OnTEPT: A multimodal OWL ontology for post-traumatic stress disorder

OnTEPT: A multimodal OWL ontology for post-traumatic stress disorder | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article OnTEPT: A multimodal OWL ontology for post-traumatic stress disorder Jose A. Salazar-Castro, Fernando Bobillo, Diego M. Lopez, Diego H. Peluffo-Ordóñez, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-9499380/v1 This work is licensed under a CC BY 4.0 License Status: Under Revision Version 1 posted 10 You are reading this latest preprint version Abstract Background Post-traumatic stress disorder (PTSD) is a heterogeneous neuropsychiatric condition that develops after exposure to traumatic events. Its diagnosis is currently governed by two major international classification systems, the DSM-5 and ICD-11, which differ in structure, granularity, and diagnostic thresholds. Moreover, PTSD assessment is also multimodal, spanning structured interviews, self-report psychometric instruments, and increasing neurophysiological recordings such as electroencephalography (EEG). Objective To develop OnTEPT, an OWL-based multimodal ontology. This ontology is intended to formalize DSM-5 and ICD-11 diagnostic criteria, integrate psychometric instruments and EEG-derived features, and support automated reasoning over individual patient instances. Results OnTEPT was developed following Ontology Development 101 (OD101) in Protégé 5. A hybrid strategy was used, combining top-down and bottom-up approaches and reusing concepts from health and mental health ontologies. The current version includes 112 classes, 18 object properties, and 113 data properties. DSM-5 (A–H) and ICD-11 (1–6) criteria are formalized as OWL equivalence axioms. These use constraints on cardinality, duration, clinical significance, and exclusions. Dissociative and complex PTSD are also represented. Four instruments (CAPS-5, PCL-C, PCL-5, PC-PTSD-5) are modeled at the item level with cutoff thresholds, and CAPS-5 and PCL-5 are linked to diagnostic criteria through annotations. The ontology was populated with psychometric data from 304 patients, EEG data from 41 participants, and 30 structured synthetic instances generated with Owlready2. 36 quantitative EEG features are encoded as typed data properties. Validation with HermiT, Pellet, and FaCT + + confirmed logical consistency and class satisfiability. Four intentionally inconsistent instances were correctly rejected due to classification issues. Query-based validation retrieved 113 patients above screening thresholds. It also found three with full DSM-5 profiles, twelve under ICD-11, two with dissociative PTSD, and one with complex PTSD. Conclusions OnTEPT provides a computable semantic framework that harmonizes PTSD diagnosis and its subtypes between DSM-5 and ICD-11. It integrates psychometric and EEG information within a single ontology. Its main contribution is an inferential layer that enables the automated classification of patient instances using both diagnostic systems. The architecture is extensible and ready to include biomarker-based rules, longitudinal data, and semantic workflows to support clinical decision-making. PTSD Dissociative PTSD Complex PTSD DSM-5 ICD-11 semantic interoperability psychometric evaluation EEG biomarkers Biomedical Semantics ontology engineering Full Text Additional Declarations No competing interests reported. Supplementary Files SuplementOnTEPTMainManuscriptICBOJBMSFinal.docx Cite Share Download PDF Status: Under Revision Version 1 posted Editorial decision: Revision requested 13 May, 2026 Reviews received at journal 11 May, 2026 Reviews received at journal 10 May, 2026 Reviewers agreed at journal 27 Apr, 2026 Reviewers agreed at journal 27 Apr, 2026 Reviewers agreed at journal 27 Apr, 2026 Reviewers invited by journal 27 Apr, 2026 Editor assigned by journal 27 Apr, 2026 Submission checks completed at journal 27 Apr, 2026 First submitted to journal 22 Apr, 2026 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-9499380","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":630579697,"identity":"0c315388-1764-4805-be56-78f219c6c6b5","order_by":0,"name":"Jose A. Salazar-Castro","email":"","orcid":"","institution":"University of Cauca","correspondingAuthor":false,"prefix":"","firstName":"Jose","middleName":"A.","lastName":"Salazar-Castro","suffix":""},{"id":630579699,"identity":"34c956bf-db09-401f-9fe7-2ca3dbf9674e","order_by":1,"name":"Fernando