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- Bondjers, Kristina, et al.
(författare)
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A Prospective Study of ICD-11 and DSM-5 PTSD, Functional Disability and Quality of Life
- 2018
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Konferensbidrag (refereegranskat)abstract
- Introduction: It is unclear if there are differences between the ICD-11 and DSM-5 diagnoses for PTSD related to type of potential traumatic event (PTE) and patient-reported outcomes.Method: In an ongoing prospective study, 250 participants were assessed with structured clinical interviews for ICD-11 and DSM-5 PTSD, functional disability (FD) and quality of life (QoL) at the first assessment point (T1). Participants were followed up after six months (T2) with self-rated symptom levels, functional disability (FD), and quality of life (QoL).Results: Interim results (N=184) from T1 indicate that 68% did not fulfil criteria for any PTSD diagnosis. Of those with PTSD, 58% fulfilled criteria for both systems, 13% for ICD-11 only and 31% for DSM-5 only. Fulfilling criteria for both disorders was associated with higher FD and lower QoL at T1. Loss was more common among those fulfilling criteria for DSM-5 only.Conclusions: The concordance between the systems were low, and there were differences regarding event type and outcome. This presentation will discuss these results and present outcomes assessed at T2.Relevance: Knowledge about the differences between the ICD-11 and DSM-5 PTSD specifications are necessary to better understand how these differences influence prevalence rates, diagnostic status, as well as to understand the advantages and disadvantages of each system.
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- Bondjers, Kristina, et al.
(författare)
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An Evaluation of the ICD-11 Trauma Interview Schedule Compared to the Clinician Administered PTSD Scale and WHODAS 2.0
- 2016
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Konferensbidrag (refereegranskat)abstract
- The 11th revision of the International Classification of Diseases (ICD) proposes two related diagnoses for posttraumatic symptomatology: posttraumatic stress disorder (PTSD) and complex PTSD (C-PTSD). The ICD- 11 task force has developed a structured clinical interview, the ICD-11 Trauma Interview Schedule, to assess the presence of the disorders.The ICD-11 proposal differ from the DSM-5 PTSD diagnosis and the divergence between the two may have important consequences for diagnostic assessments. In an ongoing study, 100 participants who have experienced a potentially traumatic event during the past 5 years are recruited via adverts in local media, primary care facilities and outpatient psychiatric care facilities. Participants are interviewed using the ICD-11 Trauma Interview Schedule, the Clinician-Administered PTSD scale (CAPS-5) and the WHODAS 2.0. The aim of this presentation is to evaluate the user experience of the ICD-11 trauma interview schedule. Furthermore, the DSM-5 and ICD-11 criteria will be compared regarding rates of PTSD, symptom profiles, functional disability, demographics, and type of trauma. Relevance: Increasing the knowledge about the differences between the DSM-5 and ICD-11 diagnosis of PTSD regarding disease rate and predictive ability will facilitate the transition from ICD-10 to ICD-11 for clinicians and researchers.
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- Bondjers, Kristina, et al.
(författare)
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DSM-5 and ICD-11 symptom profiles in a diverse sample of trauma victims
- 2017
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Konferensbidrag (refereegranskat)abstract
- Introduction: Research suggest different trajectories of posttraumatic stress symptoms over time (e.g., resilient, recovering, and chronic) among survivors from natural disasters. It is not known, however, if disaster survivors present with distinct symptom profiles and, if so, whether these profiles are related to severity, recovery and exposure characteristics.Methods and Results: This study aims to investigate symptom profiles among Swedish survivors of the 2004 Indian Ocean tsunami using latent profile analysis. Participants include adult survivors who were pulled into the waves and responded to postal surveys 1 and 3 years after the disaster (n=2009). Posttraumatic stress symptoms were assessed with the Impact of Event Scale-Revised (IES-R). The symptom profiles generated from the first year survey will be compared with regard to established predictors of posttraumatic stress, such as disaster exposure, bereavement, perceived social support as well as posttraumatic stress and general distress at three years.Discussion: The presentation will shed light on whether there are distinct symptom profiles among disaster survivors. We will discuss the implications for psychosocial care after natural disasters. The results are relevant for victims of natural disasters in general, and increases knowledge about the characteristics of posttraumatic stress and may improve psychosocial services after traumatic events.
