Guina Jeffrey, Welton Randon S, Broderick Pamela J, Correll Terry L, Peirson Ryan P
Mental Health Clinic, Wright-Patterson Medical Center, Wright-Patterson Air Force Base, Dayton, OH, 45433, USA.
Department of Psychiatry, Wright State University Boonshoft School of Medicine, 627 S. Edwin C. Moses Blvd., Dayton, OH, 45417, USA.
Curr Psychiatry Rep. 2016 May;18(5):43. doi: 10.1007/s11920-016-0686-1.
This review addresses how changes in the Diagnostic and Statistical Manual of Mental Disorders (DSM)-5 posttraumatic stress disorder (PTSD) criteria has the potential to affect the care and careers of those who have served in the military, where the diagnosis often determines fitness for duty and veterans' benefits. PTSD criteria changes were intended to integrate new knowledge acquired since previous DSM editions. Many believe the changes will improve diagnosis and treatment, but some worry these could have negative clinical, occupational, and legal consequences. We analyze the changes in classification, trauma definition, symptoms, symptom clusters, and subtypes and possible impacts on the military (e.g., over- and under-diagnosis, "drone" video exposure, subthreshold PTSD, and secondary PTSD). We also discuss critiques and proposals for future changes. Our objectives are to improve the screening, diagnosis, and treatment of those service members who have survived trauma and to improve policies related to the military mental healthcare and disability systems.
本综述探讨了《精神疾病诊断与统计手册》(DSM)-5中创伤后应激障碍(PTSD)标准的变化如何有可能影响曾在军队服役人员的护理和职业发展,在军队中,该诊断往往决定是否适合服役以及退伍军人福利。PTSD标准的变化旨在整合自DSM以前版本以来获得的新知识。许多人认为这些变化将改善诊断和治疗,但有些人担心这些变化可能会产生负面的临床、职业和法律后果。我们分析了分类、创伤定义、症状、症状群和亚型的变化以及对军队可能产生的影响(例如,诊断过度和诊断不足、“无人机”视频暴露、阈下PTSD和继发性PTSD)。我们还讨论了批评意见和对未来变化的建议。我们的目标是改善对经历过创伤的现役军人的筛查、诊断和治疗,并改进与军事精神卫生保健和残疾系统相关的政策。