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Probable Posttraumatic Stress Disorder in the US Veteran Population According to DSM-5: Results From the National Health and Resilience in Veterans Study.
J Clin Psychiatry. 2016 Nov; 77(11):1503-1510.JC

Abstract

OBJECTIVE

With the publication of DSM-5, important changes were made to the diagnostic criteria for posttraumatic stress disorder (PTSD), including the addition of 3 new symptoms. Some have argued that these changes will further increase the already high rates of comorbidity between PTSD and other psychiatric disorders. This study examined the prevalence of DSM-5 PTSD, conditional probability of PTSD given certain trauma exposures, endorsement of specific PTSD symptoms, and psychiatric comorbidities in the US veteran population.

METHODS

Data were analyzed from the National Health and Resilience in Veterans Study (NHRVS), a Web-based survey of a cross-sectional, nationally representative, population-based sample of 1,484 US veterans, which was fielded from September through October 2013. Probable PTSD was assessed using the PTSD Checklist-5.

RESULTS

The weighted lifetime and past-month prevalence of probable DSM-5 PTSD was 8.1% (SE = 0.7%) and 4.7% (SE = 0.6%), respectively. Conditional probability of lifetime probable PTSD ranged from 10.1% (sudden death of close family member or friend) to 28.0% (childhood sexual abuse). The DSM-5 PTSD symptoms with the lowest prevalence among veterans with probable PTSD were trauma-related amnesia and reckless and self-destructive behavior. Probable PTSD was associated with increased odds of mood and anxiety disorders (OR = 7.6-62.8, P < .001), substance use disorders (OR = 3.9-4.5, P < .001), and suicidal behaviors (OR = 6.7-15.1, P < .001).

CONCLUSIONS

In US veterans, the prevalence of DSM-5 probable PTSD, conditional probability of probable PTSD, and odds of psychiatric comorbidity were similar to prior findings with DSM-IV-based measures; we found no evidence that changes in DSM-5 increase psychiatric comorbidity. Results underscore the high rates of exposure to both military and nonmilitary trauma and the high public health burden of DSM-5 PTSD and comorbid conditions in veterans.

Authors+Show Affiliations

University of North Carolina at Greensboro, Department of Psychology, PO Box 26170, Greensboro, NC 27402. bewisco@uncg.edu. Department of Psychology, University of North Carolina at Greensboro, Greensboro, North Carolina, USA.National Center for PTSD, VA Boston Healthcare System and Department of Psychiatry, Boston University School of Medicine, Massachusetts, USA.National Center for PTSD, VA Boston Healthcare System and Department of Psychiatry, Boston University School of Medicine, Massachusetts, USA.National Center for PTSD, VA Boston Healthcare System and Department of Psychiatry, Boston University School of Medicine, Massachusetts, USA.National Center for PTSD, VA Connecticut Healthcare System, and Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA.National Center for PTSD, VA Connecticut Healthcare System, and Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA.National Center for PTSD, VA Connecticut Healthcare System, and Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA.National Center for PTSD, VA Connecticut Healthcare System, and Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27631148

Citation

Wisco, Blair E., et al. "Probable Posttraumatic Stress Disorder in the US Veteran Population According to DSM-5: Results From the National Health and Resilience in Veterans Study." The Journal of Clinical Psychiatry, vol. 77, no. 11, 2016, pp. 1503-1510.
Wisco BE, Marx BP, Miller MW, et al. Probable Posttraumatic Stress Disorder in the US Veteran Population According to DSM-5: Results From the National Health and Resilience in Veterans Study. J Clin Psychiatry. 2016;77(11):1503-1510.
Wisco, B. E., Marx, B. P., Miller, M. W., Wolf, E. J., Mota, N. P., Krystal, J. H., Southwick, S. M., & Pietrzak, R. H. (2016). Probable Posttraumatic Stress Disorder in the US Veteran Population According to DSM-5: Results From the National Health and Resilience in Veterans Study. The Journal of Clinical Psychiatry, 77(11), 1503-1510. https://doi.org/10.4088/JCP.15m10188
Wisco BE, et al. Probable Posttraumatic Stress Disorder in the US Veteran Population According to DSM-5: Results From the National Health and Resilience in Veterans Study. J Clin Psychiatry. 2016;77(11):1503-1510. PubMed PMID: 27631148.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Probable Posttraumatic Stress Disorder in the US Veteran Population According to DSM-5: Results From the National Health and Resilience in Veterans Study. AU - Wisco,Blair E, AU - Marx,Brian P, AU - Miller,Mark W, AU - Wolf,Erika J, AU - Mota,Natalie P, AU - Krystal,John H, AU - Southwick,Steven M, AU - Pietrzak,Robert H, PY - 2015/06/19/received PY - 2015/09/30/accepted PY - 2016/9/16/pubmed PY - 2017/5/26/medline PY - 2016/9/16/entrez SP - 1503 EP - 1510 JF - The Journal of clinical psychiatry JO - J Clin Psychiatry VL - 77 IS - 11 N2 - OBJECTIVE: With the publication of DSM-5, important changes were made to the diagnostic criteria for posttraumatic stress disorder (PTSD), including the addition of 3 new symptoms. Some have argued that these changes will further increase the already high rates of comorbidity between PTSD and other psychiatric disorders. This study examined the prevalence of DSM-5 PTSD, conditional probability of PTSD given certain trauma exposures, endorsement of specific PTSD symptoms, and psychiatric comorbidities in the US veteran population. METHODS: Data were analyzed from the National Health and Resilience in Veterans Study (NHRVS), a Web-based survey of a cross-sectional, nationally representative, population-based sample of 1,484 US veterans, which was fielded from September through October 2013. Probable PTSD was assessed using the PTSD Checklist-5. RESULTS: The weighted lifetime and past-month prevalence of probable DSM-5 PTSD was 8.1% (SE = 0.7%) and 4.7% (SE = 0.6%), respectively. Conditional probability of lifetime probable PTSD ranged from 10.1% (sudden death of close family member or friend) to 28.0% (childhood sexual abuse). The DSM-5 PTSD symptoms with the lowest prevalence among veterans with probable PTSD were trauma-related amnesia and reckless and self-destructive behavior. Probable PTSD was associated with increased odds of mood and anxiety disorders (OR = 7.6-62.8, P < .001), substance use disorders (OR = 3.9-4.5, P < .001), and suicidal behaviors (OR = 6.7-15.1, P < .001). CONCLUSIONS: In US veterans, the prevalence of DSM-5 probable PTSD, conditional probability of probable PTSD, and odds of psychiatric comorbidity were similar to prior findings with DSM-IV-based measures; we found no evidence that changes in DSM-5 increase psychiatric comorbidity. Results underscore the high rates of exposure to both military and nonmilitary trauma and the high public health burden of DSM-5 PTSD and comorbid conditions in veterans. SN - 1555-2101 UR - https://www.unboundmedicine.com/medline/citation/27631148/Probable_Posttraumatic_Stress_Disorder_in_the_US_Veteran_Population_According_to_DSM_5:_Results_From_the_National_Health_and_Resilience_in_Veterans_Study_ L2 - http://www.psychiatrist.com/JCP/article/Pages/2016/v77n11/v77n1112.aspx DB - PRIME DP - Unbound Medicine ER -