Bobillo","email":"","orcid":"","institution":"University of Zaragoza","correspondingAuthor":false,"prefix":"","firstName":"Fernando","middleName":"","lastName":"Bobillo","suffix":""},{"id":630579702,"identity":"e073ecf5-a8a4-4425-bda3-0243f70e3bc8","order_by":2,"name":"Diego M. Lopez","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA6UlEQVRIiWNgGAWjYDCCA8wNIEqOgYGxASZmQEALRKUx6VoSG5DE8Gvhu3aw8XFBRV36htvNjR9+ttnJM7A3b5NgqLHBqUXydmKz8YwzbLkb7hxsluxtSzZs4DlWJsFwLA2nFoPbiW3SvG08uRtuJLYx8LYB3SmRYybB2HCYgJZ/EukGQC2Mf9sO2DfIvyFGS4NBAkgLM9CWxAYJHvxaIH45lmA480Zis7TMueTkNp60YosEPH7hu5188HFBTZ083430hx/flNnZ9rMf3njjA54QAwFmFB4biEjAqwFdyygYBaNgFIwCdAAAg0tVm6kDGNMAAAAASUVORK5CYII=","orcid":"","institution":"University of Cauca","correspondingAuthor":true,"prefix":"","firstName":"Diego","middleName":"M.","lastName":"Lopez","suffix":""},{"id":630579705,"identity":"53b9d0e5-0e1e-4c54-86c3-e27c2512771b","order_by":3,"name":"Diego H. Peluffo-Ordóñez","email":"","orcid":"","institution":"Universidad Tecnológica Ecotec","correspondingAuthor":false,"prefix":"","firstName":"Diego","middleName":"H.","lastName":"Peluffo-Ordóñez","suffix":""},{"id":630579708,"identity":"bc199ff7-bafc-40fd-8226-e725e6221c74","order_by":4,"name":"Bernd Blobel","email":"","orcid":"","institution":"University of Regensburg","correspondingAuthor":false,"prefix":"","firstName":"Bernd","middleName":"","lastName":"Blobel","suffix":""}],"badges":[],"createdAt":"2026-04-22 17:53:27","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-9499380/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-9499380/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":108805396,"identity":"5f6989e3-9e29-4439-8c87-b0093c6ea901","added_by":"auto","created_at":"2026-05-08 15:25:51","extension":"pdf","order_by":1,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":880057,"visible":true,"origin":"","legend":"","description":"","filename":"OnTEPTMainManuscriptICBOJBMSFinalrevised.pdf","url":"https://assets-eu.researchsquare.com/files/rs-9499380/v1_covered_a85b4877-9511-4ad2-a991-38ed4ab44da9.pdf"},{"id":108687502,"identity":"fd5c49b5-040d-4878-9f44-ddd982c36f0c","added_by":"auto","created_at":"2026-05-07 10:18:17","extension":"docx","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":1129286,"visible":true,"origin":"","legend":"","description":"","filename":"SuplementOnTEPTMainManuscriptICBOJBMSFinal.docx","url":"https://assets-eu.researchsquare.com/files/rs-9499380/v1/008fc932a5c1f3a9136f872d.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"OnTEPT: A multimodal OWL ontology for post-traumatic stress disorder","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"journal-of-biomedical-semantics","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"jbsm","sideBox":"Learn more about [Journal of Biomedical Semantics](http://jbiomedsem.biomedcentral.com/)","snPcode":"13326","submissionUrl":"https://submission.nature.com/new-submission/13326/3","title":"Journal of Biomedical Semantics","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"BMC/SO AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"PTSD, Dissociative PTSD, Complex PTSD, DSM-5, ICD-11, semantic interoperability, psychometric evaluation, EEG biomarkers, Biomedical Semantics, ontology engineering","lastPublishedDoi":"10.21203/rs.3.rs-9499380/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-9499380/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cb\u003eBackground\u003c/b\u003e\u003c/p\u003e \u003cp\u003ePost-traumatic stress disorder (PTSD) is a heterogeneous neuropsychiatric condition that develops after exposure to traumatic events. Its diagnosis is currently governed by two major international classification systems, the DSM-5 and ICD-11, which differ in structure, granularity, and diagnostic thresholds. Moreover, PTSD assessment is also multimodal, spanning structured interviews, self-report psychometric instruments, and increasing neurophysiological recordings such as electroencephalography (EEG).\u003c/p\u003e\u003cp\u003e\u003cb\u003eObjective\u003c/b\u003e\u003c/p\u003e \u003cp\u003eTo develop OnTEPT, an OWL-based multimodal ontology. This ontology is intended to formalize DSM-5 and ICD-11 diagnostic criteria, integrate psychometric instruments and EEG-derived features, and support automated reasoning over individual patient instances.