Rachel Elliott1, Anna McKinnon1,2, Clare Dixon1, Adrian Boyle3, Fionnuala Murphy1, Theresa Dahm1, Emma Travers-Hill1, Cari-Lène Mul4, Sarah-Jane Archibald3, Patrick Smith5, Tim Dalgleish1,6, Richard Meiser-Stedman1,7, Caitlin Hitchcock1,6. 1. MRC: Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK. 2. Centre for Emotional Health, Macquarie University, Sydney, NSW, Australia. 3. Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK. 4. Department of Psychology, Anglia Ruskin University, Cambridge, UK. 5. Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK. 6. Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK. 7. Department of Clinical Psychology, Norwich Medical School, University of East Anglia, Norwich, UK.
Abstract
BACKGROUND: The 11th edition of the International Classification of Diseases (ICD-11) made a number of significant changes to the diagnostic criteria for post-traumatic stress disorder (PTSD). We sought to determine the prevalence and 3-month predictive values of the new ICD-11 PTSD criteria relative to ICD-10 PTSD, in children and adolescents following a single traumatic event. ICD-11 also introduced a diagnosis of Complex PTSD (CPTSD), proposed to typically result from prolonged, chronic exposure to traumatic experiences, although the CPTSD diagnostic criteria do not require a repeated experience of trauma. We therefore explored whether children and adolescents demonstrate ICD-11 CPTSD features following exposure to a single-incident trauma. METHOD: Data were analysed from a prospective cohort study of youth aged 8-17 years who had attended an emergency department following a single trauma. Assessments of PTSD, CPTSD, depressive and anxiety symptoms were performed at two to four weeks (n = 226) and nine weeks (n = 208) post-trauma, allowing us to calculate and compare the prevalence and predictive value of ICD-10 and ICD-11 PTSD criteria, along with CPTSD. Predictive abilities of different diagnostic thresholds were undertaken using positive/negative predictive values, sensitivity/specificity statistics and logistic regressions. RESULTS: At Week 9, 15 participants (7%) were identified as experiencing ICD-11 PTSD, compared to 23 (11%) experiencing ICD-10 PTSD. There was no significant difference in comorbidity rates between ICD-10 and ICD-11 PTSD diagnoses. Ninety per cent of participants with ICD-11 PTSD also met criteria for at least one CPTSD feature. Five participants met full CPTSD criteria. CONCLUSIONS: Reduced prevalence of PTSD associated with the use of ICD-11 criteria is likely to reduce identification of PTSD relative to using ICD-10 criteria but not relative to DSM-4 and DSM-5 criteria. Diagnosis of CPTSD is likely to be infrequent following single-incident trauma.
BACKGROUND: The 11th edition of the International Classification of Diseases (ICD-11) made a number of significant changes to the diagnostic criteria for post-traumatic stress disorder (PTSD). We sought to determine the prevalence and 3-month predictive values of the new ICD-11 PTSD criteria relative to ICD-10 PTSD, in children and adolescents following a single traumatic event. ICD-11 also introduced a diagnosis of Complex PTSD (CPTSD), proposed to typically result from prolonged, chronic exposure to traumatic experiences, although the CPTSD diagnostic criteria do not require a repeated experience of trauma. We therefore explored whether children and adolescents demonstrate ICD-11 CPTSD features following exposure to a single-incident trauma. METHOD: Data were analysed from a prospective cohort study of youth aged 8-17 years who had attended an emergency department following a single trauma. Assessments of PTSD, CPTSD, depressive and anxiety symptoms were performed at two to four weeks (n = 226) and nine weeks (n = 208) post-trauma, allowing us to calculate and compare the prevalence and predictive value of ICD-10 and ICD-11 PTSD criteria, along with CPTSD. Predictive abilities of different diagnostic thresholds were undertaken using positive/negative predictive values, sensitivity/specificity statistics and logistic regressions. RESULTS: At Week 9, 15 participants (7%) were identified as experiencing ICD-11 PTSD, compared to 23 (11%) experiencing ICD-10 PTSD. There was no significant difference in comorbidity rates between ICD-10 and ICD-11 PTSD diagnoses. Ninety per cent of participants with ICD-11 PTSD also met criteria for at least one CPTSD feature. Five participants met full CPTSD criteria. CONCLUSIONS: Reduced prevalence of PTSD associated with the use of ICD-11 criteria is likely to reduce identification of PTSD relative to using ICD-10 criteria but not relative to DSM-4 and DSM-5 criteria. Diagnosis of CPTSD is likely to be infrequent following single-incident trauma.
Authors: M Cloitre; M Shevlin; C R Brewin; J I Bisson; N P Roberts; A Maercker; T Karatzias; P Hyland Journal: Acta Psychiatr Scand Date: 2018-09-03 Impact factor: 6.392
Authors: Anna C Barbano; Willem F van der Mei; Terri A deRoon-Cassini; Ettie Grauer; Sarah Ryan Lowe; Yutaka J Matsuoka; Meaghan O'Donnell; Miranda Olff; Wei Qi; Andrew Ratanatharathorn; Ulrich Schnyder; Soraya Seedat; Ronald C Kessler; Karestan C Koenen; Arieh Y Shalev Journal: Depress Anxiety Date: 2019-01-25 Impact factor: 6.505
Authors: Richard Meiser-Stedman; Patrick Smith; Richard Bryant; Karen Salmon; William Yule; Tim Dalgleish; Reginald D V Nixon Journal: J Child Psychol Psychiatry Date: 2009-04 Impact factor: 8.982
Authors: Rachel M Hiller; Richard Meiser-Stedman; Pasco Fearon; Sarah Lobo; Anna McKinnon; Abigail Fraser; Sarah L Halligan Journal: J Child Psychol Psychiatry Date: 2016-05-12 Impact factor: 8.982
Authors: Richard Meiser-Stedman; Anna McKinnon; Clare Dixon; Adrian Boyle; Patrick Smith; Tim Dalgleish Journal: Depress Anxiety Date: 2017-01-30 Impact factor: 6.505