Posttraumatic Stress Disorder, Diagnostic, and Statistical Manual-5 Symptom Requirements, and Interrater Reliability

By Brock Kilbourne, Samantha Kilbourne and Jerry Goodman.

Published by The International Journal of Health, Wellness and Society

Format Price
Article: Print $US10.00
Published Online: August 19, 2016 $US5.00

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) (American Psychiatric Association 2013a) was a major revision of the DSM-IV-TR (1994). Despite numerous critiques of the DSM-5, none have analyzed statistically the actual diagnostic structure of the DSM-5 itself. That is particularly the case regarding the diagnosis of Posttraumatic Stress Disorder (PTSD), a diagnosis which has attracted international attention since the Afghanistan and Iraq wars, and which has been extensively investigated and profoundly affected by DSM-5 changes. The present study used a metatheory and content analysis approach to conceptually differentiate the Trauma-Related and Stressor-Related Disorders in the DSM-5, the diagnostic class of disorders which includes PTSD. A common Symptom Requirement Dichotomy (i.e., Mandatory versus Not Mandatory) was indicated and found to statistically differentiate the Trauma-Related and Stressor-Related Disorders in the DSM-5. That same Symptom Requirement Dichotomy was then used to conceptually and statistically differentiate Adult and Child DSM-5 disorders previously reported for the DSM-5 Field Trials (Regier et al. 2013). DSM-5 Field Trial Site Kappa Reliability Coefficients for both Adult and Child disorders were found to be a quadratic function of the “Number of Not Mandatory” symptoms in the DSM-5, an a priori feature of the diagnostic structure or coding system of the DSM-5 that preempts both clinical assessment and diagnosis. Implications of systematic error in the DSM-5 and real world outcomes were discussed, limitations of the present study were addressed, and recommendations for developing an alternative classification system of mental disorders were proffered.

Keywords: PTSD, DSM-5, Interrater Reliability Coefficients, Kappa Values

The International Journal of Health, Wellness and Society, Volume 6, Issue 3, September 2016, pp.25-40. Article: Print (Spiral Bound). Published Online: August 19, 2016 (Article: Electronic (PDF File; 735.736KB)).

Dr. Brock Kilbourne

Licensed Psychologist, Director, Psychology, El Camino Psychology Services, PC, Oceanside, California, USA

Dr. Samantha Kilbourne

Research Psychologist, El Camino Psychology Services, PC, Oceanside, California, USA

Dr. Jerry Goodman

Statistical Consultant, Research Analyst, Guru Statistics, Carlsbad, California, USA