The Role of Criterion A2 in the DSM-IV Diagnosis of Posttraumatic Stress Disorder
Identifieur interne : 002327 ( PascalFrancis/Corpus ); précédent : 002326; suivant : 002328The Role of Criterion A2 in the DSM-IV Diagnosis of Posttraumatic Stress Disorder
Auteurs : Elie George Karam ; Gavin Andrews ; Evelyn Bromet ; Maria Petukhova ; Ayelet Meron Ruscio ; Mariana Salamoun ; Nancy Sampson ; Dan J. Stein ; Jordi Alonso ; Laura Helena Andrade ; Matthias Angermeyer ; Koen Demyttenaere ; Giovanni De Girolamo ; Ron De Graaf ; Silvia Florescu ; Oye Gureje ; Debra Kaminer ; Roman Kotov ; Sing Lee ; Jean-Pierre Lepine ; Maria Elena Medina-Mora ; Mark A. Oakley Browne ; José Posada-Villa ; Rajesh Sagar ; Arieh Y. Shalev ; Tadashi Takeshima ; Toma Tomov ; Ronald C. KesslerSource :
- Biological psychiatry : (1969) [ 0006-3223 ] ; 2010.
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Abstract
Background: Controversy exists about the utility of DSM-IV posttraumatic stress disorder (PTSD) criterion A2 (A2): that exposure to a potentially traumatic experience (PTE; PTSD criterion A1) is accompanied by intense fear, helplessness, or horror. Methods: Lifetime DSM-IV PTSD was assessed with the Composite International Diagnostic Interview in community surveys of 52,826 respondents across 21 countries in the World Mental Health Surveys. Results: Of 28,490 representative PTEs reported by respondents, 37.6% met criterion A2, a proportion higher than the proportions meeting other criteria (B-F; 5.4%-9.6%). Conditional prevalence of meeting all other criteria for a diagnosis of PTSD given a PTE was significantly higher in the presence (9.7%) than absence (.1%) of A2. However, as only 1.4% of respondents who met all other criteria failed A2, the estimated prevalence of PTSD increased only slightly (from 3.64% to 3.69%) when A2 was not required for diagnosis. Posttraumatic stress disorder with or without criterion A2 did not differ in persistence or predicted consequences (subsequent suicidal ideation or secondary disorders) depending on presence-absence of A2. Furthermore, as A2 was by far the most commonly reported symptom of PTSD, initial assessment of A2 would be much less efficient than screening other criteria in quickly ruling out a large proportion of noncases. Conclusions: Removal of A2 from the DSM-IV criterion set would reduce the complexity of diagnosing PTSD, while not substantially increasing the number of people who qualify for diagnosis. Criterion A2 should consequently be reconceptualized as a risk factor for PTSD rather than as a diagnostic requirement.
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Format Inist (serveur)
| NO : | PASCAL 10-0453324 INIST |
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| ET : | The Role of Criterion A2 in the DSM-IV Diagnosis of Posttraumatic Stress Disorder |
| AU : | KARAM (Elie George); ANDREWS (Gavin); BROMET (Evelyn); PETUKHOVA (Maria); MERON RUSCIO (Ayelet); SALAMOUN (Mariana); SAMPSON (Nancy); STEIN (Dan J.); ALONSO (Jordi); ANDRADE (Laura Helena); ANGERMEYER (Matthias); DEMYTTENAERE (Koen); DE GIROLAMO (Giovanni); DE GRAAF (Ron); FLORESCU (Silvia); GUREJE (Oye); KAMINER (Debra); KOTOV (Roman); LEE (Sing); LEPINE (Jean-Pierre); MEDINA-MORA (Maria Elena); OAKLEY BROWNE (Mark A.); POSADA-VILLA (José); SAGAR (Rajesh); SHALEV (Arieh Y.); TAKESHIMA (Tadashi); TOMOV (Toma); KESSLER (Ronald C.); MANN (J. John); HAGHIGHI (Fatemeh) |
| AF : | Department of Psychiatry and Clinical Psychology, Saint George Hospital, University Medical Center/Beirut/Liban (1 aut., 6 aut.); Department of Psychiatry and Clinical Psychology, Faculty of Medicine, Balamand University Medical School/Beirut/Liban (1 aut., 6 aut.); Institute for Development, Research, Advocacy and Applied Care/Beirut/Liban (1 aut., 6 aut.); Department of Psychiatry, University of New South Wales/Sydney/Australie (2 aut.); State University of New York/Stony Brook, New York/Etats-Unis (3 aut.); Department of Health Care Policy, Harvard Medical School/Boston, Massachusetts/Etats-Unis (4 aut., 7 aut., 28 aut.); Department of Psychology, Universityof Pennsylvania/Philadelphia, Pennsylvania/Etats-Unis (5 aut.); Department of Psychiatry, Groote Schuur Hospital/Cape Town/Afrique du Sud (8 aut.); Health Services Research Unit, Institut Municipal d'Investigació Mèdica, Hospital Del Mar, Centro de Investigación Biomédica en Red en Epidemiologia y Salud Pública/Barcelona/Espagne (9 aut.); Section of Psychiatric Epidemiology-LIM 23 Department and Institute of Psychiatry, School of Medicine, University of São Paulo/São Paulo/Brésil (10 aut.); Center for Public Mental Health/Gösing am Wagram/Autriche (11 aut.); Department of Psychiatry, University Hospital Gasthuisberg/Leuven/Belgique (12 aut.); Istituto de Ricovero e Cura a Carattere Scientifico Centro S. Giovanni di Dio Fatebenefratelli/Brescia/Italie (13 aut.); Monitoring & Epidemiology Department, Psychiatric Epidemiology Unit, Netherlands Institute of Mental Health and Addiction/Utrecht/Pays-Bas (14 aut.); Public Health Research and Evidence Based Medicine Department, Department of Psychiatry, National School of Public Health and Health Services Management/Bucharest/Roumanie (15 aut.); University College Hospital, Prince of Wales/Ibadan/Nigéria (16 aut.); MRC Research Unit on Anxiety Disorders, University of Stellenbosch/CapeTown/Afrique du Sud (17 aut.); Department of Psychiatry, Stony Brook University/Stony Brook, New York/Etats-Unis (18 aut.); Department of Psychiatry, The Chinese University of Hong Kong/Hong-Kong (19 aut.); Institut national de la santé et de la recherche médicale, U705, Centre national de la recherché scientifique Unité Mixte de Recherche 7157, University Paris Diderot, Hôpital Lariboisière Fernand Widal, Assistance Publique Hôpitaux de Paris/Paris/France (20 aut.); National Institute of Psychiatry Ramon de la Fuente/Mexico City/Mexique (21 aut.); Division of Molecular Imaging and Neuropathology, Department of Psychiatry, Columbia University, New York State Psychiatric Institute/New York, New York/Etats-Unis (1 aut., 2 aut.) |
