Kraemer Bernd, Wittmann Lutz, Jenewein Josef, Maier Thomas, Schnyder Ulrich
Department of Psychiatry, University Hospital Zürich, Zürich, Switzerland.
Psychopathology. 2009;42(5):333-6. doi: 10.1159/000232976. Epub 2009 Aug 11.
The stressor criterion (criterion A) in the DSM-IV diagnosis of posttraumatic stress disorder (PTSD) is frequently questioned. To explore the clinical and diagnostic usefulness of criterion A, we examined its value in predicting and capturing PTSD symptom clusters (criteria B-D) in a sample of trauma survivors.
We studied 342 adult German-speaking Swiss tourists affected by the 2004 tsunami. We analyzed sensitivity and specificity, predictive value and variance explanation of criterion A for evoking PTSD criteria B-D.
Sensitivity of criterion A for PTSD criteria B-D was 93.2%, while positive predictive value was 23.1%. Criterion A made a small, yet statistically significant contribution of 7.5% for PTSD symptom clusters B-D.
The assessment of criterion A (A1 and A2) is not necessary for the identification of individuals suffering from PTSD symptoms according to DSM-IV. We suggest therefore that criterion A is a dispensable part of the diagnosis of PTSD.
创伤后应激障碍（PTSD）在《精神疾病诊断与统计手册》第四版（DSM-IV）中的应激源标准（A标准）常受到质疑。为探究A标准在临床及诊断方面的实用性，我们在一组创伤幸存者样本中检验了其对预测和捕捉PTSD症状群（B - D标准）的价值。
我们研究了342名受2004年海啸影响的讲德语的瑞士成年游客。我们分析了A标准引发PTSD的B - D标准的敏感性和特异性、预测价值及方差解释。
A标准对PTSD的B - D标准的敏感性为93.2%，而阳性预测值为23.1%。A标准对PTSD症状群B - D的贡献较小，但具有统计学意义，为7.5%。
根据DSM-IV，对于识别患有PTSD症状的个体而言，评估A标准（A1和A2）并非必要。因此，我们认为A标准是PTSD诊断中可有可无的部分。
