Blom Marloes, Oberink Riëtta
University of Amsterdam, Department of Clinical Psychology, The Netherlands.
Clin Child Psychol Psychiatry. 2012 Oct;17(4):571-601. doi: 10.1177/1359104511426408. Epub 2012 Jan 27.
DSM-V is on its way and doubts have been raised regarding the validity of pediatric PTSD. It is the goal of the current review to critically review the empirical literature on PTSD in youth.
A search of PsycINFO, PubMed and reference lists was conducted. Empirical information considered relevant regarding the validity of the criteria was collected.
RESULTS/CONCLUSIONS: The validity of the symptom criteria and clusters varies, with the Avoidance/Numbing cluster outperforming the Re-experiencing-and Arousal cluster. Factor analytic findings suggest that Arousal criterion D4 should be placed within the Re-experiencing cluster, and that the Avoidance/Numbing cluster should be split up. Some non-DSM-IV PTSD symptoms, among which guilt, have considerable validity in trauma-exposed youth and their inclusion in DSM-V PTSD should be considered. As for preschool children, alternative criteria are recommended that are more developmentally sensitive.
《精神疾病诊断与统计手册》第五版（DSM-V）即将问世，儿童创伤后应激障碍（PTSD）的有效性受到了质疑。本次综述的目的是对有关青少年PTSD的实证文献进行批判性回顾。
检索了心理学文摘数据库（PsycINFO）、医学期刊数据库（PubMed）及参考文献列表。收集了与标准有效性相关的实证信息。
结果/结论：症状标准和症状群的有效性各不相同，回避/麻木症状群的表现优于重新体验及觉醒症状群。因素分析结果表明，觉醒标准D4应归入重新体验症状群，回避/麻木症状群应予以拆分。一些非《精神疾病诊断与统计手册》第四版（DSM-IV）的PTSD症状，包括内疚感，在遭受创伤的青少年中具有相当的有效性，应考虑将其纳入DSM-V的PTSD诊断标准。对于学龄前儿童，建议采用更具发展敏感性的替代标准。