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- Bondjers, Kristina
(författare)
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Post-traumatic Stress Disorder – Assessment of current diagnostic definitions
- 2020
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Post-traumatic stress disorder (PTSD) is a debilitating condition that may arise after exposure to shocking, frightening, or dangerous events. Hallmark symptoms are re-experiencing, avoidance, and hyperarousal. Other common symptoms are more ancillary and overlap with other psychiatric disorders (e.g., anhedonia, interpersonal problems, and affective dysregulation). The variety of symptoms associated with PTSD allows for large differences in symptom presentation between individuals. Studies of the latent structure of PTSD (e.g., latent class analysis, confirmatory factor analysis) have been highly influential in the conceptualisation of the disorder. The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and the eleventh edition of the International Classification of Diseases (ICD-11) have taken vastly different approaches to handling the symptom variety, with DSM-5 encompassing a broad definition, and the ICD-11 instead proposing a narrow PTSD construct and introducing the new diagnosis complex PTSD (CPTSD), comprising PTSD in conjunction with ancillary symptoms.The principal aims of the present thesis were to examine how different symptom presentations of PTSD were associated with well-known predictors of PTSD and prospective outcome, to evaluate the dimensional structure of PTSD as it is proposed in current diagnostic nomenclature, to provide methods for assessing PTSD in the Swedish language, and to evaluate the diagnostic agreement between DSM-5 and ICD-11.Using latent class analysis, subgroups with differences in PTSD symptom presentation were examined and assessed regarding their predictive validity. In a sample of natural disaster survivors, subgroups differed mainly in symptom severity. In a mixed trauma sample, subgroups differed in their likelihood of fulfilling hallmark versus ancillary symptoms, and in self-reported concurrent and prospective psychological distress.As for the dimensional structure of DSM-5 symptomology, support was not found for the four-factor DSM-5 model, but rather for a six-factor and a seven-factor model. For ICD-11 symptomatology, the ICD-11 model was supported, both with and without a higher-order separation of PTSD and CPTSD. Two instruments for assessing PTSD were evaluated: the PTSD checklist for DSM-5 (PCL-5) and the International Trauma Interview for ICD-11 (ITI). Results indicated support for both instruments as valid and reliable tools. The diagnostic agreement between DSM-5 and ICD-11 was moderate.Summarised, the studies suggest that variables such as secondary stressors and event-specific exposure influence symptom expression, and that the combination of hallmark and ancillary symptoms of PTSD is associated with the long-term maintenance of psychological distress. Results support the use of the PCL-5 and the ITI as assessment tools for DSM-5 and ICD-11 PTSD. The insufficient agreement between DSM-5 and ICD-11 PTSD and CPTSD poses a challenge for future researchers and clinicians.
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- Bondjers, Kristina, et al.
(författare)
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Psychometric Properties of the PTSD Checklist for DSM-5 (PCL-5) in parents to children with burns.
- 2015
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Konferensbidrag (refereegranskat)abstract
- Introduction Symptoms of post-traumatic stress disorder (PTSD) is a common problem among parents of children with burns. However, there is a paucity of evaluated screening tools for this population. The aim was to evaluate the psychometric properties of the PTSD Checklist (PCL), which is recently revised in accordance to the Diagnostic and statistical manual of mental disorders, 5th ed. Methods The participating parents (N= 62, mean age= 38) completed self-report questionnaires 0.8-5.6 years after their child’s burn. Measures were the PCL-5 (consisting of four subscales; Intrusion, Avoidance, Negative alterations in cognitions and mood, and Arousal and reactivity), the Impact of Event Scale-Revised (with three subscales; Intrusion, Avoidance and Hyperarousal) and the Perceived Stress Scale. The children had a TBSA burned ranging from 1 to 31 % and were 0.1-15.0 years of age at injury.Results The average PCL-5 scores were low to moderate and indicated that no parent was above the recommended preliminary cut off of 38 for PTSD. Cronbach’s alpha values were acceptable and varied between 0.56 and 0.77 for the four PCL-5 subscales and mean inter-item correlations ranged from 0.22 to 0.73. The PCL-5 subscales were positively correlated with the corresponding IES-R subscales as well as the total PSS score (p<.05). There were no associations between the PCL-5 and burn severity (TBSA, TBSA-FT, and LOS), time since injury, child age or gender, or parent gender. Conclusion In conclusion, the PCL-5 had high internal consistency and evaluation of concurrent validity suggested moderate associations with other measures of traumatic stress and perceived stress as expected. The moderate associations with other measures of stress is to be expected, taking into account the slightly different constructs targeted by the three measures in this study. This first study suggests that the PCL-5 is a psychometrically sound instrument that deserves further evaluation as a screening tool for parents of children with burns.
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- Bondjers, Kristina, et al.
(författare)
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Psychometric properties of the Swedish PTSD Checklist for DSM-5 (PCL-5).
- 2016
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Konferensbidrag (refereegranskat)abstract
- Recent changes in the criteria of posttraumatic stress disorder call for new evaluations of tools to assess posttraumatic symptomatology. The aim of this study is to evaluate the psychometric properties of the Swedish PTSD Checklist (PCL-5)1, which was recently revised in accordance to the Diagnostic and statistical manual of mental disorders, 5th ed2. This poster will present data from an ongoing study with approximately 150 participants who were assessed with rating scales of posttraumatic stress and clinical interviews (CAPS-55 and MINI 6.04). The focus will be on the psychometric properties of the PCL-5 and its relationship to the CAPS-5, the Impact of Event Scale-Revised3, and the MINI. Preliminary results will detail screening and psychometric properties of the PCL-5, including internal consistency, test-retest reliability, convergent and discriminant validity as well as sensitivity and specificity for PTSD according to CAPS-5. Relevance: Information about the psychometric properties of the PCL-5 is timely and relevant for clinicians. Performance assessments in different countries also provide a basis for future evaluations of cultural invariance of a measure. PTSD poses an on-going and increasing burden on society and documented methods of detection is key to identify individuals in need of further services.
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