Did the DSM-5 Improve the Traumatic Stressor Criterion?: Association of DSM-IV and DSM-5 Criterion A with Posttraumatic Stress Disorder Symptoms

Larsen, Sadie E.; Berenbaum, Howard

doi:10.1159/000481950

Cited by 20 publications

(15 citation statements)

References 15 publications

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“…The difference in PTSD symptoms, however, was contingent on self-report of event impact: When event type was used as the sole basis for meeting the criterion, without considering self-report of impact, the difference in symptoms disappeared. Regarding Criterion A in DSM-5, no significant difference in PTSD symptoms was observed between individuals who reported a DSM-5 Criterion A event and those who did not (Franklin et al, 2019;Larsen & Berenbaum, 2017).…”

mentioning

confidence: 76%

Does requiring trauma exposure affect rates of ICD-11 PTSD and complex PTSD? Implications for DSM–5.

Hyland

Karatzias

Shevlin³

et al. 2021

Psychological Trauma: Theory, Research, Practice, and Policy

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Objective: There is little evidence that posttraumatic stress disorder (PTSD) is more likely to follow traumatic events defined by Criterion A than non-Criterion A stressors. Criterion A events might have greater predictive validity for ICD-11 PTSD which is a condition more narrowly defined by core features. We evaluated the impact of using Criterion A, an 'expanded' trauma definition in line with ICD-11 guidelines, and no exposure criterion on rates of ICD-11 PTSD and Complex PTSD (CPTSD). We also assessed if five psychologically threatening events included in the expanded definition were as strongly associated with PTSD and CPTSD as 'standard' Criterion A events. Method: A nationally representative sample from Ireland (N = 1,020) completed self-report measures. Results: Most participants were trauma-exposed based on Criterion A (82%) and the 'expanded' (88%) criterion. When no exposure criterion was used, 13.7% met diagnostic requirements for PTSD or CPTSD; 13.2% when the expanded criterion was used, and 13.2% when Criterion A was used. The five psychologically threatening events were as strongly associated with PTSD and CPTSD as the Criterion A events. In a multivariate analysis, only the psychologically threatening events were significantly associated with PTSD (stalking) and CPTSD (bullying, emotional abuse, and neglect). Conclusions: Certain non-Criterion A events involving extreme fear and horror should be considered traumatic. The ICD-11 approach of providing clinical guidance rather than a formal definition offers a viable solution to some of the problems associated with the current and previous attempts to define traumatic exposure. Running head: TRAUMA EXPOSURE AND PTSD AND CPTSD Clinical Impact Statement A diagnosis of posttraumatic stress disorder (PTSD) requires that a person has experienced a 'traumatic' life event, however, difficulties in defining what is, and what is not, a trauma has threatened the construct validity of PTSD. The newly released 11 th version of the International Classification of Diseases (ICD-11: World Health Organization, 2018) provides clinicians with guidance, rather than a formal definition, for what constitutes a traumatic event. In this study, we show that psychologically threatening events such as emotional abuse, neglect, bullying, and stalking that would not normally be considered 'traumatic' were uniquely associated with meeting the diagnostic requirements for PTSD and Complex PTSD. The ICD-11 approach of considering an event as traumatic if it is extremely threatening or horrific is helpful because it provides a context to understand trauma-related symptoms while allowing clinicians flexibility in determining what is a potentially traumatic experience.

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confidence: 76%

Does requiring trauma exposure affect rates of ICD-11 PTSD and complex PTSD? Implications for DSM–5.

Hyland

Karatzias

Shevlin³

et al. 2021

Psychological Trauma: Theory, Research, Practice, and Policy

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“…Indeed, individuals who experience threats to safety show a raised likelihood of PTSD, including war veterans and victims of stalking or natural disasters (Xu and Liao, 2011; Norris and Slone, 2013; Kessler et al ., 2017). The perception of life threat is significantly associated with PTSD (Larsen and Berenbaum, 2017), even after adjusting for objective trauma exposure (Heir et al ., 2016).…”

Section: Possible Dimensions Of Trauma Eventsmentioning

confidence: 99%

A contextual approach to trauma experience: lessons from life events research

2019

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“…; DSM -III; APA, 1980). Although there is still an ongoing debate regarding this definition (Larsen & Berenbaum, 2017), DSM -5 defines a traumatic event as one which involves a direct or indirect exposure to actual or threatened death, serious injury, or sexual violence (APA, 2013). This debate is highly relevant when examining the unique experiences of individuals with neurodevelopmental conditions.…”

