Uniwersyteckie Czasopisma NaukoweThe structure of symptoms of posttraumatic stress disorder according to DSM-5 and assessed by PDS-5 – preliminary results
Słowa kluczowe:
PTSD, DSM-5, PDS-5, structure of symptomsAbstrakt
Background
The structure of posttraumatic stress disorder (PTSD) symptoms has been studied and discussed since the introduction of PTSD as a diagnostic entity in the DSM-III (Diagnostic and Statistical Manual of Mental Disorders III) in 1980. Many studies supported a four-factor or a five-factor models, both inconsistent with DSM-IV. It is unclear whether current DSM-5 criteria appropriately reflect the empirical structure of PTSD symptoms.
Participants and procedure
In this study the structure of PTSD symptoms was examined by confirmatory factor analysis conducted on the data obtained from 388 individuals (150 males and 239 females aged 18-83) who experienced a traumatic event and completed the PDS-5 (Posttraumatic Diagnostic Scale-5), a self-report scale according to the DSM-5 criteria.
Results
Fitting of different models based on DSM-IV, DSM-5 and other the most common four- and five-factor conceptualizations of PTSD symptoms structure was examined. The data analyses demonstrated the best fit of the six-factor model based on the conceptualization of Elhai et al. (2011) with the additional factor of negative cognitions and mood.
Conclusions
The DSM-5 diagnostic criteria do not reflect the empirical PTSD symptom structure. The data suggest also that it is reasonable to separate the core PTSD symptoms from broad PTSD symptomatology.
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Bibliografia
American Psychiatric Association (1980). Diagnostic and Statistical Manual of Mental Disorders. 3rd ed. Washington, DC: Author.
American Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental Disorders. 4th ed. revised. Washington, DC: Author.
American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Washington, DC: Author.
Armour, C., & Shevlin, M. (2010). Testing the dimensionality of PTSD and the specificity of the dysphoria factor. Journal of Loss and Trauma, 15, 11-27.
Armour, C., Layne, C. M., Naifeh, J. A., Shevlin, M., Duraković-Belko, E., Djapo, N., Pynoos R. S., & Elhai, J. D. (2011). Assessing the factor structure of posttraumatic stress disorder symptoms in participants with and without criterion A2 endorsement. Journal of Anxiety Disorders, 25, 80-87.
Asmundson, G. J. G., Frombach, I., McQuaid, J., Pedrelli, P., Lenox, R., & Stein, M. B. (2000). Dimensionality of posttraumatic stress symptoms: A confirmatory factor analysis of DSM–IV symptom clusters and other symptom models. Behavior Research and Therapy, 38, 203-214.
Baschnagel, J. S., O’Connor, R. M., Colder, C. R., & Hawk, L. W. (2005). Factor structure of posttraumatic stress among Western New York undergraduates following the September 11th terrorist attack on the World Trade Center. Journal of Traumatic Stress, 18, 677-684.
Beck, J. G., Coffey, S. F., Palyo, S. A., Gudmundsdottir, B., Miller, L. M., & Colder, C. R. (2004). Psycho metric properties of the Posttraumatic Cognitions Inventory (PCTI): A replication with motor vehicle accident survivors. Psychological Assessment, 16, 289-298.
Bennet, D. C., Kerig, P. K., Chaplo, S. D., McGee, A. B., & Baucom, B. R. (2014). Validation of the five-factor model of PTSD symptom structure among delinquent youth. Psychological Trauma: Theory, Research, Practice, and Policy, 6, 438-447.
Boelen, P. A., van den Hout, M. A., & van den Bout, J. (2008). The factor structure of posttraumatic stress disorder symptoms among bereaved individuals: A confirmatory factor analysis study. Journal of Anxiety Disorders, 22, 1377-1383.
Dragan, M., Lis-Turlejska, M., Popiel, A., Szumiał, S., & Dragan, W. (2012). The validation of the Polish version of the Posttraumatic Diagnostic Scale and its factor structure. European Journal of Psychotraumatology, 3, 18479. DOI: 10.3402/ejpt.v3i0. 18479.
Elhai, J. D., Biehn, T. L., Armour, C., Klopper, J. J., Frueh, B. C., & Palmieri, P. A. (2011). Evidence for a unique PTSD construct represented by PTSD’s D1-D3 symptoms. Journal of Anxiety Disorders, 25, 340-345.
Elhai, J. D., Engdahl, R. M., Palmieri, P. A., Naifeh, J. A., Schweinle, A., & Jacobs, G. A. (2009). Assessing posttraumatic stress disorder with or without reference to a single, worst traumatic event: examining differences in factor structure. Psychological Assessment, 21, 629-634.
Elhai, J. D., & Palmieri, P. A. (2011). The factor structure of posttraumatic stress disorder: A literature update, critique of methodology, and agenda for future research. Journal of Anxiety Disorders, 25, 849-854.
Elhai, J. D., Palmieri, P. A., Biehn, T. L., Frueh, B. C., & Magruder, K. M. (2010). Posttraumatic stress disorder’s frequency and intensity ratings are associated with factor structure differences in military veterans. Psychological Assessment, 22, 723-728.