| DT : | Publication en série; Niveau analytique |
| SO : | Biological psychiatry : (1969); ISSN 0006-3223; Coden BIPCBF; Etats-Unis; Da. 2010; Vol. 68; No. 5; Pp. 465-473; Bibl. 36 ref. |
| LA : | Anglais |
| EA : | Background: Controversy exists about the utility of DSM-IV posttraumatic stress disorder (PTSD) criterion A2 (A2): that exposure to a potentially traumatic experience (PTE; PTSD criterion A1) is accompanied by intense fear, helplessness, or horror. Methods: Lifetime DSM-IV PTSD was assessed with the Composite International Diagnostic Interview in community surveys of 52,826 respondents across 21 countries in the World Mental Health Surveys. Results: Of 28,490 representative PTEs reported by respondents, 37.6% met criterion A2, a proportion higher than the proportions meeting other criteria (B-F; 5.4%-9.6%). Conditional prevalence of meeting all other criteria for a diagnosis of PTSD given a PTE was significantly higher in the presence (9.7%) than absence (.1%) of A2. However, as only 1.4% of respondents who met all other criteria failed A2, the estimated prevalence of PTSD increased only slightly (from 3.64% to 3.69%) when A2 was not required for diagnosis. Posttraumatic stress disorder with or without criterion A2 did not differ in persistence or predicted consequences (subsequent suicidal ideation or secondary disorders) depending on presence-absence of A2. Furthermore, as A2 was by far the most commonly reported symptom of PTSD, initial assessment of A2 would be much less efficient than screening other criteria in quickly ruling out a large proportion of noncases. Conclusions: Removal of A2 from the DSM-IV criterion set would reduce the complexity of diagnosing PTSD, while not substantially increasing the number of people who qualify for diagnosis. Criterion A2 should consequently be reconceptualized as a risk factor for PTSD rather than as a diagnostic requirement. |
| CC : | 002B18C08D |
| FD : | Critère; Diagnostic and Statistical Manual IV; Etat de stress posttraumatique; Stress; Entretien; Traumatisme; OMS; Monde; Santé mentale; Enquête |
| FG : | Trouble anxieux |
| ED : | Criterion; Diagnostic and Statistical Manual IV; Posttraumatic stress disorder; Stress; Interview; Trauma; WHO; World; Mental health; Survey |
| EG : | Anxiety disorder |
| SD : | Criterio; Diagnostic and Statistical Manual IV; Trastorno de estrés posttraumático; Estrés; Entrevista; Traumatismo; OMS; Mundo; Salud mental; Encuesta |
| LO : | INIST-11378.354000194219330100 |
| ID : | 10-0453324 |
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Stein</name><affiliation><inist:fA14 i1="08"><s1>Department of Psychiatry, Groote Schuur Hospital</s1><s2>Cape Town</s2><s3>ZAF</s3><sZ>8 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Alonso, Jordi" sort="Alonso, Jordi" uniqKey="Alonso J" first="Jordi" last="Alonso">Jordi Alonso</name><affiliation><inist:fA14 i1="09"><s1>Health Services Research Unit, Institut Municipal d'Investigació Mèdica, Hospital Del Mar, Centro de Investigación Biomédica en Red en Epidemiologia y Salud Pública</s1><s2>Barcelona</s2><s3>ESP</s3><sZ>9 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Andrade, Laura Helena" sort="Andrade, Laura Helena" uniqKey="Andrade L" first="Laura Helena" last="Andrade">Laura Helena Andrade</name><affiliation><inist:fA14 i1="10"><s1>Section of Psychiatric Epidemiology-LIM 23 Department and Institute of Psychiatry, School of Medicine, University of São Paulo</s1><s2>São Paulo</s2><s3>BRA</s3><sZ>10 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Angermeyer, Matthias" sort="Angermeyer, Matthias" uniqKey="Angermeyer M" first="Matthias" last="Angermeyer">Matthias Angermeyer</name><affiliation><inist:fA14 i1="11"><s1>Center for Public Mental Health</s1><s2>Gösing am Wagram</s2><s3>AUT</s3><sZ>11 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Demyttenaere, Koen" sort="Demyttenaere, Koen" uniqKey="Demyttenaere K" first="Koen" last="Demyttenaere">Koen Demyttenaere</name><affiliation><inist:fA14 i1="12"><s1>Department of Psychiatry, University Hospital Gasthuisberg</s1><s2>Leuven</s2><s3>BEL</s3><sZ>12 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="De Girolamo, Giovanni" sort="De Girolamo, Giovanni" uniqKey="De Girolamo G" first="Giovanni" last="De Girolamo">Giovanni De Girolamo</name><affiliation><inist:fA14 i1="13"><s1>Istituto de Ricovero e Cura a Carattere Scientifico Centro S. Giovanni di Dio Fatebenefratelli</s1><s2>Brescia</s2><s3>ITA</s3><sZ>13 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="De Graaf, Ron" sort="De Graaf, Ron" uniqKey="De Graaf R" first="Ron" last="De Graaf">Ron De Graaf</name><affiliation><inist:fA14 i1="14"><s1>Monitoring & Epidemiology Department, Psychiatric