创伤后应激障碍的分类

N. Feeny, A. Klein, Kathy Benhamou
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摘要

本章回顾了第五版《精神疾病诊断与统计手册》(DSM-5)中目前创伤后应激障碍(PTSD)的诊断标准,包括DSM-IV中对标准的修改。创伤后应激障碍经常与其他疾病(如重度抑郁症(MDD)和广泛性焦虑症(GAD))共同发生并共享症状。研究表明,症状不明显的症状不足以解释合并症,可能是创伤后应激障碍诊断的核心。讨论了个体症状的诊断效用和特异性,以及创伤后应激障碍、重度抑郁症和广泛性焦虑症的潜在结构。然后,本章讨论了创伤后应激障碍和其他常见的合并症之间的界限,重点是边缘性人格障碍,复杂的悲伤,并讨论了童年创伤和复杂的创伤后应激障碍。本文还讨论了有关复杂创伤后应激障碍概念的最新证据。最后,回顾PTSD诊断的跨文化效度。
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Classification of Posttraumatic Stress Disorder
This chapter reviews current diagnostic criteria of posttraumatic stress disorder (PTSD) in the fifth edition of Diagnostic and Statistical Manual of Mental Disorders (DSM-5), including changes to the criteria from DSM-IV. PTSD frequently co-occurs and shares symptoms with other conditions, such as major depressive disorder (MDD) and generalized anxiety disorder (GAD). Research suggests that syndromally indistinct symptoms are not sufficient to explain comorbidity and may be central to the PTSD diagnosis. The diagnostic utility and specificity of individual symptoms is discussed as is the latent structure of PTSD, MDD, and GAD. The chapter then discusses boundaries between PTSD and other commonly comorbid conditions, with an emphasis on borderline personality disorder, complicated grief, and a discussion of childhood trauma and complex PTSD. Recent evidence regarding the construct of complex PTSD is also discussed. Finally, the cross-cultural validity of the PTSD diagnosis is reviewed.
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