UCLA PTSD reaction index for DSM-5 (PTSD-RI-5): a psychometric study of adolescents sampled from communities in eleven countries

BackgroundThe conceptualization of post-traumatic stress disorder (PTSD) in the upcoming International Classification of Diseases (ICD)-11 differs in many respects from the diagnostic criteria in the Diagnostic and Statistical Manual for Mental Disorders, fifth edition (DSM-5). The consequences of these differences for individuals and for estimation of prevalence rates are largely unknown. This study investigated the concordance of the two diagnostic systems in two separate samples at two separate waves.MethodYoung survivors of the 2011 Norway attacks (n = 325) and their parents (n = 451) were interviewed at 4–6 months (wave 1) and 15–18 months (wave 2) after the shooting. PTSD was assessed with the UCLA PTSD Reaction Index for DSM-IV adapted for DSM-5, and a subset was used as diagnostic criteria for ICD-11.ResultsIn survivors, PTSD prevalence did not differ significantly at any time point, but in parents, the DSM-5 algorithm produced significantly higher prevalence rates than the ICD-11 criteria. The overlap was fair for survivors, but amongst parents a large proportion of individuals met the criteria for only one of the diagnostic systems. No systematic differences were found between ICD-11 and DSM-5 in predictive validity.ConclusionsThe proposed ICD-11 criteria and the DSM-5 criteria performed equally well when identifying individuals in distress. Nevertheless, the overlap between those meeting the PTSD diagnosis for both ICD-11 and DSM-5 was disturbingly low, with the ICD-11 criteria identifying fewer people than the DSM-5. This represents a major challenge in identifying individuals suffering from PTSD worldwide, possibly resulting in overtreatment or unmet needs for trauma-specific treatment, depending on the area of the world in which patients are being diagnosed.

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A Bayesian Structural Equation Modeling Factor Analysis of the UCLA Posttraumatic Stress Disorder Reaction Index for DSM-5 in a Polyvictimized Sample of Adolescents

Journal of Psychopathology and Behavioral Assessment ◽

10.1007/s10862-020-09854-z ◽

2021 ◽

Author(s):

Crosby A. Modrowski ◽

Ascher K. Munion ◽

Patricia K. Kerig ◽

Robyn E. Kilshaw

Keyword(s):

Posttraumatic Stress Disorder ◽

Factor Analysis ◽

Structural Equation Modeling ◽

Posttraumatic Stress ◽

Structural Equation ◽

Stress Disorder ◽

Equation Modeling ◽

Dsm 5 ◽

Reaction Index ◽

Bayesian Structural Equation Modeling

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25-year follow-up of treated and not-treated adolescents after the Spitak earthquake: course and predictors of PTSD and depression

Psychological Medicine ◽

10.1017/s0033291719003891 ◽

2020 ◽

pp. 1-13 ◽

Cited By ~ 1

Author(s):

Armen K. Goenjian ◽

Alan M. Steinberg ◽

David Walling ◽

Sheryl Bishop ◽

Ida Karayan ◽

...

Keyword(s):

Rating Scale ◽

Depression Scale ◽

Treated Group ◽

Epidemiological Studies ◽

Dsm 5 ◽

Disaster Studies ◽

Reaction Index ◽

Essential Components ◽

Spitak Earthquake ◽

Post Disaster

Abstract Background There is a paucity of long-term prospective disaster studies of the psychological sequelae among survivors. Methods At 1½ and 25 years after the Spitak earthquake, 142 early adolescents from two cities were assessed: Gumri (moderate–severe exposure) and Spitak (very severe exposure). The Gumri group included treated and not-treated subjects, while the Spitak group included not-treated subjects. Instruments included: DSM-III-R PTSD-Reaction Index (PTSD-RI); DSM-5 PTSD-Checklist (PCL); Depression Self-Rating Scale (DSRS); and Center for Epidemiological Studies-Depression Scale (CES-D). Results (1) Between 1½ and 25 years, PTSD rates and mean scores decreased significantly in the three groups (over 50%). However, at 25 years 9.1–22.4% met DSM-5 PTSD criteria. (2) At 1½ years, the Spitak group had higher PTSD-RI (p < 0.001) and DSRS scores (p < 0.001) compared to the Gumri-not-treated group. At 25 years, the Spitak group that had experienced fewer post-earthquake adversities (p < 0.03), had a greater decrease in PTSD-RI scores (p < 0.02), and lower CES-D scores (p < 0.01). (3) Before treatment, PTSD-RI and DSRS scores did not differ between the Gumri-treated and not-treated groups. At 25-years, the Gumri-treated group showed a greater decrease in PTSD-RI scores (p < 0.03), and lower mean PTSD-RI (p < 0.02), PCL (p < 0.02), and CES-D (p < 0.01) scores. (4) Predictors of PTSD symptom severity at 25-years included: home destruction, treatment, social support, post-earthquake adversities, and chronic medical illnesses. Conclusion Post-disaster PTSD and depressive symptoms can persist for decades. Trauma-focused treatment, alleviation of post-disaster adversities, improving the social ecology, and monitoring for chronic medical illnesses are essential components of recovery programs.

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