Elklit, A., & Shevlin, M. (2007). The structure of PTSD symptoms: A test of alternative models using confirmatory factor analysis. British Journal of Clinical Psychology, 46, 299-313.
Engdahl, R. M., Elhai, J. D., Richardson, J. D., & Frueh, B. C. (2011). Comparing posttraumatic stress disorder’s symptom structure between deployed and non-deployed veterans. Psychological Assessment, 23, 1-6.
Foa, E. B., Cashman, L., Jaycox, L., & Perry, K. (1997). The validation of a self-report measure of posttraumatic stress disorder: the Posttraumatic Diagnostic Scale. Psychological Assessment, 9, 445-451.
Foa, E. B., Ehlers, A., Clark, D. M., Tolin, D. F., & Orsillo, S. M. (1999). The Posttraumatic Cognitions Inventory (PTCI): development and validation. Psychological Assessment, 11, 303-314.
Friedman, M. J, & Karam, E. G. (2009). Posttraumatic stress disorder. In: G. Andrews, D. S. Charney, P. J. Sirovatka, & D. A. Regier (eds.), Stress induced and fear circuity disorders. Refining the Research Agenda for DSM-V (pp. 3-29). Arlington: APA.
Hetzel-Riggin, M. D., & Harbke, C. R. (2014, August 4). Hierarchical convergence of PTSD symptom clusters: A comparison of the Numbing, Dysphoria and Dysphoric Arousal models of PTSD. Traumatology. Advance online publication. http://dx.doi. org/10.1037/h0099857.
Kessler, R. C., Berglund, P., Demler, O., Jin, R. & Walters, E. E. (2005). Lifetime prevalence and age-ofonset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62, 593-602.
King, D. W., Leskin, G. A., King, L. A., & Weathers, F. W. (1998). Confirmatory factor analysis of the Clinician-Administered PTSD Scale: Evidence for the dimensionality of Posttraumatic Stress Disorder. Psychological Assessment, 10, 90-96.
Krause, E. D., Kaltman, S., Goodman, L. A., & Dutton, M. A. (2007). Longitudinal factor structure of posttraumatic stress symptoms related to intimate partner violence. Psychological Assessment, 19, 165-175.
Maercker, A., Brewin, C. R., Bryant, R. A., Cloitre, M., van Ommeren, M., Jones, L. M., Humayan, A., Kagee, A., Llosa, A. E., Rousseau, C., Somasundaram, D. J., Souza, R., Suzuki, Y., Weissbecker, I., Wessely, S. C., First, M. B., & Reed, G. M. (2013). Diagnosis and classification of disorders specifically associated with stress: proposals for ICD-11. World Psychiatry, 12, 198-206. [N/A].10.1002/wps.20057.
McWilliams, L. A., Cox, B. J., & Asmundson, G. J. D. (2005). Symptom structure of posttraumatic stress disorder in a nationally representative sample. Journal of Anxiety Disorders, 19, 626-641.
Palmieri, P. A., Weathers, F., Difede, J., & King, D. (2007). Confirmatory factor analysis of the PTSD Checklist and the Clinician-Administered PTSD Scale in disaster workers exposed to the World Trade Center ground zero. Journal of Abnormal Psychology, 116, 329-341.
Rademaker, A. R., van Minnen, A., Ebberink, F., van Zuiden, M., Hagenaars, M. A., & Geuze, E. (2012). Symptom structure of PTSD: support for a hierarchical model separating corer PTSD symptoms from dysphoria. European Journal of Psychotraumatology, 3, 17580. DOI: 10.3402/ejpt.v3i0.17580.
Schermelleh-Engel, K., Moosbrugger, H., & Müller, H. (2003). Evaluating the fit of structural equation models: Tests of significance and descriptive goodness-of-fir measures. Methods of Psychological Research Online, 8, 23-74.
Shevlin, M., & Elklit, A. (2012). The latent structure of posttraumatic stress disorder: different models or different populations? Journal of Abnormal Psychology, 121, 610-615.
Simms, L. J., Watson, D., & Doebbelling, B. N. (2002). Confirmatory factor analyses of posttraumatic stress symptoms in deployed and nondeployed veterans of the Gulf War. Journal of Abnormal Psychology, 111, 637-647.
Startup, M., Makgekgenene, L., & Webster, R. (2007). The role of self-blame for trauma as assessed by the Posttraumatic Cognitions Inventory (PTCI): A self-protective cognition? Behaviour Research and Therapy, 45, 395-403.
Yufik, T., & Simms, L. J. (2010). A meta-analytic investigation of the structure of posttraumatic stress symptoms. Journal of Abnormal Psychology, 119, 764-776.
Zawadzki, B., Popiel, A., Cyniak-Cieciura, M., Jakubowska, B., & Pragłowska, E. (2015). Diagnoza pourazowego zaburzenia stresowego (PTSD) za pomocą ustrukturalizowanego wywiadu klinicznego SCID-I [Diagnosis of posttraumatic stress disorder (PTSD) by Structured Clinical Interview SCID-I]. Psychiatria Polska, 49, 159-169.
