ABSTRACT

Background and Objectives

New diagnostic criteria for posttraumatic stress disorder (PTSD) were introduced by DSM-5 and ICD-11. It remains unclear how well these new definitions of PTSD capture the posttrauma responses of children, particularly when using parent report. This study compared different conceptual models of PTSD in children following the Boston Marathon bombing and manhunt.

Design and Methods

Parents/caretakers (N = 254) reported on PTSD symptoms of their children (ages 4–11) following the Boston Marathon bombing and manhunt. Algorithms compared criteria from ICD-11, DSM-IV, and DSM-5 (specifically the “Preschool” criteria).

Results

DSM-5 Preschool criteria identified twice as many children as ICD-11, and over four times as many as DSM-IV. DSM-5 Preschool criteria identified all cases detected by ICD-11 and DSM-IV. Across models, all identified cases had greater trauma exposure than non-identified children. DSM-5 Preschool and ICD-11 (but not DSM-IV) cases had greater clinical decline than non-identified children. The Avoidance cluster showed the most variability in identifying cases.

Conclusions

Newer models of PTSD are likely to identify more children than DSM-IV, mostly related to changes in the Avoidance criteria. The DSM-5 Preschool definition is the most inclusive model. ICD-11 may provide a balance between inclusivity and stringency in detecting childhood PTSD.

中文翻译：

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名字里有什么？波士顿马拉松爆炸和搜捕后青春期前儿童创伤后应激障碍的不同概念的比较

摘要

背景和目标

DSM-5 和 ICD-11 引入了创伤后应激障碍 (PTSD) 的新诊断标准。目前尚不清楚这些 PTSD 的新定义在多大程度上反映了儿童的创伤后反应，特别是在使用家长报告时。这项研究比较了波士顿马拉松爆炸和搜捕后儿童的创伤后应激障碍的不同概念模型。

设计与方法

家长/看护人 ( N  = 254) 报告了波士顿马拉松爆炸和搜捕后其孩子（4-11 岁）的 PTSD 症状。算法比较了 ICD-11、DSM-IV 和 DSM-5 的标准（特别是“学前”标准）。

结果

DSM-5 学前标准确定的儿童数量是 ICD-11 的两倍，是 DSM-IV 的四倍多。DSM-5 学前班标准确定了 ICD-11 和 DSM-IV 检测到的所有病例。在各个模型中，所有已识别的病例都比未识别的儿童遭受更大的创伤。DSM-5 学前班和 ICD-11（但不是 DSM-IV）病例比未确诊的儿童有更大的临床下降。回避簇在识别病例方面表现出最大的变异性。

结论

较新的 PTSD 模型可能比 DSM-IV 识别出更多的儿童，这主要与回避标准的变化有关。DSM-5 学前班定义是最具包容性的模型。ICD-11 可以在检测儿童 PTSD 方面提供包容性和严格性之间的平衡。