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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

Overview of attention for article published in BMC Psychiatry, May 2016
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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
Published in
BMC Psychiatry, May 2016
DOI 10.1186/s12888-016-0849-y
Pubmed ID
Authors

Henna Haravuori, Olli Kiviruusu, Laura Suomalainen, Mauri Marttunen

Abstract

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. 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. 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. 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.

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Mendeley readers

The data shown below were compiled from readership statistics for 93 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
United States 1 1%
Unknown 92 99%

Demographic breakdown

Readers by professional status Count As %
Student > Master 12 13%
Student > Ph. D. Student 11 12%
Student > Doctoral Student 8 9%
Student > Bachelor 6 6%
Researcher 5 5%
Other 14 15%
Unknown 37 40%
Readers by discipline Count As %
Psychology 31 33%
Medicine and Dentistry 7 8%
Social Sciences 4 4%
Nursing and Health Professions 4 4%
Neuroscience 3 3%
Other 6 6%
Unknown 38 41%