Franklin C Laurel, Piazza Vivian, Chelminski Iwona, Zimmerman Mark
*Southeast Louisiana Veterans Health Care System; †South Central VA Mental Illness Research, Education and Clinical Centers (MIRECC); ‡Tulane University Medical School, New Orleans, LA; and §Brown University and ∥Rhode Island Hospital, Providence, RI.
J Nerv Ment Dis. 2015 Aug;203(8):574-7. doi: 10.1097/NMD.0000000000000332.
Subthreshold posttraumatic stress disorder (PTSD), whether due to absence of symptom development or partial remission, is the subject of research and clinical work despite being absent from the DSM. A problem with the literature is that subthreshold definitions are inconsistent across studies and therefore aggregating results is difficult. This study compared the diagnostic hit rates and validity of commonly used definitions of Subthreshold PTSD in a single sample. Three definitions of Subthreshold PTSD were extracted from the literature and two were formed, including a model of DSM-5 PTSD-criterion sets, and a definition that requires six or more PTSD symptoms, but no particular criterion set. Participants (N = 654) with a criterion A stressor, but without full PTSD diagnosis, were included. Most individuals did not meet any definition of Subthreshold PTSD. Findings are discussed in light of previous research and need for increased understanding of the diagnostic implications of Subthreshold PTSD.
阈下创伤后应激障碍(PTSD),无论是由于未出现症状发展还是部分缓解,尽管未被《精神疾病诊断与统计手册》(DSM)收录,但仍是研究和临床工作的主题。文献中的一个问题是,阈下定义在不同研究中不一致,因此汇总结果很困难。本研究在单个样本中比较了常用阈下PTSD定义的诊断命中率和效度。从文献中提取了三种阈下PTSD定义,并形成了另外两种定义,包括DSM-5 PTSD标准集模型,以及一种要求有六种或更多PTSD症状但无特定标准集的定义。纳入了有A类应激源但未被诊断为完全PTSD的参与者(N = 654)。大多数个体不符合任何阈下PTSD的定义。根据先前的研究以及对加深理解阈下PTSD诊断意义的需求对研究结果进行了讨论。