National College of Ireland, Dublin, Ireland.
Centre for Global Health, Trinity College Dublin, Dublin, Ireland.
Acta Psychiatr Scand. 2017 Sep;136(3):313-322. doi: 10.1111/acps.12771. Epub 2017 Jul 11.
The 11th version of the International Classification of Diseases (ICD-11) has proposed two related trauma diagnoses: Post-traumatic stress disorder (PTSD) and Complex PTSD (CPTSD). Using a newly developed, disorder-specific measure of PTSD and CPTSD called the International Trauma Questionnaire (ITQ) the current study will (i) assess the factorial validity of ICD-11 PTSD and CPTSD; (ii) provide the first test of the discriminant validity of these constructs; and (iii) provide the first comparison of ICD-11, and Diagnostic and Statistical Manual, Fifth Edition (DSM-5), PTSD diagnostic rates using disorder-specific measures.
ICD-11 and DSM-5 PTSD-specific measures were completed by a British clinical sample of trauma-exposed patients (N = 171). The structure and validity of ICD-11 PTSD and CPTSD were assessed by means of factor analysis and assessing relationships with criterion variables.
Diagnostic rates under ICD-11 were significantly lower than those under DSM-5. A two-factor second-order model reflecting the distinction between PTSD and CPTSD best represented the data from the ITQ; and the PTSD and CPTSD factors differentially predicted multiple psychological variables.
The factorial and discriminant validity of ICD-11 PTSD and CPTSD was supported, and ICD-11 produces fewer diagnostic cases than DSM-5.
第 11 版《国际疾病分类》(ICD-11)提出了两个相关的创伤诊断:创伤后应激障碍(PTSD)和复杂性创伤后应激障碍(CPTSD)。本研究使用一种新开发的、针对特定障碍的 PTSD 和 CPTSD 测量工具——国际创伤问卷(ITQ),将(i)评估 ICD-11 PTSD 和 CPTSD 的因子有效性;(ii)首次检验这些结构的判别有效性;以及(iii)首次比较使用特定障碍测量工具的 ICD-11 和《精神障碍诊断与统计手册》第五版(DSM-5)的 PTSD 诊断率。
ICD-11 和 DSM-5 特定于 PTSD 的测量工具由英国一组创伤暴露患者(N=171)完成。通过因子分析和评估与标准变量的关系,评估 ICD-11 PTSD 和 CPTSD 的结构和有效性。
根据 ICD-11 的诊断率明显低于根据 DSM-5 的诊断率。一个反映 PTSD 和 CPTSD 区别的两因素二阶模型最能代表 ITQ 的数据;PTSD 和 CPTSD 因素分别预测了多个心理变量。
ICD-11 PTSD 和 CPTSD 的因子和判别有效性得到了支持,而且 ICD-11 比 DSM-5 产生的诊断案例更少。