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Diagnostic alterations for post-traumatic stress disorder: examining data from the National Comorbidity Survey Replication and National Survey of Adolescents

Published online by Cambridge University Press:  20 April 2009

Jon D. Elhai ,
Julian D. Ford ,
Kenneth J. Ruggiero  and
B. Christopher Frueh
Jon D. Elhai*
Affiliation:
University of South Dakota, Vermillion, SD, USA
Julian D. Ford
Affiliation:
University of Connecticut Medical School, Farmington, CT, USA
Kenneth J. Ruggiero
Affiliation:
Medical University of South Carolina, Charleston, SC, USA
B. Christopher Frueh
Affiliation:
Baylor College of Medicine and the Menninger Clinic, Houston, TX, USA
*
*Address for correspondence: J. D. Elhai, Ph.D., Disaster Mental Health Institute, The University of South Dakota, 414 East Clark Street – SDU 114, Vermillion, South Dakota57069-2390, USA. (Email: jonelhai@gmail.com)
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Abstract

Background

Two alternative models of post-traumatic stress disorder (PTSD) appear to represent the disorder's latent structure better than the traditional Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) three-factor PTSD model. The present study examines the impact of using these structural models for the diagnosis of lifetime PTSD while retaining the DSM-IV PTSD's six-symptom diagnostic requirement.

Method

Data were gathered from large-scale, epidemiological datasets collected with adults (National Comorbidity Survey Replication) and adolescents (National Survey of Adolescents). Two alternative, empirically supported four-factor models of PTSD were compared with the DSM-IV three-factor PTSD diagnostic model.

Results

Results indicated that the diagnostic alterations resulted in substantially improved structural validity, downward adjustments of PTSD's lifetime prevalence (roughly 1 percentage point decreases in adults, 1–2.5 percentage point decreases in adolescents), and equivalent psychiatric co-morbidity and sociodemographic associations.

Conclusions

Implications for modifying PTSD diagnostic criteria in future editions of DSM are discussed.

Keywords

Construct validitydiagnosisDSMepidemiologypost-traumatic stress disordertrauma
Type
Original Articles
Information
Psychological Medicine , Volume 39 , Issue 12 , December 2009 , pp. 1957 - 1966
Copyright
Copyright © Cambridge University Press 2009

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