Section: Introductionmentioning

confidence: 99%

Autism Spectrum Disorder and Post-Traumatic Stress Disorder: An unexplored co-occurrence of conditions

Haruvi-Lamdan

Horesh

Zohar

et al. 2020

Autism

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People with Autism Spectrum Disorder show an increased risk of experiencing potentially traumatic events, particularly social victimization. However, Autism Spectrum Disorder and Post-Traumatic Stress Disorder co-occurrence was hardly studied. We examined exposure to potentially traumatic life events and PTSD symptoms in adults with Autism Spectrum Disorder vs typical adults. Twenty-five adults with Autism Spectrum Disorder and 25 typical adults were comparable on age and gender. Participants self-reported on potentially traumatic life events of social and non-social nature, and on PTSD symptoms related to their most distressing event. Results showed higher rates of probable-Post-Traumatic Stress Disorder in the Autism Spectrum Disorder group (32%) compared with the typical adults group (4%). Individuals with Autism Spectrum Disorder reported more PTSD symptoms, particularly re-experiencing and hyper-arousal, compared with typical adults, although the latter was elevated only in females with Autism Spectrum Disorder. Participants with Autism Spectrum Disorder, especially females, reported more negative life events, particularly social events, than typical adults. Sixty percent of Autism Spectrum Disorder participants, but only 20% of typical adults, chose a social event as their most distressing event. Individuals with Autism Spectrum Disorder and probable-Post-Traumatic Stress Disorder co-occurrence presented poorer social skills compared with those with Autism Spectrum Disorder alone. Results indicate increased vulnerability of individuals with Autism Spectrum Disorder to trauma and Post-Traumatic Stress Disorder, especially due to social stressors. Females with Autism Spectrum Disorder may be particularly vulnerable to Post-Traumatic Stress Disorder. Lay Abstract People with Autism Spectrum Disorder show an increased risk of experiencing traumatic events, particularly social victimization. However, Autism Spectrum Disorder and Post-Traumatic Stress Disorder co-occurrence was hardly studied. We examined exposure to traumatic life events and Post-Traumatic Stress Disorder symptoms in adults with Autism Spectrum Disorder vs typical adults. Two groups took part in this study: Twenty-five adults with Autism Spectrum Disorder and 25 typical adults of similar age and male to female ratio. Participants completed questionnaires on potentially traumatic life events of social and non-social nature, as well as on Post-Traumatic Stress Disorder symptoms related to their most distressing event. Participants also filled out an autism traits questionnaire. Results showed a higher Post-Traumatic Stress Disorder rate in the Autism Spectrum Disorder group (32%) compared with the typical group (4%). Individuals with Autism Spectrum Disorder reported more Post-Traumatic Stress Disorder symptoms, particularly re-experiencing and increased physiological arousal, compared with typical adults, although the latter was elevated only in females with Autism Spectrum Disorder. Participants with Autism Spectrum Disorder, especially females, reported more negative life events, particularly social events, than typical adults. Sixty percent of Autism Spectrum Disorder participants, but only 20% of typical participants, chose a social event as their most distressing event. Individuals with Autism Spectrum Disorder who were also suspected as having Post-Traumatic Stress Disorder (based on their questionnaires) presented poorer social skills compared with those with Autism Spectrum Disorder alone. Results indicate that individuals with Autism Spectrum Disorder are more susceptible to trauma and Post-Traumatic Stress Disorder, particularly due to social stressors. Females with Autism Spectrum Disorder may be especially vulnerable to Post-Traumatic Stress Disorder.

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Did the DSM-5 Improve the Traumatic Stressor Criterion?: Association of DSM-IV and DSM-5 Criterion A with Posttraumatic Stress Disorder Symptoms

Cited by 20 publications

References 15 publications

Does requiring trauma exposure affect rates of ICD-11 PTSD and complex PTSD? Implications for DSM–5.

Does requiring trauma exposure affect rates of ICD-11 PTSD and complex PTSD? Implications for DSM–5.

A contextual approach to trauma experience: lessons from life events research

Autism Spectrum Disorder and Post-Traumatic Stress Disorder: An unexplored co-occurrence of conditions

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