Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA.
J Trauma Stress. 2013 Oct;26(5):563-6. doi: 10.1002/jts.21844.
Friedman in his article in this issue describes the posttraumatic stress disorder (PTSD) diagnosis according to the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5) and provides considerable information about the process that resulted in the revisions, as well as how PTSD in the DSM-5 differs from proposals for PTSD in the International Classification of Mental Disorders and Related Health Problems (ICD-11). In this commentary, I argue that (a) the placement of PTSD in the DSM-5 category of Trauma and Stressor-Related Disorders is a major advance because it draws attention to the role of "nurture" when there is an overemphasis on "nature" by some; (b) the broader construct of PTSD in DSM-5 is justified because it includes clinically important problems and can be reliably diagnosed; and (c) the web surveys contributed substantially to the provision of data needed to support proposed changes. Concerns are raised about the proposed ICD-11 approach, and the case is presented that substantial evidence should be required before these proposed changes are made because they differ substantially from a DSM-5 PTSD diagnosis that has demonstrated reliability and validity.
弗里德曼在本期文章中根据《精神障碍诊断与统计手册（第五版）》（DSM-5）描述了创伤后应激障碍（PTSD）的诊断，并提供了大量关于修订过程的信息，以及 DSM-5 中的 PTSD 与《国际疾病分类与相关健康问题统计分类（第 11 版）》（ICD-11）中 PTSD 提案的区别。在这篇评论中，我认为：（a）将 PTSD 置于 DSM-5 创伤和应激相关障碍类别中是一个重大进展，因为它在有些人过分强调“天性”时，引起了对“后天培养”的关注；（b）DSM-5 中 PTSD 的更广泛的概念是合理的，因为它包括了临床上重要的问题，可以可靠地诊断；（c）网络调查为支持拟议变更提供了所需数据做出了重大贡献。对 ICD-11 提案提出了担忧，并提出了一个观点，即在做出这些拟议变更之前，应该需要有实质性的证据，因为这些变更与已经证明了可靠性和有效性的 DSM-5 PTSD 诊断有很大的不同。
