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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
neuroscience
The role of criterion A2 in the DSM-IV diagnosis of posttraumatic stress disorder
Biological Psychiatry, Volume 68, No. 5, Year 2010
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Description
Background: Controversy exists about the utility of DSM-IV posttraumatic stress disorder (PTSD) criterion A2 (A2): that exposure to a potentially traumatic experience (PTE; PTSD criterion A1) is accompanied by intense fear, helplessness, or horror. Methods: Lifetime DSM-IV PTSD was assessed with the Composite International Diagnostic Interview in community surveys of 52,826 respondents across 21 countries in the World Mental Health Surveys. Results: Of 28,490 representative PTEs reported by respondents, 37.6% met criterion A2, a proportion higher than the proportions meeting other criteria (BF; 5.4%9.6%). Conditional prevalence of meeting all other criteria for a diagnosis of PTSD given a PTE was significantly higher in the presence (9.7%) than absence (.1%) of A2. However, as only 1.4% of respondents who met all other criteria failed A2, the estimated prevalence of PTSD increased only slightly (from 3.64% to 3.69%) when A2 was not required for diagnosis. Posttraumatic stress disorder with or without criterion A2 did not differ in persistence or predicted consequences (subsequent suicidal ideation or secondary disorders) depending on presence-absence of A2. Furthermore, as A2 was by far the most commonly reported symptom of PTSD, initial assessment of A2 would be much less efficient than screening other criteria in quickly ruling out a large proportion of noncases. Conclusions: Removal of A2 from the DSM-IV criterion set would reduce the complexity of diagnosing PTSD, while not substantially increasing the number of people who qualify for diagnosis. Criterion A2 should consequently be reconceptualized as a risk factor for PTSD rather than as a diagnostic requirement. © 2010 Society of Biological Psychiatry.
Authors & Co-Authors
Karam, Elie Georges
United States, Princeton
Medical Center
Andrews, Gavin A.
Lebanon, Al Koura
University of Balamand
Bromet, Evelyn J.
Australia, Sydney
Unsw Sydney
Petukhova, Maria V.
Lebanon, Beirut
Research
Ruscio, Ayelet Meron
United States, Stony Brook
Stony Brook University
Salamoun, Mariana M.
United States, Princeton
Medical Center
Sampson, Nancy A.
Lebanon, Beirut
Research
Stein, Dan J.
United States, Boston
Harvard Medical School
Alonso Caballero, J. L.
United States, Philadelphia
University of Pennsylvania
Andrade, Laura Helena Silveira Guerra
South Africa, Observatory
Groote Schuur Hospital
Angermeyer, Matthias Claus
Spain, Madrid
Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública
Demyttenaere, Koen
Brazil, Sao Paulo
Universidade de São Paulo
de Girolamo, Giovanni
Austria, Vienna
Center for Public Mental Health
de Graaf, Ron
Belgium, Leuven
Ku Leuven– University Hospital Leuven
Florescu, Silvia E.
Italy, Brescia
Irccs Centro San Giovanni Di Dio Fatebenefratelli
Gureje, Oye
Netherlands, Utrecht
Trimbos Institute, Netherlands Institute of Mental Health and Addiction
Kaminer, Debra
Romania, Bucharest
Scoala Nationala de Sanatate Publica si Management Sanitar, Bucharest
Kotov, Roman
Nigeria, Ibadan
University College Hospital, Ibadan
Lee, Sing
South Africa, Stellenbosch
Stellenbosch University
Lpine, Jean Pierre
United States, Stony Brook
Renaissance School of Medicine at Stony Brook University
Medina-Mora, M. E.
Hong Kong, Hong Kong
Chinese University of Hong Kong
Oakley-Browne, Mark A.
France, Paris
Ap-hp Assistance Publique - Hopitaux de Paris
Posada-Villa, J. A.
Mexico, Mexico
Instituto Nacional de Psiquiatría Ramon de la Fuente
Sagar, Rajesh Pragna
Australia, Hobart
University of Tasmania
Shalev, Arieh Y.
Colombia, Bogota
Universidad Colegio Mayor de Cundinamarca
Takeshima, Tadashi
India, New Delhi
All India Institute of Medical Sciences, new Delhi
Tomov, Toma
Israel, Jerusalem
Hadassah University Medical Centre
Japan, Kodaira
National Center of Neurology and Psychiatry
Bulgaria, Sofia
New Bulgarian University
Kessler, Ronald C.
Lebanon, Beirut
Research
Statistics
Citations: 89
Authors: 28
Affiliations: 27
Identifiers
Doi:
10.1016/j.biopsych.2010.04.032
ISSN:
00063223
Research Areas
Mental Health
Study Design
Cross Sectional Study