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  • Title: Support for a novel five-factor model of posttraumatic stress symptoms in three independent samples of Iraq/Afghanistan veterans: a confirmatory factor analytic study.
    Author: Pietrzak RH, Tsai J, Harpaz-Rotem I, Whealin JM, Southwick SM.
    Journal: J Psychiatr Res; 2012 Mar; 46(3):317-22. PubMed ID: 22154134.
    Abstract:
    BACKGROUND: A large body of confirmatory factor analytic studies of posttraumatic stress disorder (PTSD) symptoms has demonstrated the superiority of 4-factor dysphoria and emotional numbing models over the DSM-IV model. Recently, a novel 5-factor model, which separates the DSM-IV hyperarousal symptom cluster into distinct dysphoric and anxious arousal clusters, has been identified. However, little research has evaluated the best-fitting representation of PTSD symptoms in veterans of the Iraq and Afghanistan wars. METHODS: Confirmatory factor analyses were used to examine the factor structure of the PTSD Checklist in three independent samples of Iraq/Afghanistan veterans, including two community samples and a treatment-seeking sample. RESULTS: In all three samples, a novel model with five correlated factors reflecting symptoms of re-experiencing, avoidance, emotional numbing, dysphoric arousal, and anxious arousal provided a significantly better representation of PTSD symptoms than the DSM-IV, dysphoria, and numbing models. This model also showed evidence of "excellent fit" in the community samples according to empirically-defined benchmarks. CONCLUSIONS: These findings suggest that PTSD symptomatology in both community and treatment-seeking Iraq/Afghanistan veterans may be best represented by a 5-factor model that separates the DSM-IV PTSD hyperarousal symptom cluster into distinct dysphoric arousal and anxious arousal clusters.
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