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The Role of Criterion A2 in the DSM-IV Diagnosis of Posttraumatic Stress Disorder

dc.creatorKaram, Elie George
dc.creatorAndrews, Gavin
dc.creatorBromet, Evelyn
dc.creatorPetukhova, María
dc.creatorRuscio, Ayelet Meron
dc.creatorSalamoun, Mariana
dc.creatorSampson, Nancy
dc.creatorStein, Dan J.
dc.creatorAlonso, Jordi
dc.creatorAndrade, Laura Helena
dc.creatorAngermeyer, Matthias
dc.creatorDemyttenaere, Koen
dc.creatorDe Girolamo, Giovanni
dc.creatorDe Graaf, Ron
dc.creatorFlorescu, Silvia
dc.creatorGureje, Oye
dc.creatorKaminer, Debra
dc.creatorKotov, Roman
dc.creatorLee, Sing
dc.creatorLepine, Jean-Pierre
dc.creatorMedina-Mora, María Elena
dc.creatorBrowne, Mark A. Oakley
dc.creatorPosada-Villa, José
dc.creatorSagar, Rajesh
dc.creatorShalev, Arieh Y.
dc.creatorTakeshima, Tadashi
dc.creatorTomov, Toma
dc.creatorKessler, Ronald C.
dc.date.accessioned2017-06-30T04:04:53Z
dc.date.available2017-06-30T04:04:53Z
dc.date.issued2010
dc.identifier2493es_ES
dc.identifier.issn0006-3223es_ES
dc.identifier.urihttp://repositorio.inprf.gob.mx/handle/123456789/7134
dc.language.isoenges_ES
dc.publisherELSEVIER SCIENCE INC, 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USAes_ES
dc.relation68 (5) 465-473 p.es_ES
dc.relationversión del editores_ES
dc.rightsAcceso Cerradoes_ES
dc.subjectMEDICINA Y CIENCIAS DE LA SALUDes_ES
dc.subject.meshWORLD-HEALTH-ORGANIZATIONes_ES
dc.subject.meshMAJOR DEPRESSIVE DISORDERes_ES
dc.subject.meshTRAUMAes_ES
dc.subject.meshVERSIONes_ES
dc.subject.meshPTSDes_ES
dc.subject.meshCIDIes_ES
dc.subject.meshUTILITYes_ES
dc.titleThe Role of Criterion A2 in the DSM-IV Diagnosis of Posttraumatic Stress Disorderes_ES
dc.typeArticlees_ES
dc.contributor.affiliationHarvard Univ, Sch Med, Dept Hlth Care Policy, 180 Longwood Ave, Boston, MA 02115 USA.es_ES
dc.contributor.emailkessler@hcp.med.harvard.edues_ES
dc.relation.jnabreviadoBIOL PSYCHIATRYes_ES
dc.relation.journalBiological psychiatryes_ES
dc.identifier.placeNew Yorkes_ES
dc.date.published2010es_ES
dc.identifier.organizacionInstituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, México.es_ES
dc.identifier.eissn1873-2402es_ES
dc.identifier.doi10.1016/j.biopsych.2010.04.032es_ES
dc.description.monthSepes_ES
dc.description.abstractotrodiomaControversy 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.es_ES


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