Gender differences in DSM-5 versus DSM-IV-TR PTSD prevalence and criteria comparison among 512 survivors to the L'Aquila earthquake

Background: Post traumatic Stress Disorder (PTSD) has demonstrated gender specific prevalence and expressions across the different DSM definitions, since its first introduction in DSM-III. The DSM-5 recently introduced important revisions to PTSD symptomatological criteria. Aim of the present study is to explore whether gender moderates rates of DSM-5 PTSD expression in a non clinical sample of survivors to a massive earthquake in Italy. Methods: 512 survivors of the L'Aquila 2009 earthquake, previously investigated for the presence DSM-IV-TR PTSD, were reassessed according to DSM-5 criteria in order to explore gender differences. All subjects completed the Trauma and Loss Spectrum Self Report (TALS-SR). Results: Females showed significantly higher DSM-5 PTSD rates and rates of endorsement of almost all DSM-5 PTSD criteria. Significant gender differences emerged in almost half of PTSD symptomatological criteria with women reporting higher rates in 8 of them, while men in only one (a new symptom in DSM-5: reckless. or self-destructive behavior). Considering the impact of the three new DSM-5 symptoms on the diagnosis, significant gender differences emerged with these being crucial in almost half of the PTSD diagnoses in males but in about one-fourth in females. By using ROC curves, DSM-5 criteria E and D showed the highest AUC values in males (.876) and females (.837), respectively. Limitations: The use of self-report instrument; no information On comorbidity; homogeneity of study sample; lack of assessment on functional impairment. Conclusions: This study provides a contribution to the ongoing need for reassessment on how gender moderates rates of expression of particular disorders such as PTSD. (C) 2014 Elsevier B.V. All rights reserved