An evaluation of ICD-11 posttraumatic stress disorder criteria in two samples of adolescents and young adults exposed to mass shootings : factor analysis and comparisons to ICD-10 and DSM-IV

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Haravuori , H , Kiviruusu , O , Suomalainen , L & Marttunen , M 2016 , ' An evaluation of ICD-11 posttraumatic stress disorder criteria in two samples of adolescents and young adults exposed to mass shootings : factor analysis and comparisons to ICD-10 and DSM-IV ' BMC Psychiatry , vol. 16 , 140 . DOI: 10.1186/s12888-016-0849-y

Title: An evaluation of ICD-11 posttraumatic stress disorder criteria in two samples of adolescents and young adults exposed to mass shootings : factor analysis and comparisons to ICD-10 and DSM-IV
Author: Haravuori, Henna; Kiviruusu, Olli; Suomalainen, Laura; Marttunen, Mauri
Contributor: University of Helsinki, Department of Psychiatry
University of Helsinki, Department of Psychiatry
Date: 2016-05-12
Language: eng
Number of pages: 10
Belongs to series: BMC Psychiatry
ISSN: 1471-244X
URI: http://hdl.handle.net/10138/163543
Abstract: Background: The proposed posttraumatic stress disorder (PTSD) criteria for the International Classification of Diseases (ICD) 11th revision are simpler than the criteria in ICD-10, DSM-IV or DSM-5. The aim of this study was to evaluate the ICD-11 PTSD factor structure in samples of young people, and to compare PTSD prevalence rates and diagnostic agreement between the different diagnostic systems. Possible differences in clinical characteristics of the PTSD cases identified by ICD-11, ICD-10 and DSM-IV are explored. Methods: Two samples of adolescents and young adults were followed after exposure to similar mass shooting incidents in their schools. Semi-structured diagnostic interviews were performed to assess psychiatric diagnoses and PTSD symptom scores (N = 228, mean age 17.6 years). PTSD symptom item scores were used to compose diagnoses according to the different classification systems. Results: Confirmatory factor analyses indicated that the proposed ICD-11 PTSD symptoms represented two rather than three factors; re-experiencing and avoidance symptoms comprised one factor and hyperarousal symptoms the other factor. In the studied samples, the three-factor ICD-11 criteria identified 51 (22.4 %) PTSD cases, the two-factor ICD-11 identified 56 (24.6 %) cases and the DSM-IV identified 43 (18.9 %) cases, while the number of cases identified by ICD-10 was larger, being 85 (37.3 %) cases. Diagnostic agreement of the ICD-11 PTSD criteria with ICD-10 and DSM-IV was moderate, yet the diagnostic agreement turned to be good when an impairment criterion was imposed on ICD-10. Compared to ICD-11, ICD-10 identified cases with less severe trauma exposure and posttraumatic symptoms and DSM-IV identified cases with less severe trauma exposure. Conclusions: The findings suggest that the two-factor model of ICD-11 PTSD is preferable to the three-factor model. The proposed ICD-11 criteria are more restrictive compared to the ICD-10 criteria. There were some differences in the clinical characteristics of the PTSD cases identified by ICD-11, when compared to ICD-10 and DSM-IV.
Subject: Posttraumatic stress disorder
PTSD
Mass shooting
ICD-11
ICD-10
DSM-IV
Adolescent
Young adult
K-SADS-PL
MENTAL-DISORDERS
INTERNATIONAL CLASSIFICATION
CLINICAL UTILITY
LIFETIME VERSION
SCHIZOPHRENIA
SCHEDULE
VALIDITY
POPULATION
PREVALENCE
3124 Neurology and psychiatry
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