Diagnostic criteria for ptsd dsm 5
The underlying factor structure of PTSD symptoms outlined in the DSM-IV has been the topic of longstanding academic debate. To investigate this, the current study assessed the construct validity of the DSM-5 PTSD structure, alongside alternate models commonly identified in western populations, in a refugee sample from non-western backgrounds. Theorists and researchers have questioned the capacity of DSM-derived PTSD models to capture the psychological sequelae arising from experiences of persecution and/or displacement in non-western populations. The symptom structure of PTSD underwent a major revision in the recent formulation in DSM-5, and this reformulation has yet to be comprehensively investigated in the context of PTSD arising from refugee experiences. Since the introduction of PTSD in the third edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III), the symptom structure of PTSD has been investigated using samples predominantly from high-income western countries, such as single incident trauma survivors and military personnel. Despite this, refugees remain under-represented in research on traumatic stress. Refugees and asylum-seekers are often exposed to multiple types of potentially traumatic events (PTEs) and report elevated rates of psychological disorders, including posttraumatic stress disorder (PTSD). There are currently an estimated 65.6 million refugees, asylum seekers and internally displaced people worldwide and this number is growing. The psychological presentation of traumatised refugees and asylum seekers is complex and presents a global challenge to public health. Our findings offer preliminary support for the applicability of the Anhedonia model to a culturally diverse refugee sample, and contribute to a growing body of studies which indicate that the DSM-5 model may not best represent the symptom structure of PTSD found across non-western conflict-affected populations. Instead, we found preliminary evidence in support of the six-factor Anhedonia model, comprising the symptom clusters of re-experiencing, avoidance, negative affect, anhedonia, dysphoric arousal and anxious arousal, as the superior model for our data.
However, an examination of relative fit revealed that the DSM-5 model provided the poorest fit overall for our sample. Resultsįindings from five confirmatory factor analyses (CFAs) revealed that all models demonstrated acceptable model fit.
All measures were translated into Arabic, Farsi or Tamil using rigorous translation procedures, or provided in English. MethodsĪ total of 246 refugees settled in Australia were assessed using the Harvard Trauma Questionnaire, to measure exposure to potentially traumatic events (PTEs), and the Posttraumatic Diagnostic Scale, to assess symptoms of PTSD based on DSM-5 criteria. The current study assessed the construct validity of the DSM-5 PTSD structure in a refugee sample from a variety of cultural backgrounds alongside four alternate models commonly identified in western populations, namely the four-factor Dysphoria model, the five-factor Dysphoric Arousal model, and the six-factor Anhedonia and Externalising Behaviours models. The symptom structure of PTSD underwent a major revision in the recent formulation in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), and this reformulation has yet to be comprehensively investigated in the context of PTSD arising from traumatic events experienced by refugees.
Considering this, refugee populations merit continued research in the field of traumatic stress to better understand the psychological impact of these experiences.