Epidemiology Unit, Netherlands Institute of Mental Health and Addiction</s1><s2>Utrecht</s2><s3>NLD</s3><sZ>14 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Florescu, Silvia" sort="Florescu, Silvia" uniqKey="Florescu S" first="Silvia" last="Florescu">Silvia Florescu</name><affiliation><inist:fA14 i1="15"><s1>Public Health Research and Evidence Based Medicine Department, Department of Psychiatry, National School of Public Health and Health Services Management</s1><s2>Bucharest</s2><s3>ROU</s3><sZ>15 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Gureje, Oye" sort="Gureje, Oye" uniqKey="Gureje O" first="Oye" last="Gureje">Oye Gureje</name><affiliation><inist:fA14 i1="16"><s1>University College Hospital, Prince of Wales</s1><s2>Ibadan</s2><s3>NGA</s3><sZ>16 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Kaminer, Debra" sort="Kaminer, Debra" uniqKey="Kaminer D" first="Debra" last="Kaminer">Debra Kaminer</name><affiliation><inist:fA14 i1="17"><s1>MRC Research Unit on Anxiety Disorders, University of Stellenbosch</s1><s2>CapeTown</s2><s3>ZAF</s3><sZ>17 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Kotov, Roman" sort="Kotov, Roman" uniqKey="Kotov R" first="Roman" last="Kotov">Roman Kotov</name><affiliation><inist:fA14 i1="18"><s1>Department of Psychiatry, Stony Brook University</s1><s2>Stony Brook, New York</s2><s3>USA</s3><sZ>18 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Lee, Sing" sort="Lee, Sing" uniqKey="Lee S" first="Sing" last="Lee">Sing Lee</name><affiliation><inist:fA14 i1="19"><s1>Department of Psychiatry, The Chinese University of Hong Kong</s1><s3>HKG</s3><sZ>19 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Lepine, Jean Pierre" sort="Lepine, Jean Pierre" uniqKey="Lepine J" first="Jean-Pierre" last="Lepine">Jean-Pierre Lepine</name><affiliation><inist:fA14 i1="20"><s1>Institut national de la santé et de la recherche médicale, U705, Centre national de la recherché scientifique Unité Mixte de Recherche 7157, University Paris Diderot, Hôpital Lariboisière Fernand Widal, Assistance Publique Hôpitaux de Paris</s1><s2>Paris</s2><s3>FRA</s3><sZ>20 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Medina Mora, Maria Elena" sort="Medina Mora, Maria Elena" uniqKey="Medina Mora M" first="Maria Elena" last="Medina-Mora">Maria Elena Medina-Mora</name><affiliation><inist:fA14 i1="21"><s1>National Institute of Psychiatry Ramon de la Fuente</s1><s2>Mexico City</s2><s3>MEX</s3><sZ>21 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Oakley Browne, Mark A" sort="Oakley Browne, Mark A" uniqKey="Oakley Browne M" first="Mark A." last="Oakley Browne">Mark A. Oakley Browne</name></author><author><name sortKey="Posada Villa, Jose" sort="Posada Villa, Jose" uniqKey="Posada Villa J" first="José" last="Posada-Villa">José Posada-Villa</name></author><author><name sortKey="Sagar, Rajesh" sort="Sagar, Rajesh" uniqKey="Sagar R" first="Rajesh" last="Sagar">Rajesh Sagar</name></author><author><name sortKey="Shalev, Arieh Y" sort="Shalev, Arieh Y" uniqKey="Shalev A" first="Arieh Y." last="Shalev">Arieh Y. Shalev</name></author><author><name sortKey="Takeshima, Tadashi" sort="Takeshima, Tadashi" uniqKey="Takeshima T" first="Tadashi" last="Takeshima">Tadashi Takeshima</name></author><author><name sortKey="Tomov, Toma" sort="Tomov, Toma" uniqKey="Tomov T" first="Toma" last="Tomov">Toma Tomov</name></author><author><name sortKey="Kessler, Ronald C" sort="Kessler, Ronald C" uniqKey="Kessler R" first="Ronald C." last="Kessler">Ronald C. Kessler</name><affiliation><inist:fA14 i1="06"><s1>Department of Health Care Policy, Harvard Medical School</s1><s2>Boston, Massachusetts</s2><s3>USA</s3><sZ>4 aut.</sZ><sZ>7 aut.</sZ><sZ>28 aut.</sZ></inist:fA14></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">INIST</idno><idno type="inist">10-0453324</idno><date when="2010">2010</date><idno type="stanalyst">PASCAL 10-0453324 INIST</idno><idno type="RBID">Pascal:10-0453324</idno><idno type="wicri:Area/PascalFrancis/Corpus">002327</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a">The Role of Criterion A2 in the DSM-IV Diagnosis of Posttraumatic Stress Disorder</title><author><name sortKey="Karam, Elie George" sort="Karam, Elie George" uniqKey="Karam E" first="Elie George" last="Karam">Elie George Karam</name><affiliation><inist:fA14 i1="01"><s1>Department of Psychiatry and Clinical Psychology, Saint George Hospital, University Medical Center</s1><s2>Beirut</s2><s3>LBN</s3><sZ>1 aut.</sZ><sZ>6 aut.</sZ></inist:fA14></affiliation><affiliation><inist:fA14 i1="02"><s1>Department of Psychiatry and Clinical Psychology, Faculty of Medicine, Balamand University Medical School</s1><s2>Beirut</s2><s3>LBN</s3><sZ>1 aut.</sZ><sZ>6 aut.</sZ></inist:fA14></affiliation><affiliation><inist:fA14 i1="03"><s1>Institute for Development, Research, Advocacy and Applied Care</s1><s2>Beirut</s2><s3>LBN</s3><sZ>1 aut.</sZ><sZ>6 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Andrews, Gavin" sort="Andrews, Gavin" uniqKey="Andrews G" first="Gavin" last="Andrews">Gavin Andrews</name><affiliation><inist:fA14 i1="04"><s1>Department of Psychiatry, University of New South Wales</s1><s2>Sydney</s2><s3>AUS</s3><sZ>2 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Bromet, Evelyn" sort="Bromet, Evelyn" uniqKey="Bromet E" first="Evelyn" last="Bromet">Evelyn Bromet</name><affiliation><inist:fA14 i1="05"><s1>State University of New York</s1><s2>Stony Brook, New York</s2><s3>USA</s3><sZ>3 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Petukhova, Maria" sort="Petukhova, Maria" uniqKey="Petukhova M" first="Maria" last="Petukhova">Maria Petukhova</name><affiliation><inist:fA14 i1="06"><s1>Department of Health Care Policy, Harvard Medical School</s1><s2>Boston, Massachusetts</s2><s3>USA</s3><sZ>4 aut.