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首页> 美国卫生研究院文献>Journal of Child and Adolescent Psychopharmacology >Evaluating Diagnostic and Statistical Manual of Mental Disorders Fifth Edition Posttraumatic Stress Disorder Diagnostic Criteria in Older Children and Adolescents
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Evaluating Diagnostic and Statistical Manual of Mental Disorders Fifth Edition Posttraumatic Stress Disorder Diagnostic Criteria in Older Children and Adolescents

机译：评估精神疾病诊断和统计手册第五版大龄儿童和青少年的创伤后应激障碍诊断标准

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>Objectives: Few studies have assessed how the diagnostic criteria for posttraumatic stress disorder (PTSD) apply to older children and adolescents. With the introduction of a new, developmentally sensitive set of criteria for very young children (age 6 years and younger) in Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5), this raises new questions about the validity of the criteria for older children and adolescents. The current study investigated how diagnostic changes in DSM-5 impact diagnosis rates in 7–18-year olds.>Methods: PTSD, impairment, and comorbid psychopathology were assessed in 135 trauma-exposed, treatment-seeking participants. Children (ages 7–12) were examined separately from adolescents (ages 13–18) to assess for potential developmental differences.>Results: A significantly higher proportion of 7–12-year-old children met criteria for DSM-5 diagnosis (53%) compared to Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) (37%). However, among 13–18-year-old adolescents, the proportions diagnosed with DSM-5 (73%) and DSM-IV (74%) did not differ. Participants who met criteria for DSM-5 only (17%) did not differ from those diagnosed with DSM-IV in terms impairment or comorbidity. Using the newly accepted age 6 years and younger criteria resulted in a significantly higher proportion of 7–12-year-old (but not 13–18-year olds) children meeting criteria compared to DSM-IV or DSM-5. However, these children showed less impairment and comorbidity than those diagnosed with DSM-IV.>Conclusion: These findings suggest that DSM-5 criteria may be more developmentally sensitive than DSM-IV criteria, and may lead to higher prevalence rates of PTSD for 7–12-year-old children, but not for adolescents. Using the very young children criteria for 7–12-year-old children may further increase prevalence, but capture children with less severe psychopathology.
机译：>目标：很少有研究评估创伤后应激障碍（PTSD）的诊断标准如何适用于年龄较大的儿童和青少年。在《精神障碍诊断和统计手册》第五版（DSM-5）中引入了针对非常年幼的儿童（6岁及以下）的一套新的，对发育敏感的标准，这对标准的有效性提出了新的疑问。适用于年龄较大的儿童和青少年。当前的研究调查了DSM-5的诊断变化如何影响7-18岁年龄组的诊断率。>方法：对135名创伤暴露且寻求治疗的参与者进行了PTSD，功能障碍和合并症的心理病理学评估。对儿童（7至12岁）和青少年（13至18岁）分别进行了检查，以评估其潜在的发育差异。>结果：更高比例的7至12岁儿童达到了DSM-5诊断（53％）与《精神疾病诊断和统计手册》第四版（DSM-IV）（37％）相比。但是，在13至18岁的青少年中，诊断为DSM-5（73％）和DSM-IV（74％）的比例没有差异。仅符合DSM-5标准的参与者（17％）与受损或合并症在诊断为DSM-IV的参与者方面没有差异。与DSM-IV或DSM-5相比，使用新接受的6岁及以下的新标准导致符合标准的7-12岁（而非13-18岁）儿童的比例显着更高。但是，这些儿童的障碍和合并症比诊断为DSM-IV的儿童少。>结论：这些发现表明，DSM-5的标准可能比DSM-IV的标准对发育更敏感，并且可能导致更高的敏感性。 7-12岁儿童的PTSD患病率，而青少年则没有。对7至12岁的儿童使用很小的儿童标准可能会进一步增加患病率，但会捕获精神病理学较轻的儿童。

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