Diagnostic alterations for post-traumatic stress disorder: Examining data from the national comorbidity survey replication and national survey of adolescents

Jon D. Elhai, Julian D. Ford, Kenneth J. Ruggiero, B. Christopher Frueh

Research output: Contribution to journalArticlepeer-review

63 Scopus citations

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, 12.5 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.

Original languageEnglish (US)
Pages (from-to)1957-1966
Number of pages10
JournalPsychological Medicine
Volume39
Issue number12
DOIs
StatePublished - Dec 2009
Externally publishedYes

Keywords

  • Construct validity
  • DSM
  • Diagnosis
  • Epidemiology
  • Post-traumatic stress disorder
  • Trauma

ASJC Scopus subject areas

  • Applied Psychology
  • Psychiatry and Mental health

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