</sZ><sZ>7 aut.</sZ><sZ>28 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Meron Ruscio, Ayelet" sort="Meron Ruscio, Ayelet" uniqKey="Meron Ruscio A" first="Ayelet" last="Meron Ruscio">Ayelet Meron Ruscio</name><affiliation><inist:fA14 i1="07"><s1>Department of Psychology, Universityof Pennsylvania</s1><s2>Philadelphia, Pennsylvania</s2><s3>USA</s3><sZ>5 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Salamoun, Mariana" sort="Salamoun, Mariana" uniqKey="Salamoun M" first="Mariana" last="Salamoun">Mariana Salamoun</name><affiliation><inist:fA14 i1="01"><s1>Department of Psychiatry and Clinical Psychology, Saint George Hospital, University Medical Center</s1><s2>Beirut</s2><s3>LBN</s3><sZ>1 aut.</sZ><sZ>6 aut.</sZ></inist:fA14></affiliation><affiliation><inist:fA14 i1="02"><s1>Department of Psychiatry and Clinical Psychology, Faculty of Medicine, Balamand University Medical School</s1><s2>Beirut</s2><s3>LBN</s3><sZ>1 aut.</sZ><sZ>6 aut.</sZ></inist:fA14></affiliation><affiliation><inist:fA14 i1="03"><s1>Institute for Development, Research, Advocacy and Applied Care</s1><s2>Beirut</s2><s3>LBN</s3><sZ>1 aut.</sZ><sZ>6 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Sampson, Nancy" sort="Sampson, Nancy" uniqKey="Sampson N" first="Nancy" last="Sampson">Nancy Sampson</name><affiliation><inist:fA14 i1="06"><s1>Department of Health Care Policy, Harvard Medical School</s1><s2>Boston, Massachusetts</s2><s3>USA</s3><sZ>4 aut.</sZ><sZ>7 aut.</sZ><sZ>28 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Stein, Dan J" sort="Stein, Dan J" uniqKey="Stein D" first="Dan J." last="Stein">Dan J. Stein</name><affiliation><inist:fA14 i1="08"><s1>Department of Psychiatry, Groote Schuur Hospital</s1><s2>Cape Town</s2><s3>ZAF</s3><sZ>8 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Alonso, Jordi" sort="Alonso, Jordi" uniqKey="Alonso J" first="Jordi" last="Alonso">Jordi Alonso</name><affiliation><inist:fA14 i1="09"><s1>Health Services Research Unit, Institut Municipal d'Investigació Mèdica, Hospital Del Mar, Centro de Investigación Biomédica en Red en Epidemiologia y Salud Pública</s1><s2>Barcelona</s2><s3>ESP</s3><sZ>9 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Andrade, Laura Helena" sort="Andrade, Laura Helena" uniqKey="Andrade L" first="Laura Helena" last="Andrade">Laura Helena Andrade</name><affiliation><inist:fA14 i1="10"><s1>Section of Psychiatric Epidemiology-LIM 23 Department and Institute of Psychiatry, School of Medicine, University of São Paulo</s1><s2>São Paulo</s2><s3>BRA</s3><sZ>10 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Angermeyer, Matthias" sort="Angermeyer, Matthias" uniqKey="Angermeyer M" first="Matthias" last="Angermeyer">Matthias Angermeyer</name><affiliation><inist:fA14 i1="11"><s1>Center for Public Mental Health</s1><s2>Gösing am Wagram</s2><s3>AUT</s3><sZ>11 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Demyttenaere, Koen" sort="Demyttenaere, Koen" uniqKey="Demyttenaere K" first="Koen" last="Demyttenaere">Koen Demyttenaere</name><affiliation><inist:fA14 i1="12"><s1>Department of Psychiatry, University Hospital Gasthuisberg</s1><s2>Leuven</s2><s3>BEL</s3><sZ>12 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="De Girolamo, Giovanni" sort="De Girolamo, Giovanni" uniqKey="De Girolamo G" first="Giovanni" last="De Girolamo">Giovanni De Girolamo</name><affiliation><inist:fA14 i1="13"><s1>Istituto de Ricovero e Cura a Carattere Scientifico Centro S. Giovanni di Dio Fatebenefratelli</s1><s2>Brescia</s2><s3>ITA</s3><sZ>13 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="De Graaf, Ron" sort="De Graaf, Ron" uniqKey="De Graaf R" first="Ron" last="De Graaf">Ron De Graaf</name><affiliation><inist:fA14 i1="14"><s1>Monitoring & Epidemiology Department, Psychiatric Epidemiology Unit, Netherlands Institute of Mental Health and Addiction</s1><s2>Utrecht</s2><s3>NLD</s3><sZ>14 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Florescu, Silvia" sort="Florescu, Silvia" uniqKey="Florescu S" first="Silvia" last="Florescu">Silvia Florescu</name><affiliation><inist:fA14 i1="15"><s1>Public Health Research and Evidence Based Medicine Department, Department of Psychiatry, National School of Public Health and Health Services Management</s1><s2>Bucharest</s2><s3>ROU</s3><sZ>15 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Gureje, Oye" sort="Gureje, Oye" uniqKey="Gureje O" first="Oye" last="Gureje">Oye Gureje</name><affiliation><inist:fA14 i1="16"><s1>University College Hospital, Prince of Wales</s1><s2>Ibadan</s2><s3>NGA</s3><sZ>16 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Kaminer, Debra" sort="Kaminer, Debra" uniqKey="Kaminer D" first="Debra" last="Kaminer">Debra Kaminer</name><affiliation><inist:fA14 i1="17"><s1>MRC Research Unit on Anxiety Disorders, University of Stellenbosch</s1><s2>CapeTown</s2><s3>ZAF</s3><sZ>17 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Kotov, Roman" sort="Kotov, Roman" uniqKey="Kotov R" first="Roman" last="Kotov">Roman Kotov</name><affiliation><inist:fA14 i1="18"><s1>Department of