An Examination of Chronic Pain Indices and the Updated Posttraumatic Stress Disorder Checklist for Diagnostic and Statistical Manual of Mental-Disorders-Fifth Edition

2020 ◽  
Author(s):  
Elizabeth Lehinger ◽  
David E Reed ◽  
Paul Nabity ◽  
Nicole Brackins ◽  
Robert Villarreal ◽  
...  

ABSTRACT Introduction Chronic pain and post-traumatic stress disorder (PTSD) comorbidity is prevalent among veterans and is associated with increased levels of pain severity and pain-related disability. An improved understanding of the relationship between these co-occurring disorders, in addition to effective integrated treatments, will develop by considering the changes to the PTSD diagnostic criteria in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). The current study examined the relationship between the revised PTSD Checklist for DSM-5 (PCL-5) symptom clusters (i.e., intrusion, avoidance, negative alterations in cognition and mood [NACM], and arousal) and chronic pain measurements (i.e., pain severity, interference, and disability). Materials and Methods Participants included 103 veterans (ages 26-70, mean = 45.33) participating in a randomized clinical trial examining the efficacy of an interdisciplinary pain management program for chronic musculoskeletal pain. The study was approved by a university system Institutional Review Board and affiliated healthcare system. Results The participants with a provisional PTSD diagnosis based on PCL-5 responses (N = 76) had significantly greater pain severity, interference, and disability than the participants without a provisional diagnosis (N = 23). Correlations between symptom clusters and pain measurements were mostly significant and positive with varying strengths. The avoidance symptom cluster, however, had relatively weaker correlations with pain measurements and was not significantly associated with the numeric rating scale of pain severity. Path analyses revealed that, after controlling for avoidance symptoms, significant associations remained between NACM and all the pain measurements. After controlling for NACM symptoms, however, there were no significant associations between avoidance symptoms and pain measurements. Conclusion The current study highlights a need to re-examine the leading theories about the mutual maintenance of these disorders in order to develop effective integrative treatment approaches. PTSD-related avoidance may have a relatively weaker role in co-occurring chronic pain than the other symptom clusters and may have a qualitatively different role than chronic pain–related avoidance. Future research should explore the relationship between the avoidance in PTSD and the avoidance in chronic pain as well as identify which chronic pain measurements are the most useful when examining the relationship between PTSD and chronic pain. The potential impact of trauma-related cognition and mood on chronic pain indicates that this is an important area for intervention and should be considered in the development of integrated treatments for chronic pain and PTSD among veterans.

Author(s):  
Terence M. Keane ◽  
Mark W. Miller

This chapter reviews the status of modifications to the definition of PTSD and proposed changes for DSM-5. We include a brief history of the diagnosis and trace its evolution in the Diagnostic and Statistical Manual of Mental Disorders (DSM). We discuss some of the current controversies related to the definition of PTSD including its location among the anxiety disorders, the utility of Criterion A and its subcomponents, and the factor structure of the symptoms. We review the rationale for the addition of new symptoms and modifications to existing criteria now and conclude with comments on future directions for research on PTSD.


2015 ◽  
Vol 22 (2) ◽  
pp. 127-133 ◽  
Author(s):  
Mohammad A. Aboul-ata ◽  
Fatma A. Amin

Objective: In the present study, we created a new valid rating scale to estimate the prevalence of ADHD among school-age children in Fayoum City. Method: We conducted two consequential studies (Studies 1 and 2). In Study 1, the sample comprised 106 children. The ages of the sample participants ranged between 6 and 14 years. The purpose of that study was to validate a new Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5)-based ADHD rating scale. In Study 2, the sample consisted of 420 children with ages ranging from 6 to 14 years. We used the new rating scale to estimate the prevalence of ADHD. Results: The first study showed that the new rating scale for ADHD was valid. The second study revealed that the prevalence of ADHD in Fayoum City was 20.5%, with 33.8% among boys and 6.8% among girls. Conclusion: We validated a new ADHD rating scale and estimated the prevalence of ADHD in Fayoum City for the first time in Egypt.


