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Post-traumatic stress disorder: some diagnostic and clinical issues
1Department of Psychology, University of Melbourne, Parkville, Vic.
The Australian and New Zealand Journal of Psychiatry
|December 1, 1989
Summary
This study found that the revised DSM-III-R criteria for post-traumatic stress disorder (PTSD) identified fewer individuals than the original DSM-III criteria. New PTSD symptoms were less common, while excluded symptoms like guilt were prevalent.
Area of Science:
- Psychiatry
- Trauma Studies
- Mental Health
Background:
- Post-traumatic stress disorder (PTSD) is a mental health condition that can develop after exposure to a traumatic event.
- Diagnostic criteria for PTSD have evolved, with significant revisions in the DSM-III-R compared to the DSM-III.
Purpose of the Study:
- To examine the development of PTSD in individuals exposed to a multiple homicide.
- To compare the diagnostic rates of PTSD using DSM-III and DSM-III-R criteria in a trauma-exposed sample.
Main Methods:
- A cohort of 42 individuals exposed to a multiple homicide was assessed.
- Diagnostic interviews were conducted to compare symptom reporting against DSM-III and DSM-III-R criteria.
Main Results:
- A significantly higher percentage of individuals met PTSD criteria under DSM-III (74%) compared to DSM-III-R (33%).
- Intrusive recollections and exaggerated startle response were the most frequent symptoms.
- Symptoms newly added to DSM-III-R were less commonly reported, while guilt, excluded from DSM-III-R, was reported by 38% of the sample.
Conclusions:
- The revised DSM-III-R criteria may not accurately capture the core syndrome of PTSD in all trauma-exposed populations.
- The exclusion of certain symptoms, such as guilt, from DSM-III-R may lead to underdiagnosis or mischaracterization of PTSD.