Psychiatry, Stony Brook University</s1><s2>Stony Brook, New York</s2><s3>USA</s3><sZ>18 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Lee, Sing" sort="Lee, Sing" uniqKey="Lee S" first="Sing" last="Lee">Sing Lee</name><affiliation><inist:fA14 i1="19"><s1>Department of Psychiatry, The Chinese University of Hong Kong</s1><s3>HKG</s3><sZ>19 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Lepine, Jean Pierre" sort="Lepine, Jean Pierre" uniqKey="Lepine J" first="Jean-Pierre" last="Lepine">Jean-Pierre Lepine</name><affiliation><inist:fA14 i1="20"><s1>Institut national de la santé et de la recherche médicale, U705, Centre national de la recherché scientifique Unité Mixte de Recherche 7157, University Paris Diderot, Hôpital Lariboisière Fernand Widal, Assistance Publique Hôpitaux de Paris</s1><s2>Paris</s2><s3>FRA</s3><sZ>20 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Medina Mora, Maria Elena" sort="Medina Mora, Maria Elena" uniqKey="Medina Mora M" first="Maria Elena" last="Medina-Mora">Maria Elena Medina-Mora</name><affiliation><inist:fA14 i1="21"><s1>National Institute of Psychiatry Ramon de la Fuente</s1><s2>Mexico City</s2><s3>MEX</s3><sZ>21 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Oakley Browne, Mark A" sort="Oakley Browne, Mark A" uniqKey="Oakley Browne M" first="Mark A." last="Oakley Browne">Mark A. Oakley Browne</name></author><author><name sortKey="Posada Villa, Jose" sort="Posada Villa, Jose" uniqKey="Posada Villa J" first="José" last="Posada-Villa">José Posada-Villa</name></author><author><name sortKey="Sagar, Rajesh" sort="Sagar, Rajesh" uniqKey="Sagar R" first="Rajesh" last="Sagar">Rajesh Sagar</name></author><author><name sortKey="Shalev, Arieh Y" sort="Shalev, Arieh Y" uniqKey="Shalev A" first="Arieh Y." last="Shalev">Arieh Y. Shalev</name></author><author><name sortKey="Takeshima, Tadashi" sort="Takeshima, Tadashi" uniqKey="Takeshima T" first="Tadashi" last="Takeshima">Tadashi Takeshima</name></author><author><name sortKey="Tomov, Toma" sort="Tomov, Toma" uniqKey="Tomov T" first="Toma" last="Tomov">Toma Tomov</name></author><author><name sortKey="Kessler, Ronald C" sort="Kessler, Ronald C" uniqKey="Kessler R" first="Ronald C." last="Kessler">Ronald C. Kessler</name><affiliation><inist:fA14 i1="06"><s1>Department of Health Care Policy, Harvard Medical School</s1><s2>Boston, Massachusetts</s2><s3>USA</s3><sZ>4 aut.</sZ><sZ>7 aut.</sZ><sZ>28 aut.</sZ></inist:fA14></affiliation></author></analytic><series><title level="j" type="main">Biological psychiatry : (1969)</title><title level="j" type="abbreviated">Biol. psychiatry : (1969)</title><idno type="ISSN">0006-3223</idno><imprint><date when="2010">2010</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">Biological psychiatry : (1969)</title><title level="j" type="abbreviated">Biol. psychiatry : (1969)</title><idno type="ISSN">0006-3223</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Criterion</term><term>Diagnostic and Statistical Manual IV</term><term>Interview</term><term>Mental health</term><term>Posttraumatic stress disorder</term><term>Stress</term><term>Survey</term><term>Trauma</term><term>WHO</term><term>World</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Critère</term><term>Diagnostic and Statistical Manual IV</term><term>Etat de stress posttraumatique</term><term>Stress</term><term>Entretien</term><term>Traumatisme</term><term>OMS</term><term>Monde</term><term>Santé mentale</term><term>Enquête</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Background: Controversy exists about the utility of DSM-IV posttraumatic stress disorder (PTSD) criterion A2 (A2): that exposure to a potentially traumatic experience (PTE; PTSD criterion A1) is accompanied by intense fear, helplessness, or horror. Methods: Lifetime DSM-IV PTSD was assessed with the Composite International Diagnostic Interview in community surveys of 52,826 respondents across 21 countries in the World Mental Health Surveys. Results: Of 28,490 representative PTEs reported by respondents, 37.6% met criterion A2, a proportion higher than the proportions meeting other criteria (B-F; 5.4%-9.6%). Conditional prevalence of meeting all other criteria for a diagnosis of PTSD given a PTE was significantly higher in the presence (9.7%) than absence (.1%) of A2. However, as only 1.4% of respondents who met all other criteria failed A2, the estimated prevalence of PTSD increased only slightly (from 3.64% to 3.69%) when A2 was not required for diagnosis. Posttraumatic stress disorder with or without criterion A2 did not differ in persistence or predicted consequences (subsequent suicidal ideation or secondary disorders) depending on presence-absence of A2. Furthermore, as A2 was by far the most commonly reported symptom of PTSD, initial assessment of A2 would be much less efficient than screening other criteria in quickly ruling out a large proportion of noncases. Conclusions: Removal of A2 from the DSM-IV criterion set would reduce the complexity of diagnosing PTSD, while not substantially increasing the number of people who qualify for diagnosis. Criterion A2 should consequently be reconceptualized as a risk factor for PTSD rather than as a diagnostic requirement.