CNS Spectrums ◽  
2016 ◽  
Vol 21 (4) ◽  
pp. 279-282 ◽  
Author(s):  
Lior Carmi ◽  
Leah Fostick ◽  
Shimon Burshtein ◽  
Shlomit Cwikel-Hamzany ◽  
Joseph Zohar

One of the main changes in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) was the separation of Stress Related Disorders from the Anxiety chapter. This separation paves the way to examine the unique characteristics of posttraumatic stress disorder (PTSD) (ie, identifiable onset, memory processes, etc) and related neural mechanisms. The time that elapses between the traumatic event and the manifestation of the disorder may also be addressed as the “golden hours,” or the window of opportunity in which critical processes take place and relevant interventions may be administrated.


Author(s):  
Timo D. Vloet ◽  
Marcel Romanos

Zusammenfassung. Hintergrund: Nach 12 Jahren Entwicklung wird die 11. Version der International Classification of Diseases (ICD-11) von der Weltgesundheitsorganisation (WHO) im Januar 2022 in Kraft treten. Methodik: Im Rahmen eines selektiven Übersichtsartikels werden die Veränderungen im Hinblick auf die Klassifikation von Angststörungen von der ICD-10 zur ICD-11 zusammenfassend dargestellt. Ergebnis: Die diagnostischen Kriterien der generalisierten Angststörung, Agoraphobie und spezifischen Phobien werden angepasst. Die ICD-11 wird auf Basis einer Lebenszeitachse neu organisiert, sodass die kindesaltersspezifischen Kategorien der ICD-10 aufgelöst werden. Die Trennungsangststörung und der selektive Mutismus werden damit den „regulären“ Angststörungen zugeordnet und können zukünftig auch im Erwachsenenalter diagnostiziert werden. Neu ist ebenso, dass verschiedene Symptomdimensionen der Angst ohne kategoriale Diagnose verschlüsselt werden können. Diskussion: Die Veränderungen im Bereich der Angsterkrankungen umfassen verschiedene Aspekte und sind in der Gesamtschau nicht unerheblich. Positiv zu bewerten ist die Einführung einer Lebenszeitachse und Parallelisierung mit dem Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Schlussfolgerungen: Die entwicklungsbezogene Neuorganisation in der ICD-11 wird auch eine verstärkte längsschnittliche Betrachtung von Angststörungen in der Klinik sowie Forschung zur Folge haben. Damit rückt insbesondere die Präventionsforschung weiter in den Fokus.


Author(s):  
Thomas A. Widiger ◽  
Maryanne Edmundson

The Diagnostic and Statistical Manual of Mental Disorders, Third Edition (DSM-III) is often said to have provided a significant paradigm shift in how psychopathology is diagnosed. The authors of DSM-5 have the empirical support and the opportunity to lead the field of psychiatry to a comparably bold new future in diagnosis and classification. The purpose of this chapter is to address the validity of the categorical and dimensional models for the classification and diagnosis of psychopathology. Considered in particular will be research concerning substance use disorders, mood disorders, and personality disorders. Limitations and concerns with respect to a dimensional classification of psychopathology are also considered. The chapter concludes with a recommendation for a conversion to a more quantitative, dimensional classification of psychopathology.


2011 ◽  
Vol 58 (2) ◽  
pp. 209-223 ◽  
Author(s):  
AISLINN MELCHIOR

Post-traumatic stress disorder (PTSD) made its first appearance in the Diagnostic and Statistical Manual of Mental Disorders in 1980, partly as a result of the ongoing treatment of veterans from the Vietnam War. Although PTSD is not only or even primarily a disorder caused by combat, combat is a regular trigger and my chief concern in what follows. Therefore I will not be examining such evidence as exists for the psychological traumas of civilians in the ancient world who were exposed to violence, rape, enslavement, or the execution of family members in the context of conquest. My focus is on the soldier.


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