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The cross-cultural validity of posttraumatic stress disorder: Implications for DSM-5

机译：创伤后应激障碍的跨文化有效性：对DSM-5的影响

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摘要

There is considerable debate about the cross-cultural applicability of the posttraumatic stress disorder (PTSD) category as currently specified. Concerns include the possible status of PTSD as a Western culture-bound disorder and the validity of individual items and criteria thresholds. This review examines various types of cross-cultural validity of the PTSD criteria as defined in DSM-IV-TR, and presents options and preliminary recommendations to be considered for DSM-5. Methods: Searches were conducted of the mental health literature, particularly since 1994, regarding cultural-, race-, or ethnicity-related factors that might limit the universal applicability of the diagnostic criteria of PTSD in DSM-IV-TR and the possible criteria for DSM-5. Results: Substantial evidence of the cross-cultural validity of PTSD was found. However, evidence of cross-cultural variability in certain areas suggests the need for further research: the relative salience of avoidanceumbing symptoms, the role of the interpretation of trauma-caused symptoms in shaping symptomatology, and the prevalence of somatic symptoms. This review also indicates the need to modify certain criteria, such as the items on distressing dreams and on foreshortened future, to increase their cross-cultural applicability. Text additions are suggested to increase the applicability of the manual across cultural contexts: specifying that cultural syndromes-such as those indicated in the DSM-IV-TR Glossary-may be a prominent part of the trauma response in certain cultures, and that those syndromes may influence PTSD symptom salience and comorbidity. Conclusions: The DSM-IV-TR PTSD category demonstrates various types of validity. Criteria modification and textual clarifications are suggested to further improve its cross-cultural applicability. Depression and Anxiety, 2011.
机译：目前，关于创伤后应激障碍（PTSD）类别的跨文化适用性存在很多争论。关注的问题包括PTSD可能是西方文化约束的疾病，以及个别项目和标准阈值的有效性。这次审查检查了DSM-IV-TR中定义的PTSD标准的各种跨文化有效性，并提出了DSM-5可以考虑的选项和初步建议。方法：特别是从1994年以来，对精神健康文献进行了搜索，涉及与文化，种族或种族相关的因素，这些因素可能会限制PTSD诊断标准在DSM-IV-TR中的普遍适用性以及可能的诊断标准。 DSM-5。结果：发现了PTSD跨文化有效性的大量证据。但是，某些地区跨文化差异的证据表明需要进一步研究：避免/麻木症状的相对显着性，解释外伤性症状在塑造症状方面的作用以及躯体症状的普遍性。这篇评论还指出，有必要修改某些标准，例如关于梦dream以求的项目和缩短未来的项目，以提高其跨文化适用性。建议增加文字以提高本手册在不同文化背景下的适用性：指定文化综合症（例如DSM-IV-TR术语表中指出的那些）可能是某些文化中创伤反应的重要部分，并且这些综合症可能会影响PTSD症状的严重性和合并症。结论：DSM-IV-TR PTSD类别展示了各种类型的有效性。建议修改标准和澄清文字，以进一步提高其跨文化适用性。抑郁症和焦虑症，2011年。

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