</div></front></TEI><inist><standard h6="B"><pA><fA01 i1="01" i2="1"><s0>0006-3223</s0></fA01><fA02 i1="01"><s0>BIPCBF</s0></fA02><fA03 i2="1"><s0>Biol. psychiatry : (1969)</s0></fA03><fA05><s2>68</s2></fA05><fA06><s2>5</s2></fA06><fA08 i1="01" i2="1" l="ENG"><s1>The Role of Criterion A2 in the DSM-IV Diagnosis of Posttraumatic Stress Disorder</s1></fA08><fA09 i1="01" i2="1" l="ENG"><s1>Stress, Neuroplasticity, and Posttraumatic Stress Disorder</s1></fA09><fA11 i1="01" i2="1"><s1>KARAM (Elie George)</s1></fA11><fA11 i1="02" i2="1"><s1>ANDREWS (Gavin)</s1></fA11><fA11 i1="03" i2="1"><s1>BROMET (Evelyn)</s1></fA11><fA11 i1="04" i2="1"><s1>PETUKHOVA (Maria)</s1></fA11><fA11 i1="05" i2="1"><s1>MERON RUSCIO (Ayelet)</s1></fA11><fA11 i1="06" i2="1"><s1>SALAMOUN (Mariana)</s1></fA11><fA11 i1="07" i2="1"><s1>SAMPSON (Nancy)</s1></fA11><fA11 i1="08" i2="1"><s1>STEIN (Dan J.)</s1></fA11><fA11 i1="09" i2="1"><s1>ALONSO (Jordi)</s1></fA11><fA11 i1="10" i2="1"><s1>ANDRADE (Laura Helena)</s1></fA11><fA11 i1="11" i2="1"><s1>ANGERMEYER (Matthias)</s1></fA11><fA11 i1="12" i2="1"><s1>DEMYTTENAERE (Koen)</s1></fA11><fA11 i1="13" i2="1"><s1>DE GIROLAMO (Giovanni)</s1></fA11><fA11 i1="14" i2="1"><s1>DE GRAAF (Ron)</s1></fA11><fA11 i1="15" i2="1"><s1>FLORESCU (Silvia)</s1></fA11><fA11 i1="16" i2="1"><s1>GUREJE (Oye)</s1></fA11><fA11 i1="17" i2="1"><s1>KAMINER (Debra)</s1></fA11><fA11 i1="18" i2="1"><s1>KOTOV (Roman)</s1></fA11><fA11 i1="19" i2="1"><s1>LEE (Sing)</s1></fA11><fA11 i1="20" i2="1"><s1>LEPINE (Jean-Pierre)</s1></fA11><fA11 i1="21" i2="1"><s1>MEDINA-MORA (Maria Elena)</s1></fA11><fA11 i1="22" i2="1"><s1>OAKLEY BROWNE (Mark A.)</s1></fA11><fA11 i1="23" i2="1"><s1>POSADA-VILLA (José)</s1></fA11><fA11 i1="24" i2="1"><s1>SAGAR (Rajesh)</s1></fA11><fA11 i1="25" i2="1"><s1>SHALEV (Arieh Y.)</s1></fA11><fA11 i1="26" i2="1"><s1>TAKESHIMA (Tadashi)</s1></fA11><fA11 i1="27" i2="1"><s1>TOMOV (Toma)</s1></fA11><fA11 i1="28" i2="1"><s1>KESSLER (Ronald C.)</s1></fA11><fA12 i1="01" i2="1"><s1>MANN (J. John)</s1><s9>limin.</s9></fA12><fA12 i1="02" i2="1"><s1>HAGHIGHI (Fatemeh)</s1><s9>limin.</s9></fA12><fA14 i1="01"><s1>Department of Psychiatry and Clinical Psychology, Saint George Hospital, University Medical Center</s1><s2>Beirut</s2><s3>LBN</s3><sZ>1 aut.</sZ><sZ>6 aut.</sZ></fA14><fA14 i1="02"><s1>Department of Psychiatry and Clinical Psychology, Faculty of Medicine, Balamand University Medical School</s1><s2>Beirut</s2><s3>LBN</s3><sZ>1 aut.</sZ><sZ>6 aut.</sZ></fA14><fA14 i1="03"><s1>Institute for Development, Research, Advocacy and Applied Care</s1><s2>Beirut</s2><s3>LBN</s3><sZ>1 aut.</sZ><sZ>6 aut.</sZ></fA14><fA14 i1="04"><s1>Department of Psychiatry, University of New South Wales</s1><s2>Sydney</s2><s3>AUS</s3><sZ>2 aut.</sZ></fA14><fA14 i1="05"><s1>State University of New York</s1><s2>Stony Brook, New York</s2><s3>USA</s3><sZ>3 aut.</sZ></fA14><fA14 i1="06"><s1>Department of Health Care Policy, Harvard Medical School</s1><s2>Boston, Massachusetts</s2><s3>USA</s3><sZ>4 aut.</sZ><sZ>7 aut.</sZ><sZ>28 aut.</sZ></fA14><fA14 i1="07"><s1>Department of Psychology, Universityof Pennsylvania</s1><s2>Philadelphia, Pennsylvania</s2><s3>USA</s3><sZ>5 aut.</sZ></fA14><fA14 i1="08"><s1>Department of Psychiatry, Groote Schuur Hospital</s1><s2>Cape Town</s2><s3>ZAF</s3><sZ>8 aut.</sZ></fA14><fA14 i1="09"><s1>Health Services Research Unit, Institut Municipal d'Investigació Mèdica, Hospital Del Mar, Centro de Investigación Biomédica en Red en Epidemiologia y Salud Pública</s1><s2>Barcelona</s2><s3>ESP</s3><sZ>9 aut.</sZ></fA14><fA14 i1="10"><s1>Section of Psychiatric Epidemiology-LIM 23 Department and Institute of Psychiatry, School of Medicine, University of São Paulo</s1><s2>São Paulo</s2><s3>BRA</s3><sZ>10 aut.</sZ></fA14><fA14 i1="11"><s1>Center for Public Mental Health</s1><s2>Gösing am Wagram</s2><s3>AUT</s3><sZ>11 aut.</sZ></fA14><fA14 i1="12"><s1>Department of Psychiatry, University Hospital Gasthuisberg</s1><s2>Leuven</s2><s3>BEL</s3><sZ>12 aut.</sZ></fA14><fA14 i1="13"><s1>Istituto de Ricovero e Cura a Carattere Scientifico Centro S. Giovanni di Dio Fatebenefratelli</s1><s2>Brescia</s2><s3>ITA</s3><sZ>13 aut.</sZ></fA14><fA14 i1="14"><s1>Monitoring & Epidemiology Department, Psychiatric Epidemiology Unit, Netherlands Institute of Mental Health and Addiction</s1><s2>Utrecht</s2><s3>NLD</s3><sZ>14 aut.</sZ></fA14><fA14 i1="15"><s1>Public Health Research and Evidence Based Medicine Department, Department of Psychiatry, National School of Public Health and Health Services Management</s1><s2>Bucharest</s2><s3>ROU</s3><sZ>15 aut.</sZ></fA14><fA14 i1="16"><s1>University College Hospital, Prince of Wales</s1><s2>Ibadan</s2><s3>NGA</s3><sZ>16 aut.</sZ></fA14><fA14 i1="17"><s1>MRC Research Unit on Anxiety Disorders, University of Stellenbosch</s1><s2>CapeTown</s2><s3>ZAF</s3><sZ>17 aut.</sZ></fA14><fA14 i1="18"><s1>Department of Psychiatry, Stony Brook University</s1><s2>Stony Brook, New York</s2><s3>USA</s3><sZ>18 aut.</sZ></fA14><fA14 i1="19"><s1>Department of Psychiatry, The Chinese University of Hong Kong</s1><s3>HKG</s3><sZ>19 aut.</sZ></fA14><fA14 i1="20"><s1>Institut national de la santé et de la recherche médicale, U705, Centre national de la recherché scientifique Unité Mixte de Recherche 7157, University Paris Diderot, Hôpital Lariboisière Fernand Widal, Assistance Publique Hôpitaux de Paris</s1><s2>Paris</s2><s3>FRA</s3><sZ>20 aut.</sZ></fA14><fA14 i1="21"><s1>National Institute of Psychiatry Ramon de la Fuente</s1><s2>Mexico City</s2><s3>MEX</s3><sZ>21 aut.