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National Estimates of Exposure to Traumatic Events and PTSD Prevalence Using DSM-IV and DSM-5 Criteria

Authors

  • Dean G. Kilpatrick,

    Corresponding author
    1. Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
    • Correspondence concerning this article should be addressed to Dean G. Kilpatrick, 67 President Street, South Building, Suite 200, Charleston, SC 29425. E-mail: kilpatdg@musc.edu

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  • Heidi S. Resnick,

    1. Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
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  • Melissa E. Milanak,

    1. Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
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  • Mark W. Miller,

    1. National Center for PTSD at VA Boston Healthcare System, Boston, MA, USA
    2. Boston University School of Medicine, Boston, Massachusetts, USA
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  • Katherine M. Keyes,

    1. Department of Epidemiology, Columbia University, New York, New York, USA
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  • Matthew J. Friedman

    1. Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA
    2. National Center for PTSD, White River Junction, Vermont, USA
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  • This research was funded by an American Psychiatric Association DSM grant to Dean Kilpatrick and by funding from the U.S. Department of Veterans Affairs Mental Health Services. This work was supported in part by the South Carolina Clinical & Translational Research Institute, with an academic home at the Medical University of South Carolina, National Institute of Health Grant numbers UL1 RR029882 and UL1 TR000062. Manuscript preparation was supported by NIMH grant T32 MH018869 (Principal Investigator: Dean G. Kilpatrick), National Institute on Drug Abuse grant R01 DA023099 (Principal Investigator: Heidi Resnick), and Veterans Affairs Merit Review Award 5I01CX000431-02 (Principal Investigator: Mark W. Miller). We acknowledge Brittany Baber's significant role in interview programming, and colleagues Drs. Kirstin Gros, Constance Guille, Kate Walsh, and Dawne Vogt for reviews of interview questions and/or classification of open ended stressor event descriptions.

  • Contents are solely the responsibility of the authors and views expressed do not necessarily represent those of the APA or other agencies supporting this research.

Abstract

Prevalence of posttraumatic stress disorder (PTSD) defined according to the American Psychiatric Association's Diagnostic and Statistical Manual fifth edition (DSM-5; 2013) and fourth edition (DSM-IV; 1994) was compared in a national sample of U.S. adults (N = 2,953) recruited from an online panel. Exposure to traumatic events, PTSD symptoms, and functional impairment were assessed online using a highly structured, self-administered survey. Traumatic event exposure using DSM-5 criteria was high (89.7%), and exposure to multiple traumatic event types was the norm. PTSD caseness was determined using Same Event (i.e., all symptom criteria met to the same event type) and Composite Event (i.e., symptom criteria met to a combination of event types) definitions. Lifetime, past-12-month, and past 6-month PTSD prevalence using the Same Event definition for DSM-5 was 8.3%, 4.7%, and 3.8% respectively. All 6 DSM-5 prevalence estimates were slightly lower than their DSM-IV counterparts, although only 2 of these differences were statistically significant. DSM-5 PTSD prevalence was higher among women than among men, and prevalence increased with greater traumatic event exposure. Major reasons individuals met DSM-IV criteria, but not DSM-5 criteria were the exclusion of nonaccidental, nonviolent deaths from Criterion A, and the new requirement of at least 1 active avoidance symptom.

Traditional and Simplified Chinese Abstracts by AsianSTSS

標題:使用DSM-Ⅳ和DSM-5準則去估算全國的創傷經歷和PTSD患病率

撮要 : 透過網上小組集合美國全國成人樣本(N=2,953), 套用美國精神學協會的精神疾病診斷和統計手冊(DSM)的DSM-5和DSM IV版本來診斷PTSD的患病率並比較。評估是在網上利用一個高度結構自我評估調查:創傷經歷,PTSD症狀,和功能障礙。創傷經歷若使用DSM-5準則會有高比率(89.7%),但標準是多重創傷經歷。利用同一事件(即所有症狀準則符合同一事件類別)和綜合事件(即症狀準則符合事件類別的混合)定義來決定PTSD病例。使用DSM-5和同一事件定義的終身、過去12個月及過去6個月PTSD患病率分別為8.3%,4.7%和3.8%。所有6個DSM-5患病率估量都比DSM-IV者為低,雖然其中只有2個的差別是統計上有效的。DSM-5 PTSD患病率是女性高於男性,而且隨着更大創傷經歷而增加。有些人符合DSM-IV但不合DSM-5診斷的主因是:撇除在準則A內非意外非暴力死亡和新加的最少一個主動迴避症狀的要求。

标题:使用DSM-Ⅳ和DSM-5准则去估算全国的创伤经历和PTSD患病率

撮要 : 透过网上小组集合美国全国成人样本(N=2,953), 套用美国精神学协会的精神疾病诊断和统计手册(DSM)的DSM-5和DSM IV版本来诊断PTSD的患病率并比较。评估是在网上利用一个高度结构自我评估调查:创伤经历,PTSD症状,和功能障碍。创伤经历若使用DSM-5准则会有高比率(89.7%),但标准是多重创伤经历。利用同一事件(即所有症状准则符合同一事件类别)和综合事件(即症状准则符合事件类别的混合)定义来决定PTSD病例。使用DSM-5和同一事件定义的终身、过去12个月及过去6个月PTSD患病率分别为8.3%,4.7%和3.8%。所有6个DSM-5患病率估量都比DSM-IV者为低,虽然其中只有2个的差别是统计上有效的。DSM-5 PTSD患病率是女性高于男性,而且随着更大创伤经历而增加。有些人符合DSM-IV但不合DSM-5诊断的主因是:撇除在准则A内非意外非暴力死亡和新加的最少一个主动回避症状的要求。

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