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

Figures & data

Table 1 Frequency of Symptom Endorsement according to DSM-IV and DSM-5 symptoms of PTSD (rated ≥1 at the PSS-I, Foa & Tolin, 2000)

DSM-IV items	%	n	DSM-5 items	%	n
Reexperiencing (B)			Reexperiencing (B)
B1: Intrusions	83.2	79	B1: Intrusions	83.2	79
B2: Nightmares	53.7	51	B2: Nightmares	53.7	51
B3: Flashbacks	65.3	62	B3: Flashbacks	65.3	62
B4: Emotional Reactivity	77.9	74	B4: Emotional Reactivity	77.9	74
B5: Physical Reactivity	76.8	73	B5: Physical Reactivity	76.8	73
Avoidance (C)			Avoidance (C)
C1: Avoid thoughts/feelings	65.3	62	C1: Avoid thoughts/feelings	65.3	62
C2: Avoid places/activities	61.1	58	C2: Avoid places/activities/objects/situations/conversation^a	69.5	66
C3: Amnesia	14.7	14	Negative alterations in mood/cognitions (D)
C4: Loss of interest	44.2	42	D1: Amnesia	14.7	14
C5: Social detachment	33.7	32	D2: Negative beliefs^a	51.6	49
C6: Psychological numbing	23.2	22	D3: Distorted blame^a	66.3	63
C7: Foreshortened future	56.8	54	D4: Negative emotional state^a	53.7	51
			D5: Loss of interest	44.2	42
			D6: Social detachment	33.7	32
			D7: Low positive emotions^a	21.1	20
Hyperarousal (D)			Hyperarousal (E)
D1: Difficulty sleeping	62.1	59	E1: Aggression/irritability/anger^a	27.4	26
D2: Irritability/anger outbursts	41.1	39	E2: Reckless/self-destructive^a	22.1	21
D3: Difficulty concentrating	67.4	64	E3: Hypervigilance	37.9	36
D4: Hypervigilance	37.9	36	E4: Exaggerated startle response	38.9	37
D5: Exaggerated startle response	38.9	37	E5: Difficulty concentrating	67.4	64
			E6: Difficulty sleeping	62.1	59

^aSymptoms not included in the DSM-IV.

Table 2 Exact wording of the new DSM-5 items integrated into the PSS-I (Foa & Tolin, 2000)

Item	Wording
C2	Have you persistently been making efforts to avoid objects, situations or conversations that arouse distressing memories, thoughts or feelings about, or that are closely associated with the traumatic event?
D2	Have you had strong negative beliefs or expectations about yourself, others, or the world? (e.g., “I am bad,” “No one can be trusted,” “The world is completely dangerous”, “My whole nervous system is permanently ruined”)
D3	Have you blamed yourself or others about the traumatic event, its cause or consequences? (do not include the aggressor)
D4	Have you had any strong negative feelings (e.g., fear, horror, anger, guilt, or shame)?
D7	Have you felt difficulty to experience positive feelings? (e.g., unable to have loving or happy feelings)
E1	Have you shown irritable or aggressive behavior? (expressed verbally or physically towards people or objects)
E2	Have you shown reckless or self-destructive behavior (doing things that might have caused you harm)?

Table 3 Frequency of PTSD Symptom Criteria Endorsement according to DSM-IV and DSM-5

DSM-IV symptom criteria				DSM-5 symptom criteria
	%	n	Cronbach's α		%	n	Cronbach's α
Criterion A	100.0	95		Criterion A	100.0	95
Criterion B	86.3	82	0.85	Criterion B	86.3	82	0.85
Criterion C	55.8	53	0.74	Criterion C	80.0	76	0.88
Criterion D	65.3	62	0.84	Criterion D	75.8	72	0.64
Criterion E	86.3	82		Criterion E	67.4	64	0.81
Criterion F	85.3	81		Criterion F	86.3	82
				Criterion G	85.3	81
				Criterion H	93.7	89
PTSD diagnosis	44.2	42		PTSD diagnosis	49.5	47

Fig. 1 PTSD diagnosis according to DSM-IV and DSM-5 symptom criteria.

Table 4 Hierarchical multiple regression analyses with DSM-5 PTSD severity score as the dependent variable (N=95)

Variable/model	R ^2	f ^2	df	F	B	SE B	β
Step 1	0.38	0.61	2	28.54***
Traumatic event types experienced					2.08	0.57	0.36***
Traumatic event types witnessed					2.30	0.68	0.34***
Step 2	0.40	0.67	3	20.09***
Traumatic event types experienced					1.74	0.61	0.30**
Traumatic event types witnessed					1.73	0.77	0.25*
Types of perpetrated violent acts					0.43	0.28	0.18 ns

Note. *p<0.05, *p<0.01, ***p<0.001.

Foa E. B., Tolin D. F. Comparison of the PTSD Symptom Scale-Interview version and the clinician-administered PTSD scale. Journal of Traumatic Stress. 2000; 13: 181–191. [PubMed Abstract].

 Google Scholar