</sZ></fA14><fA15 i1="01"><s1>Division of Molecular Imaging and Neuropathology, Department of Psychiatry, Columbia University, New York State Psychiatric Institute</s1><s2>New York, New York</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ></fA15><fA20><s1>465-473</s1></fA20><fA21><s1>2010</s1></fA21><fA23 i1="01"><s0>ENG</s0></fA23><fA43 i1="01"><s1>INIST</s1><s2>11378</s2><s5>354000194219330100</s5></fA43><fA44><s0>0000</s0><s1>© 2010 INIST-CNRS. All rights reserved.</s1></fA44><fA45><s0>36 ref.</s0></fA45><fA47 i1="01" i2="1"><s0>10-0453324</s0></fA47><fA60><s1>P</s1></fA60><fA61><s0>A</s0></fA61><fA64 i1="01" i2="1"><s0>Biological psychiatry : (1969)</s0></fA64><fA66 i1="01"><s0>USA</s0></fA66><fC01 i1="01" l="ENG"><s0>Background: Controversy exists about the utility of DSM-IV posttraumatic stress disorder (PTSD) criterion A2 (A2): that exposure to a potentially traumatic experience (PTE; PTSD criterion A1) is accompanied by intense fear, helplessness, or horror. Methods: Lifetime DSM-IV PTSD was assessed with the Composite International Diagnostic Interview in community surveys of 52,826 respondents across 21 countries in the World Mental Health Surveys. Results: Of 28,490 representative PTEs reported by respondents, 37.6% met criterion A2, a proportion higher than the proportions meeting other criteria (B-F; 5.4%-9.6%). Conditional prevalence of meeting all other criteria for a diagnosis of PTSD given a PTE was significantly higher in the presence (9.7%) than absence (.1%) of A2. However, as only 1.4% of respondents who met all other criteria failed A2, the estimated prevalence of PTSD increased only slightly (from 3.64% to 3.69%) when A2 was not required for diagnosis. Posttraumatic stress disorder with or without criterion A2 did not differ in persistence or predicted consequences (subsequent suicidal ideation or secondary disorders) depending on presence-absence of A2. Furthermore, as A2 was by far the most commonly reported symptom of PTSD, initial assessment of A2 would be much less efficient than screening other criteria in quickly ruling out a large proportion of noncases. Conclusions: Removal of A2 from the DSM-IV criterion set would reduce the complexity of diagnosing PTSD, while not substantially increasing the number of people who qualify for diagnosis. Criterion A2 should consequently be reconceptualized as a risk factor for PTSD rather than as a diagnostic requirement.</s0></fC01><fC02 i1="01" i2="X"><s0>002B18C08D</s0></fC02><fC03 i1="01" i2="X" l="FRE"><s0>Critère</s0><s5>01</s5></fC03><fC03 i1="01" i2="X" l="ENG"><s0>Criterion</s0><s5>01</s5></fC03><fC03 i1="01" i2="X" l="SPA"><s0>Criterio</s0><s5>01</s5></fC03><fC03 i1="02" i2="X" l="FRE"><s0>Diagnostic and Statistical Manual IV</s0><s5>02</s5></fC03><fC03 i1="02" i2="X" l="ENG"><s0>Diagnostic and Statistical Manual IV</s0><s5>02</s5></fC03><fC03 i1="02" i2="X" l="SPA"><s0>Diagnostic and Statistical Manual IV</s0><s5>02</s5></fC03><fC03 i1="03" i2="X" l="FRE"><s0>Etat de stress posttraumatique</s0><s2>NM</s2><s5>03</s5></fC03><fC03 i1="03" i2="X" l="ENG"><s0>Posttraumatic stress disorder</s0><s2>NM</s2><s5>03</s5></fC03><fC03 i1="03" i2="X" l="SPA"><s0>Trastorno de estrés posttraumático</s0><s2>NM</s2><s5>03</s5></fC03><fC03 i1="04" i2="X" l="FRE"><s0>Stress</s0><s5>04</s5></fC03><fC03 i1="04" i2="X" l="ENG"><s0>Stress</s0><s5>04</s5></fC03><fC03 i1="04" i2="X" l="SPA"><s0>Estrés</s0><s5>04</s5></fC03><fC03 i1="05" i2="X" l="FRE"><s0>Entretien</s0><s5>05</s5></fC03><fC03 i1="05" i2="X" l="ENG"><s0>Interview</s0><s5>05</s5></fC03><fC03 i1="05" i2="X" l="SPA"><s0>Entrevista</s0><s5>05</s5></fC03><fC03 i1="06" i2="X" l="FRE"><s0>Traumatisme</s0><s5>06</s5></fC03><fC03 i1="06" i2="X" l="ENG"><s0>Trauma</s0><s5>06</s5></fC03><fC03 i1="06" i2="X" l="SPA"><s0>Traumatismo</s0><s5>06</s5></fC03><fC03 i1="07" i2="X" l="FRE"><s0>OMS</s0><s5>07</s5></fC03><fC03 i1="07" i2="X" l="ENG"><s0>WHO</s0><s5>07</s5></fC03><fC03 i1="07" i2="X" l="SPA"><s0>OMS</s0><s5>07</s5></fC03><fC03 i1="08" i2="X" l="FRE"><s0>Monde</s0><s2>NG</s2><s5>08</s5></fC03><fC03 i1="08" i2="X" l="ENG"><s0>World</s0><s2>NG</s2><s5>08</s5></fC03><fC03 i1="08" i2="X" l="SPA"><s0>Mundo</s0><s2>NG</s2><s5>08</s5></fC03><fC03 i1="09" i2="X" l="FRE"><s0>Santé mentale</s0><s5>09</s5></fC03><fC03 i1="09" i2="X" l="ENG"><s0>Mental health</s0><s5>09</s5></fC03><fC03 i1="09" i2="X" l="SPA"><s0>Salud mental</s0><s5>09</s5></fC03><fC03 i1="10" i2="X" l="FRE"><s0>Enquête</s0><s5>10</s5></fC03><fC03 i1="10" i2="X" l="ENG"><s0>Survey</s0><s5>10</s5></fC03><fC03 i1="10" i2="X" l="SPA"><s0>Encuesta</s0><s5>10</s5></fC03><fC07 i1="01" i2="X" l="FRE"><s0>Trouble anxieux</s0><s5>37</s5></fC07><fC07 i1="01" i2="X" l="ENG"><s0>Anxiety disorder</s0><s5>37</s5></fC07><fC07 i1="01" i2="X" l="SPA"><s0>Trastorno ansiedad</s0><s5>37</s5></fC07><fN21><s1>291</s1></fN21><fN44 i1="01"><s1>OTO</s1></fN44><fN82><s1>OTO</s1></fN82></pA></standard><server><NO>PASCAL 10-0453324 INIST</NO><ET>The Role of Criterion A2 in the DSM-IV Diagnosis of Posttraumatic Stress Disorder</ET><AU>KARAM (Elie George); ANDREWS (Gavin); BROMET (Evelyn); PETUKHOVA (Maria); MERON RUSCIO (Ayelet); SALAMOUN (Mariana); SAMPSON (Nancy); STEIN (Dan J.); ALONSO (Jordi); ANDRADE (Laura Helena); ANGERMEYER (Matthias); DEMYTTENAERE (Koen); DE GIROLAMO (Giovanni); DE GRAAF (Ron); FLORESCU (Silvia); GUREJE (Oye); KAMINER (Debra); KOTOV (Roman); LEE (Sing); LEPINE (Jean-Pierre); MEDINA-MORA (Maria Elena); OAKLEY BROWNE (Mark A.); POSADA-VILLA (José); SAGAR (Rajesh); SHALEV (Arieh Y.); TAKESHIMA (Tadashi); TOMOV (Toma); KESSLER (Ronald C.); MANN (J. John); HAGHIGHI (Fatemeh)</AU><AF>Department of Psychiatry and Clinical Psychology, Saint George Hospital, University Medical Center/Beirut/Liban (1 aut., 6 aut.); Department of Psychiatry and Clinical Psychology, Faculty of Medicine, Balamand University Medical School/Beirut/Liban (1 aut., 6 aut.); Institute for Development, Research, Advocacy and Applied Care/Beirut/Liban (1 aut., 6 aut.); Department of Psychiatry, University of New South Wales/Sydney/Australie (2 aut.); State University of New York/Stony Brook, New York/Etats-Unis (3 aut.); Department of Health Care Policy, Harvard Medical School/Boston, Massachusetts/Etats-Unis (4 aut., 7 aut., 28 aut.); Department of Psychology, Universityof Pennsylvania/Philadelphia, Pennsylvania/Etats-Unis (5 aut.); Department of Psychiatry, Groote Schuur Hospital/Cape Town/Afrique du Sud (8 aut.); Health Services Research Unit, Institut Municipal d'Investigació Mèdica, Hospital Del Mar, Centro de Investigación Biomédica en Red en Epidemiologia y Salud Pública/Barcelona/Espagne (9 aut.); Section of Psychiatric Epidemiology-LIM 23 Department and Institute of Psychiatry, School of Medicine, University of São Paulo/São Paulo/Brésil (10 aut.); Center for Public Mental Health/Gösing am Wagram/Autriche (11 aut.); Department of Psychiatry, University Hospital Gasthuisberg/Leuven/Belgique (12 aut.); Istituto de Ricovero e Cura a Carattere Scientifico Centro S. Giovanni di Dio Fatebenefratelli/Brescia/Italie (13 aut.); Monitoring & Epidemiology Department, Psychiatric Epidemiology Unit, Netherlands Institute of Mental Health and Addiction/Utrecht/Pays-Bas (14 aut.); Public Health Research and Evidence Based Medicine Department, Department of Psychiatry, National School of Public Health and Health Services Management/Bucharest/Roumanie (15 aut.); University College Hospital, Prince of Wales/Ibadan/Nigéria (16 aut.); MRC Research Unit on Anxiety Disorders, University of Stellenbosch/CapeTown/Afrique du Sud (17 aut.); Department of Psychiatry, Stony Brook University/Stony Brook, New York/Etats-Unis (18 aut.); Department of Psychiatry, The Chinese University of Hong Kong/Hong-Kong (19 aut.); Institut national de la santé et de la recherche médicale, U705, Centre national de la recherché scientifique Unité Mixte de Recherche 7157, University Paris Diderot, Hôpital Lariboisière Fernand Widal, Assistance Publique Hôpitaux de Paris/Paris/France (20 aut.); National Institute of Psychiatry Ramon de la Fuente/Mexico City/Mexique (21 aut.); Division of Molecular Imaging and Neuropathology, Department of Psychiatry, Columbia University, New York State Psychiatric Institute/New York, New York/Etats-Unis (1 aut., 2 aut.)</AF><DT>Publication en série; Niveau analytique</DT><SO>Biological psychiatry : (1969); ISSN 0006-3223; Coden BIPCBF; Etats-Unis; Da. 2010; Vol. 68; No. 5; Pp. 465-473; Bibl. 36 ref.</SO><LA>Anglais</LA><EA>Background: Controversy exists about the utility of DSM-IV posttraumatic stress disorder (PTSD) criterion A2 (A2): that exposure to a potentially traumatic experience (PTE; PTSD criterion A1) is accompanied by intense fear, helplessness, or horror. Methods: Lifetime DSM-IV PTSD was assessed with the Composite International Diagnostic Interview in community surveys of 52,826 respondents across 21 countries in the World Mental Health Surveys. Results: Of 28,490 representative PTEs reported by respondents, 37.6% met criterion A2, a proportion higher than the proportions meeting other criteria (B-F; 5.4%-9.6%). Conditional prevalence of meeting all other criteria for a diagnosis of PTSD given a PTE was significantly higher in the presence (9.7%) than absence (.1%) of A2. However, as only 1.4% of respondents who met all other criteria failed A2, the estimated prevalence of PTSD increased only slightly (from 3.64% to 3.69%) when A2 was not required for diagnosis. Posttraumatic stress disorder with or without criterion A2 did not differ in persistence or predicted consequences (subsequent suicidal ideation or secondary disorders) depending on presence-absence of A2. Furthermore, as A2 was by far the most commonly reported symptom of PTSD, initial assessment of A2 would be much less efficient than screening other criteria in quickly ruling out a large proportion of noncases. Conclusions: Removal of A2 from the DSM-IV criterion set would reduce the complexity of diagnosing PTSD, while not substantially increasing the number of people who qualify for diagnosis. Criterion A2 should consequently be reconceptualized as a risk factor for PTSD rather than as a diagnostic requirement.</EA><CC>002B18C08D</CC><FD>Critère; Diagnostic and Statistical Manual IV; Etat de stress posttraumatique; Stress; Entretien; Traumatisme; OMS; Monde; Santé mentale; Enquête</FD><FG>Trouble anxieux</FG><ED>Criterion; Diagnostic and Statistical Manual IV; Posttraumatic stress disorder; Stress; Interview; Trauma; WHO; World; Mental health; Survey</ED><EG>Anxiety disorder</EG><SD>Criterio; Diagnostic and Statistical Manual IV; Trastorno de estrés posttraumático; Estrés; Entrevista; Traumatismo; OMS; Mundo; Salud mental; Encuesta</SD><LO>INIST-11378.354000194219330100</LO><ID>10-0453324</ID></server></inist></record>Pour manipuler ce document sous Unix (Dilib)
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