A Comparison of DSM-5 and DSM-IV Diagnostic Criteria for Posttraumatic Stress Disorder in Traumatized Refugees

The aim of this study was to compare the prevalence rate and factor structure of posttraumatic stress disorder (PTSD) based on the diagnostic criteria of the fourth and fifth editions of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV; DSM-5; American Psychiatric Association, , ) in traumatized refugees. There were 134 adult treatment-seeking, severely and multiply traumatized patients from various refugee backgrounds were assessed in their mother tongue using a computerized set of questionnaires consisting of a trauma list, the Posttraumatic Diagnostic Scale, and the new PTSD items that had been suggested by the DSM-5 Task Force of the American Psychiatric Association. Using DSM-IV, 60.4% of participants met diagnostic criteria for PTSD; using DSM-5, only 49.3% fulfilled all criteria (p < .001). Confirmatory factor analysis of DSM-IV and DSM-5 items showed good and comparable model fits. Furthermore, classification functions in the DSM-5 were satisfactory. The new Cluster D symptoms showed relatively high sensitivity, specificity, positive predictive power, and negative predictive power. The DSM-5 symptom structure appears to be applicable to traumatized refugees. Negative alterations in cognitions and mood may be especially useful for clinicians, not only to determine the extent to which an individual refugee is likely to meet criteria for PTSD, but also in providing targets for clinical intervention. Resumen El objetivo de este estudio fue comparar la tasa de prevalencia y estructura factorial del trastorno por estres post-traumatico (TEPT) basado en el criterio diagnostico de la quinta y cuarta edicion del Manual Diagnostico y Estadistico de los Trastornos Mentales (DSM-5 Y DSM-IV) en refugiados traumatizados. Un total de 134 adultos que buscan tratamiento, pacientes traumatizados severamente y politraumatizados refugiados de diversos origenes fueron evaluados en su lengua materna usando un conjunto de cuestionarios computarizados consistentes en una lista de traumas, Escala de Diagnostico Post-traumatico, y los nuevos items de TEPT que han sido sugeridos por el grupo de trabajo del DSM-5 de la Asociacion de Psiquiatria Americana. Usando el DSM-IV, 60.4% de los participantes cumplian el criterio diagnostico para TEPT; usando DSM-5, solo el 49.3% cumplia todos los criterios (p<.001). Analisis factorial confirmatorio de items de DSM-IV y DSM-5 mostraron buenos ajustes al modelo y comparables. Ademas, las funciones de clasificacion en el DSM-5 fueron satisfactorias. Los nuevos sintomas cluster D mostraron sensibilidad relativamente alta, especificidad, poder predictivo positivo, y poder predictivo negativo. La estructura de sintomas del DSM-5 parece ser aplicable a refugiados traumatizados. Alteraciones negativas en las cogniciones y animo pueden ser especialmente utiles para los clinicos, no solo para determinar el grado en el que es probable que un refugiado pueda cumplir con los criterios para TEPT, sino tambien para proveer objetivos para la intervencion clinica. Traditional and Simplified Chinese Abstracts by AsianSTSS ?? : ???????DSM-5?DSM-IV??????????? ??: ???????????????????????????(DSM-5 ? DSM-IV)?????,????????????(PTSD)????????????134???????????,???????????????????????????????????????,????????????????????????DSM-5????????PTSD?????DSM-IV,60.4%??????PTSD?????;??DSM-5,???49.3%??????(p < .001)??DSM-IV?DSM-5????????????,????????,??????DSM-5?????????????????D??????????????????????????DSM-5????????????????????????,?????????????????????,????????????PTSD???????,??????????????? ?? : ???????DSM-5?DSM-IV??????????? ??: ???????????????????????????(DSM-5 ? DSM-IV)?????,????????????(PTSD)????????????134???????????,????????????????????????????????????????,????????????????????????DSM-5????????PTSD?????DSM-IV,60.4%??????PTSD?????;??DSM-5,???49.3%??????(p < .001)??DSM-IV?DSM-5????????????,????????,??????DSM-5?????????????????D??????????????????????????DSM-5????????????????????????,?????????????????????,????????????PTSD???????,???????????????