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DSM-5 是否改善了创伤性应激源标准?:DSM-IV 和 DSM-5 标准 A 与创伤后应激障碍症状的关联。

Did the DSM-5 Improve the Traumatic Stressor Criterion?: Association of DSM-IV and DSM-5 Criterion A with Posttraumatic Stress Disorder Symptoms.

机构信息

University of Illinois at Urbana-Champaign, Champaign, IL, USA.

出版信息

Psychopathology. 2017;50(6):373-378. doi: 10.1159/000481950. Epub 2017 Nov 17.

Abstract

OBJECTIVE

A recent meta-analysis found that DSM-III- and DSM-IV-defined traumas were associated with only slightly higher posttraumatic stress disorder (PTSD) symptoms than nontraumatic stressors. The current study is the first to examine whether DSM-5-defined traumas were associated with higher levels of PTSD than DSM-IV-defined traumas. Further, we examined theoretically relevant event characteristics to determine whether characteristics other than those outlined in the DSM could predict PTSD symptoms.

METHOD

One hundred six women who had experienced a trauma or significant stressor completed questionnaires assessing PTSD, depression, impairment, and event characteristics. Events were rated for whether they qualified as DSM-IV and DSM-5 trauma.

RESULTS

There were no significant differences between DSM-IV-defined traumas and stressors. For DSM-5, effect sizes were slightly larger but still nonsignificant (except for significantly higher hyperarousal following traumas vs. stressors). Self-reported fear for one's life significantly predicted PTSD symptoms.

CONCLUSIONS

Our results indicate that the current DSM-5 definition of trauma, although a slight improvement from DSM-IV, is not highly predictive of who develops PTSD symptoms. Our study also indicates the importance of individual perception of life threat in the prediction of PTSD.

摘要

目的

最近的一项荟萃分析发现,DSM-III 和 DSM-IV 定义的创伤与创伤后应激障碍(PTSD)症状的相关性仅略高于非创伤性应激源。本研究首次检验了 DSM-5 定义的创伤是否与 DSM-IV 定义的创伤相比,与更高水平的 PTSD 相关。此外,我们还研究了理论上相关的事件特征,以确定除了 DSM 中概述的特征之外,是否还有其他特征可以预测 PTSD 症状。

方法

106 名经历过创伤或重大应激源的女性完成了评估 PTSD、抑郁、损伤和事件特征的问卷。对事件进行 DSM-IV 和 DSM-5 创伤的评定。

结果

DSM-IV 定义的创伤与应激源之间无显著差异。对于 DSM-5,效应大小略大,但仍无统计学意义(除了创伤后明显高于应激源的过度警觉)。自我报告的对生命的恐惧显著预测了 PTSD 症状。

结论

我们的结果表明,目前的 DSM-5 创伤定义虽然比 DSM-IV 略有改进,但对谁会发展出 PTSD 症状的预测性并不高。我们的研究还表明,个体对生命威胁的感知在 PTSD 的预测中很重要。

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