\u003c/p\u003e\u003cp\u003e\u003cb\u003eResults\u003c/b\u003e\u003c/p\u003e \u003cp\u003eOnTEPT was developed following Ontology Development 101 (OD101) in Prot\u0026eacute;g\u0026eacute; 5. A hybrid strategy was used, combining top-down and bottom-up approaches and reusing concepts from health and mental health ontologies. The current version includes 112 classes, 18 object properties, and 113 data properties. DSM-5 (A\u0026ndash;H) and ICD-11 (1\u0026ndash;6) criteria are formalized as OWL equivalence axioms. These use constraints on cardinality, duration, clinical significance, and exclusions. Dissociative and complex PTSD are also represented. Four instruments (CAPS-5, PCL-C, PCL-5, PC-PTSD-5) are modeled at the item level with cutoff thresholds, and CAPS-5 and PCL-5 are linked to diagnostic criteria through annotations. The ontology was populated with psychometric data from 304 patients, EEG data from 41 participants, and 30 structured synthetic instances generated with Owlready2. 36 quantitative EEG features are encoded as typed data properties. Validation with HermiT, Pellet, and FaCT\u0026thinsp;+\u0026thinsp;+\u0026thinsp;confirmed logical consistency and class satisfiability. Four intentionally inconsistent instances were correctly rejected due to classification issues. Query-based validation retrieved 113 patients above screening thresholds. It also found three with full DSM-5 profiles, twelve under ICD-11, two with dissociative PTSD, and one with complex PTSD.\u003c/p\u003e\u003cp\u003e\u003cb\u003eConclusions\u003c/b\u003e\u003c/p\u003e \u003cp\u003eOnTEPT provides a computable semantic framework that harmonizes PTSD diagnosis and its subtypes between DSM-5 and ICD-11. It integrates psychometric and EEG information within a single ontology. Its main contribution is an inferential layer that enables the automated classification of patient instances using both diagnostic systems. The architecture is extensible and ready to include biomarker-based rules, longitudinal data, and semantic workflows to support clinical decision-making.\u003c/p\u003e","manuscriptTitle":"OnTEPT: A multimodal OWL ontology for post-traumatic stress disorder","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-05-07 10:18:13","doi":"10.21203/rs.3.rs-9499380/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2026-05-13T23:14:19+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-05-11T20:36:55+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-05-10T07:35:19+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"158374674753191171023977485306099906505","date":"2026-04-27T19:40:30+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"59933392395877359100728091201985641837","date":"2026-04-27T19:15:08+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"141988788696882432024298451696959099050","date":"2026-04-27T19:00:55+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2026-04-27T18:57:12+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-04-27T04:19:08+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2026-04-27T04:17:51+00:00","index":"","fulltext":""},{"type":"submitted","content":"Journal of Biomedical Semantics","date":"2026-04-22T17:49:51+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"journal-of-biomedical-semantics","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"jbsm","sideBox":"Learn more about [Journal of Biomedical Semantics](http://jbiomedsem.biomedcentral.com/)","snPcode":"13326","submissionUrl":"https://submission.nature.com/new-submission/13326/3","title":"Journal of Biomedical Semantics","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"BMC/SO AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"2bb94903-fd2e-4132-8199-ad01b05f79de","owner":[],"postedDate":"May 7th, 2026","published":true,"recentEditorialEvents":[{"type":"decision","content":"Revision requested","date":"2026-05-13T23:14:19+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-05-11T20:36:55+00:00","index":23,"fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-05-10T07:35:19+00:00","index":22,"fulltext":""}],"rejectedJournal":[],"revision":"","amendment":"","status":"in-revision","subjectAreas":[],"tags":[],"updatedAt":"2026-05-13T23:23:47+00:00","versionOfRecord":[],"versionCreatedAt":"2026-05-07 10:18:13","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-9499380","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-9499380","identity":"rs-9499380","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}