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Contribution of Criterion A2 to PTSD Screening in the Presence of Traumatic Events


  • Noemí Pereda,

    1. Grup de Recerca en Victimització Infantil i Adolescent (GReVIA), Universitat de Barcelona, Barcelona, Spain
    2. Institute for Brain, Cognition and Behavior (IR3C), Universitat de Barcelona, Barcelona, Spain
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  • Carlos G. Forero

    Corresponding author
    1. CIBER en Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
    • IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
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  • Both authors contributed equally to this work. Funding provided by grants PSI 2009-11542 and FSE (JCI-2009-05486) from the “Ministerio de Ciencia e Innovación” (MICINN); 2007FIC00736 and 2005SGR00365 from the Departament d'Universitats, Recerca i Societat de la Informació de la Generalitat de Catalunya. These institutions had no further role in study design; data collection, analysis and interpretation of data; in the writing of the report; and in the decision to submit the paper for publication. The authors report no conflict of interest. The authors alone are responsible for the content and writing of the paper.

Correspondence concerning this article should be addressed to Carlos García Forero, Health Services Research Unit, IMIM, PRBB-Parc de Recerca Científica de Barcelona Dr., Aiguader, 88, 08003, Barcelona, Spain. E-mail:


Criterion A2 according to the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV; American Psychiatric Association [APA], 1994) for posttraumatic stress disorder (PTSD) aims to assess the individual's subjective appraisal of an event, but it has been claimed that it might not be sufficiently specific for diagnostic purposes. We analyse the contribution of Criterion A2 and DSM-IV criteria to detect PTSD for the most distressing life events experienced by our subjects. Young adults (N = 1,033) reported their most distressing life events, together with PTSD criteria (Criteria A2, B, C, D, E, and F). PTSD prevalence and criterion specificity and agreement with probable diagnoses were estimated. Our results indicate 80.30% of the individuals experienced traumatic events and met one or more PTSD criteria; 13.22% cases received a positive diagnosis of PTSD. Criterion A2 showed poor agreement with the final probable PTSD diagnosis (correlation with PTSD .13, specificity = .10); excluding it from PTSD diagnosis did not the change the estimated disorder prevalence significantly. Based on these findings it appears that Criterion A2 is scarcely specific and provides little information to confirm a probable PTSD case.

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