):1957-66. doi: 10.1017/S0033291709005819. Epub 2009 Apr 20.

Abstract

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.

Method: 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.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Alcoholism / classification
  • Alcoholism / diagnosis
  • Alcoholism / epidemiology
  • Alcoholism / psychology
  • Anxiety Disorders / classification
  • Anxiety Disorders / diagnosis
  • Anxiety Disorders / epidemiology
  • Anxiety Disorders / psychology
  • Comorbidity
  • Cross-Sectional Studies
  • Depressive Disorder, Major / classification
  • Depressive Disorder, Major / diagnosis
  • Depressive Disorder, Major / epidemiology
  • Depressive Disorder, Major / psychology
  • Diagnostic and Statistical Manual of Mental Disorders
  • Health Surveys
  • Humans
  • Life Change Events
  • Models, Psychological
  • Phobic Disorders / classification
  • Phobic Disorders / diagnosis
  • Phobic Disorders / epidemiology
  • Phobic Disorders / psychology
  • Psychometrics / statistics & numerical data
  • Reproducibility of Results
  • Socioeconomic Factors
  • Stress Disorders, Post-Traumatic / classification
  • Stress Disorders, Post-Traumatic / diagnosis*
  • Stress Disorders, Post-Traumatic / epidemiology
  • Stress Disorders, Post-Traumatic / psychology
  • United States
  • Young Adult