Crespo María, Gómez M M
Universidad Complutense de Madrid.
Psicothema. 2016 May;28(2):161-6. doi: 10.7334/psicothema2015.213.
The present study aims to analyze diagnostic concordance between the DSM-IV and the DSM-5 for posttraumatic stress disorder (PTSD) diagnostic criteria and their different groups of symptoms. Furthermore, analyses are conducted to establish the features of participants with no concordant diagnoses.
The study assessed 166 people over 18 who had experienced at least one traumatic event. PTSD diagnosis was established using the Global Scale for Posttraumatic Stress (EGEP), a self-report measure to assess PTSD.
The presence of cognitive avoidance was a determinant in the PTSD DSM-5 diagnosis (86% positive predictive value). The analysis of the non-concordant individuals revealed that individuals who were diagnosed according to the DSM-IV criteria but not the DSM-5 criteria were primarily indirect victims. Conversely, individuals who were diagnosed with the DSM-5 criteria and not with the DSM-IV criteria presented cognitive avoidance and alterations in cognition not included in the DSM-IV criteria.
A within-subjects concordance analysis showed high agreement for PTSD diagnosis between the two classifications. Differences between the diagnoses are due to the new definition of C (avoidance) and D (negative alterations in cognitions and mood) in the DSM-5.
本研究旨在分析《精神疾病诊断与统计手册第四版》（DSM-IV）和《精神疾病诊断与统计手册第五版》（DSM-5）在创伤后应激障碍（PTSD）诊断标准及其不同症状组之间的诊断一致性。此外，还进行了分析以确定诊断不一致的参与者的特征。
该研究评估了166名18岁以上经历过至少一次创伤事件的人。使用创伤后应激全球量表（EGEP）建立PTSD诊断，这是一种评估PTSD的自我报告测量方法。
认知回避的存在是PTSD DSM-5诊断的一个决定因素（阳性预测值为86%）。对诊断不一致个体的分析表明，根据DSM-IV标准诊断但未根据DSM-5标准诊断的个体主要是间接受害者。相反，根据DSM-5标准诊断但未根据DSM-IV标准诊断的个体表现出认知回避以及DSM-IV标准中未包括的认知改变。
一项受试者内一致性分析显示，两种分类在PTSD诊断方面具有高度一致性。诊断之间的差异归因于DSM-5中C（回避）和D（认知和情绪的负面改变）的新定义。
