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Should A2 be a diagnostic requirement for posttraumatic stress disorder in DSM-V?
Psychiatry Res. 2010 Apr 30; 176(2-3):257-60.PR

Abstract

The requirement that trauma survivors experience fear, helplessness or horror (Criterion A2) as a part of their posttraumatic stress disorder (PTSD) diagnosis was introduced into DSM-IV. The imminent re-definition of PTSD in DSM-V highlights the need for empirical studies to validate the utility of the A2 requirement. We aimed to identify (i) how often A2 was associated with PTSD (B-F criteria) at 3 months after trauma and (ii) what was the peritraumatic emotional experience for those who met PTSD criteria but were A2 negative. In a prospective design cohort study we assessed the peritraumatic emotional experience of 535 injury patients in four Australian hospitals. These patients were followed up 3 months later and assessed for PTSD using a structured clinical interview. The majority of those who developed PTSD (B-F criterion) at 3 months met A2 criteria. A substantial minority, however (23%), did not meet A2 criteria. Those PTSD patients who were A2 negative fell into three groups: (i) those who experienced subthreshold levels of A2; (ii) those who experienced intense peritrauma emotional responses other than fear, helplessness or horror; and (iii) those who were amnesic to their peritrauma emotional experience. These findings do not support the inclusion of A2 as diagnostic requirement for DSM-V.

Authors+Show Affiliations

Australian Centre for Posttraumatic Mental Health, East Melbourne, Victoria, Australia. mod@unimelb.edu.auNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

20207009

Citation

O'Donnell, Meaghan L., et al. "Should A2 Be a Diagnostic Requirement for Posttraumatic Stress Disorder in DSM-V?" Psychiatry Research, vol. 176, no. 2-3, 2010, pp. 257-60.
O'Donnell ML, Creamer M, McFarlane AC, et al. Should A2 be a diagnostic requirement for posttraumatic stress disorder in DSM-V? Psychiatry Res. 2010;176(2-3):257-60.
O'Donnell, M. L., Creamer, M., McFarlane, A. C., Silove, D., & Bryant, R. A. (2010). Should A2 be a diagnostic requirement for posttraumatic stress disorder in DSM-V? Psychiatry Research, 176(2-3), 257-60. https://doi.org/10.1016/j.psychres.2009.05.012
O'Donnell ML, et al. Should A2 Be a Diagnostic Requirement for Posttraumatic Stress Disorder in DSM-V. Psychiatry Res. 2010 Apr 30;176(2-3):257-60. PubMed PMID: 20207009.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Should A2 be a diagnostic requirement for posttraumatic stress disorder in DSM-V? AU - O'Donnell,Meaghan L, AU - Creamer,Mark, AU - McFarlane,Alexander C, AU - Silove,Derrick, AU - Bryant,Richard A, Y1 - 2010/03/06/ PY - 2009/01/22/received PY - 2009/05/08/revised PY - 2009/05/19/accepted PY - 2010/3/9/entrez PY - 2010/3/9/pubmed PY - 2010/5/15/medline SP - 257 EP - 60 JF - Psychiatry research JO - Psychiatry Res VL - 176 IS - 2-3 N2 - The requirement that trauma survivors experience fear, helplessness or horror (Criterion A2) as a part of their posttraumatic stress disorder (PTSD) diagnosis was introduced into DSM-IV. The imminent re-definition of PTSD in DSM-V highlights the need for empirical studies to validate the utility of the A2 requirement. We aimed to identify (i) how often A2 was associated with PTSD (B-F criteria) at 3 months after trauma and (ii) what was the peritraumatic emotional experience for those who met PTSD criteria but were A2 negative. In a prospective design cohort study we assessed the peritraumatic emotional experience of 535 injury patients in four Australian hospitals. These patients were followed up 3 months later and assessed for PTSD using a structured clinical interview. The majority of those who developed PTSD (B-F criterion) at 3 months met A2 criteria. A substantial minority, however (23%), did not meet A2 criteria. Those PTSD patients who were A2 negative fell into three groups: (i) those who experienced subthreshold levels of A2; (ii) those who experienced intense peritrauma emotional responses other than fear, helplessness or horror; and (iii) those who were amnesic to their peritrauma emotional experience. These findings do not support the inclusion of A2 as diagnostic requirement for DSM-V. SN - 0165-1781 UR - https://www.unboundmedicine.com/medline/citation/20207009/Should_A2_be_a_diagnostic_requirement_for_posttraumatic_stress_disorder_in_DSM_V L2 - https://linkinghub.elsevier.com/retrieve/pii/S0165-1781(09)00195-4 DB - PRIME DP - Unbound Medicine ER -