Does size really matter? A multisite study assessing the latent structure of the proposed ICD-11 and the DSM-5 diagnostic criteria for PTSD

Maj Hansen, Phillip Hyland, Karen-Inge Karstoft, Henrick Vaegter, Rikke Bramsen, Anni Nielsen, Cherie Armour, Søren B Andersen, Mette Terp Hoybye, Simone Kongshoj Larsen, Tonny E Andersen

Research output: Contribution to journalArticle

Abstract

Background: Researchers and clinicians within the field of trauma have to choose between different diagnostic descriptions of posttraumatic stress disorder (PTSD) in the DSM-5 and the proposed ICD-11. Several studies support different competing models of the PTSD structure according to both diagnostic systems; however, findings show that the choice of diagnostic systems can affect the estimated prevalence rates.Objectives: The present study aimed to investigate the potential impact of using a large (i.e. the DSM-5) compared to a small (i.e. the ICD-11) diagnostic description of PTSD. In other words, does the size of PTSD really matter?Methods: The aim was investigated by examining differences in diagnostic rates between the two diagnostic systems and independently examining the model fit of the competing DSM-5 and ICD-11 models of PTSD across three trauma samples: university students (N = 4213), chronic pain patients (N = 573), and military personnel (N = 118).Results: Diagnostic rates of PTSD were significantly lower according to the proposed ICD-11 criteria in the university sample, but no significant differences were found for chronic pain patients and military personnel. The proposed ICD-11 three-factor model provided the best fit of the tested ICD-11 models across all samples, whereas the DSM-5 seven-factor Hybrid model provided the best fit in the university and pain samples, and the DSM-5 six-factor Anhedonia model provided the best fit in the military sample of the tested DSM-5 models.Conclusions: The advantages and disadvantages of using a broad or narrow set of symptoms for PTSD can be debated, however, this study demonstrated that choice of diagnostic system may influence the estimated PTSD rates both qualitatively and quantitatively. In the current described diagnostic criteria only the ICD-11 model can reflect the configuration of symptoms satisfactorily. Thus, size does matter when assessing PTSD.
LanguageEnglish
Pages1-12
JournalEuropean Journal of Psychotraumatology
Volume8
Issue numbersup7
Early online date13 Nov 2017
DOIs
Publication statusE-pub ahead of print - 13 Nov 2017

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Post-Traumatic Stress Disorders
Military Personnel
Chronic Pain
Anhedonia
Wounds and Injuries
Research Personnel
Students
Pain

Keywords

  • PTSD
  • DSM-5
  • ICD-11
  • CFA
  • DIAGNOSIS

Cite this

Hansen, Maj ; Hyland, Phillip ; Karstoft, Karen-Inge ; Vaegter, Henrick ; Bramsen, Rikke ; Nielsen, Anni ; Armour, Cherie ; Andersen, Søren B ; Hoybye, Mette Terp ; Larsen, Simone Kongshoj ; Andersen, Tonny E. / Does size really matter? A multisite study assessing the latent structure of the proposed ICD-11 and the DSM-5 diagnostic criteria for PTSD. In: European Journal of Psychotraumatology. 2017 ; Vol. 8, No. sup7. pp. 1-12.
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abstract = "Background: Researchers and clinicians within the field of trauma have to choose between different diagnostic descriptions of posttraumatic stress disorder (PTSD) in the DSM-5 and the proposed ICD-11. Several studies support different competing models of the PTSD structure according to both diagnostic systems; however, findings show that the choice of diagnostic systems can affect the estimated prevalence rates.Objectives: The present study aimed to investigate the potential impact of using a large (i.e. the DSM-5) compared to a small (i.e. the ICD-11) diagnostic description of PTSD. In other words, does the size of PTSD really matter?Methods: The aim was investigated by examining differences in diagnostic rates between the two diagnostic systems and independently examining the model fit of the competing DSM-5 and ICD-11 models of PTSD across three trauma samples: university students (N = 4213), chronic pain patients (N = 573), and military personnel (N = 118).Results: Diagnostic rates of PTSD were significantly lower according to the proposed ICD-11 criteria in the university sample, but no significant differences were found for chronic pain patients and military personnel. The proposed ICD-11 three-factor model provided the best fit of the tested ICD-11 models across all samples, whereas the DSM-5 seven-factor Hybrid model provided the best fit in the university and pain samples, and the DSM-5 six-factor Anhedonia model provided the best fit in the military sample of the tested DSM-5 models.Conclusions: The advantages and disadvantages of using a broad or narrow set of symptoms for PTSD can be debated, however, this study demonstrated that choice of diagnostic system may influence the estimated PTSD rates both qualitatively and quantitatively. In the current described diagnostic criteria only the ICD-11 model can reflect the configuration of symptoms satisfactorily. Thus, size does matter when assessing PTSD.",
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Hansen, M, Hyland, P, Karstoft, K-I, Vaegter, H, Bramsen, R, Nielsen, A, Armour, C, Andersen, SB, Hoybye, MT, Larsen, SK & Andersen, TE 2017, 'Does size really matter? A multisite study assessing the latent structure of the proposed ICD-11 and the DSM-5 diagnostic criteria for PTSD', European Journal of Psychotraumatology, vol. 8, no. sup7, pp. 1-12. https://doi.org/10.1080/20008198.2017.1398002

Does size really matter? A multisite study assessing the latent structure of the proposed ICD-11 and the DSM-5 diagnostic criteria for PTSD. / Hansen, Maj; Hyland, Phillip; Karstoft, Karen-Inge; Vaegter, Henrick; Bramsen, Rikke; Nielsen, Anni; Armour, Cherie; Andersen, Søren B; Hoybye, Mette Terp; Larsen, Simone Kongshoj; Andersen, Tonny E.

