Subthreshold posttraumatic stress disorder (PTSD) has long been recognized as an important construct that identifies a subgroup of individuals who report significant PTSD symptoms and associated disability but do not endorse enough symptoms to meet the criteria for a full PTSD diagnosis. Different investigators have defined subthreshold PTSD in various ways, making it difficult to interpret findings across studies. To address this problem, we systematically compared individuals who met criteria for nine different subthreshold PTSD definitions with individuals diagnosed with either full PTSD or no PTSD (i.e., failed to meet the criteria for a subthreshold definition) with respect to prevalence and associated clinical outcomes of interest. Participants were 1,082 veterans enrolled in the Veterans After Discharge Longitudinal Registry. PTSD and subthreshold PTSD diagnostic status were determined using the Structured Clinical Interview for DSM-5 (SCID-5) and validated self-report instruments were used to assess clinical outcomes. Across outcomes, subthreshold definitions generally identified a group of participants that was distinguishable from participants in both the PTSD and no PTSD groups, rs = .02–.47. We discuss the benefits and drawbacks of various subthreshold definitions and highlight the need for additional work evaluating these definitions across additional outcomes and samples. In the interim, we propose a working case definition of subthreshold PTSD as meeting any three of the four DSM-5 symptom criteria (i.e., Criteria B, C, D, and E) along with Criterion A and Criteria F–H. The results suggest subthreshold PTSD is a clinically meaningful construct.

中文翻译：

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阈下创伤后应激障碍定义的实证研究

阈下创伤后应激障碍（PTSD）长期以来一直被认为是一个重要的概念，它可以识别报告显着 PTSD 症状和相关残疾但没有足够的症状来满足完整 PTSD 诊断标准的个体亚组。不同的研究人员以不同的方式定义阈下创伤后应激障碍，因此很难解释跨研究的结果。为了解决这个问题，我们系统地将符合九种不同阈值下 PTSD 定义标准的个体与诊断为完全 PTSD 或无 PTSD（即，未能满足阈下定义标准）的个体进行比较，了解其患病率和相关临床结果。兴趣。参与者是退伍军人后纵向登记处登记的 1,082 名退伍军人。使用DSM-5结构化临床访谈 (SCID-5) 确定 PTSD 和阈下 PTSD 诊断状态，并使用经过验证的自我报告工具评估临床结果。就结果而言，阈下定义通常确定了一组与 PTSD 组和无 PTSD 组的参与者都不同的参与者，rs = .02–.47。我们讨论了各种亚阈值定义的优点和缺点，并强调需要进行额外的工作来评估其他结果和样本的这些定义。在此期间，我们提出阈下 PTSD 的工作案例定义为满足四个DSM-5症状标准中的任何三个（即标准 B、C、D 和 E）以及标准 A 和标准 F–H。结果表明，阈下 PTSD 是一个具有临床意义的概念。