Hyland, P;
Karatzias, T;
Shevlin, M;
McElroy, E;
Ben-Ezra, M;
Cloitre, M;
Brewin, CR;
(2020)
Does requiring trauma exposure affect rates of ICD-11 PTSD and complex PTSD? Implications for DSM-5.
Psychological Trauma: Theory, Research, Practice, and Policy
10.1037/tra0000908.
(In press).
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Brewin_Hyland et al Psychol Trauma 2020 Final manuscript.pdf - Accepted Version Download (536kB) | Preview |
Abstract
OBJECTIVE: There is little evidence that posttraumatic stress disorder (PTSD) is more likely to follow traumatic events defined by Criterion A than non-Criterion A stressors. Criterion A events might have greater predictive validity for International Classification of Diseases (ICD)-11 PTSD, which is a condition more narrowly defined by core features. We evaluated the impact of using Criterion A, an expanded trauma definition in line with ICD-11 guidelines, and no exposure criterion on rates of ICD-11 PTSD and Complex PTSD (CPTSD). We also assessed whether 5 psychologically threatening events included in the expanded definition were as strongly associated with PTSD and CPTSD as standard Criterion A events. METHOD: A nationally representative sample from Ireland (N = 1,020) completed self-report measures. RESULTS: Most participants were trauma-exposed based on Criterion A (82%) and the expanded (88%) criterion. When no exposure criterion was used, 13.7% met diagnostic requirements for PTSD or CPTSD, 13.2% when the expanded criterion was used, and 13.2% when Criterion A was used. The 5 psychologically threatening events were as strongly associated with PTSD and CPTSD as the Criterion A events. In a multivariate analysis, only the psychologically threatening events were significantly associated with PTSD (stalking) and CPTSD (bullying, emotional abuse, and neglect). CONCLUSIONS: Certain non-Criterion A events involving extreme fear and horror should be considered traumatic. The ICD-11 approach of providing clinical guidance rather than a formal definition offers a viable solution to some of the problems associated with the current and previous attempts to define traumatic exposure. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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