In: European Journal of Psychotraumatology, Vol. 8, No. sup7, 13.11.2017, p. 1-12.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Does size really matter? A multisite study assessing the latent structure of the proposed ICD-11 and the DSM-5 diagnostic criteria for PTSD

AU - Hansen, Maj

AU - Hyland, Phillip

AU - Karstoft, Karen-Inge

AU - Vaegter, Henrick

AU - Bramsen, Rikke

AU - Nielsen, Anni

AU - Armour, Cherie

AU - Andersen, Søren B

AU - Hoybye, Mette Terp

AU - Larsen, Simone Kongshoj

AU - Andersen, Tonny E

PY - 2017/11/13

Y1 - 2017/11/13

N2 - Background: Researchers and clinicians within the field of trauma have to choose between different diagnostic descriptions of posttraumatic stress disorder (PTSD) in the DSM-5 and the proposed ICD-11. Several studies support different competing models of the PTSD structure according to both diagnostic systems; however, findings show that the choice of diagnostic systems can affect the estimated prevalence rates.Objectives: The present study aimed to investigate the potential impact of using a large (i.e. the DSM-5) compared to a small (i.e. the ICD-11) diagnostic description of PTSD. In other words, does the size of PTSD really matter?Methods: The aim was investigated by examining differences in diagnostic rates between the two diagnostic systems and independently examining the model fit of the competing DSM-5 and ICD-11 models of PTSD across three trauma samples: university students (N = 4213), chronic pain patients (N = 573), and military personnel (N = 118).Results: Diagnostic rates of PTSD were significantly lower according to the proposed ICD-11 criteria in the university sample, but no significant differences were found for chronic pain patients and military personnel. The proposed ICD-11 three-factor model provided the best fit of the tested ICD-11 models across all samples, whereas the DSM-5 seven-factor Hybrid model provided the best fit in the university and pain samples, and the DSM-5 six-factor Anhedonia model provided the best fit in the military sample of the tested DSM-5 models.Conclusions: The advantages and disadvantages of using a broad or narrow set of symptoms for PTSD can be debated, however, this study demonstrated that choice of diagnostic system may influence the estimated PTSD rates both qualitatively and quantitatively. In the current described diagnostic criteria only the ICD-11 model can reflect the configuration of symptoms satisfactorily. Thus, size does matter when assessing PTSD.

AB - Background: Researchers and clinicians within the field of trauma have to choose between different diagnostic descriptions of posttraumatic stress disorder (PTSD) in the DSM-5 and the proposed ICD-11. Several studies support different competing models of the PTSD structure according to both diagnostic systems; however, findings show that the choice of diagnostic systems can affect the estimated prevalence rates.Objectives: The present study aimed to investigate the potential impact of using a large (i.e. the DSM-5) compared to a small (i.e. the ICD-11) diagnostic description of PTSD. In other words, does the size of PTSD really matter?Methods: The aim was investigated by examining differences in diagnostic rates between the two diagnostic systems and independently examining the model fit of the competing DSM-5 and ICD-11 models of PTSD across three trauma samples: university students (N = 4213), chronic pain patients (N = 573), and military personnel (N = 118).Results: Diagnostic rates of PTSD were significantly lower according to the proposed ICD-11 criteria in the university sample, but no significant differences were found for chronic pain patients and military personnel. The proposed ICD-11 three-factor model provided the best fit of the tested ICD-11 models across all samples, whereas the DSM-5 seven-factor Hybrid model provided the best fit in the university and pain samples, and the DSM-5 six-factor Anhedonia model provided the best fit in the military sample of the tested DSM-5 models.Conclusions: The advantages and disadvantages of using a broad or narrow set of symptoms for PTSD can be debated, however, this study demonstrated that choice of diagnostic system may influence the estimated PTSD rates both qualitatively and quantitatively. In the current described diagnostic criteria only the ICD-11 model can reflect the configuration of symptoms satisfactorily. Thus, size does matter when assessing PTSD.

KW - PTSD

KW - DSM-5

KW - ICD-11

KW - CFA

KW - DIAGNOSIS

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DO - 10.1080/20008198.2017.1398002

M3 - Article

VL - 8

SP - 1

EP - 12

JO - European Journal of Psychotraumatology

T2 - European Journal of Psychotraumatology

JF - European Journal of Psychotraumatology

SN - 2000-8198

IS - sup7

ER -