Posttraumatic stress disorder according to DSM-5 and DSM-IV diagnostic criteria: a comparison in a sample of Congolese ex-combatants

Abstract

Background

Compared to DSM-IV, the criteria for diagnosing posttraumatic stress disorder (PTSD) have been modified in DSM-5.

Objective

The first aim of this study was to examine how these modifications impact rates of PTSD in a sample of Congolese ex-combatants. The second goal of this study was to investigate whether PTSD symptoms were associated with perpetrator-related acts or victim-related traumatic events.

Method

Ninety-five male ex-combatants in the eastern Democratic Republic of Congo were interviewed. Both the DSM-IV and the DSM-5 PTSD symptom criteria were assessed.

Results

The DSM-5 symptom criteria yielded a PTSD rate of 50% (n=47), whereas the DSM-IV symptom criteria were met by 44% (n=42). If the DSM-5 would be set as the current “gold standard,” then DSM-IV would have produced more false negatives (8%) than false positives (3%). A minority of participants (19%, n=18) indicated an event during which they were involved as a perpetrator as their most stressful event. Results of a regression analysis (R ²=0.40) showed that, after accounting for the number of types of traumatic events, perpetrated violent acts were not associated with the symptom severity of PTSD.

Conclusions

The findings demonstrate that more diagnostic cases were produced with the DSM-5 diagnostic rules than were dropped resulting in an increase in PTSD rates compared to the DSM-IV system. The missing association between PTSD symptoms and perpetrated violent acts might be explained by a potential fascinating and excited perception of these acts.

• PTSD
• DSM-5
• DSM-IV
• Congo
• ex-combatants
• violence

For the abstract or full text in other languages, please see Supplementary files under ‘Article Tools’

For the abstract or full text in other languages, please see Supplementary files under ‘Article Tools’

Authors' contributions

SS conceived the study, participated in its design and the coordination of the study, participated in the training and supervision of local interviewers, performed the statistical analyses and drafted the manuscript. AK conceived the study, participated in the design and the coordination of the study and the training and supervision of local interviewers. HH participated in the design and coordination of the study. TE participated in the design of the study and contributed to the interpretation of findings and writing of the paper. All authors read and approved the final version.

Acknowledgements

We thank the respondents for their trust and openness and appreciate the reliable support of Ben Ombeni Cigolo, Zacharie Muhave, and Lisette Panzu Katakya as well as Jean-Marc Tafani, Ndiaga Diagnen, Mass Walimba, Djoda Fidele, Zenaid Gatelli, Topesse Lokonde, and the whole team in Disarmament, Demobilization, and Reintegration. Research was funded by the World Bank and supported by the Deutsche Forschungsgemeinschaft (German Research Foundation).

Conflict of interest and funding

There is no conflict of interest in the present study for any of the authors.

Notes

For the abstract or full text in other languages, please see Supplementary files under ‘Article Tools’