A meta-analytic investigation of the structure of posttraumatic stress disorder symptoms.
A meta-analytic investigation of the structure of posttraumatic stress disorder symptoms.
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DOI：
10.1037/a0020981
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发表时间：
2010-11
影响因子：
4.6
通讯作者：
Simms LJ
中科院分区：
文献类型：
--
作者：
Yufik T;Simms LJ
越来越多的证据对基于《精神疾病诊断和统计手册》(DSM)的创伤后应激障碍(PTSD)概念的有效性提出了质疑，并建议了PTSD症状学的替代结构模型。我们对40项创伤后应激障碍研究(N=14,827名研究对象)进行了荟萃分析，使用基于DSM的测量方法来评估创伤后应激障碍的严重程度。我们汇总了所有研究的相关矩阵，然后对聚合的矩阵应用验证性因子分析，以测试已在文献中获得支持的PTSD症状学竞争模型的适用性。结果表明，创伤后应激障碍症状学的两个突出的四因素模型在研究的子样本中都产生了很好的模型匹配性；然而，包括干扰、回避、过度觉醒和烦躁不安因素的模型似乎更适合于跨研究。结果还表明，最好的拟合模型不受测量或样本类型的影响。研究结果在创伤后应激障碍的结构模型和诊断病因学方面进行了讨论。
Converging lines of evidence have called into question the validity of conceptualizations of posttraumatic stress disorder (PTSD) based on the Diagnostic and Statistical Manual of Mental Disorders (DSM) and suggested alternative structural models of PTSD symptomatology. We conducted a meta-analysis of 40 PTSD studies (N = 14,827 participants across studies) that used a DSM-based measure to assess PTSD severity. We aggregated correlation matrices across studies and then applied confirmatory factor analysis to the aggregated matrices to test the fit of competing models of PTSD symptomatology that have gained support in the literature. Results indicated that both prominent 4-factor models of PTSD symptomatology yielded good model fit across subsamples of studies; however, the model comprising Intrusions, Avoidance, Hyperarousal, and Dysphoria factors appeared to fit better across studies. Results also indicated that the best fitting models were not moderated by measure or sample type. Results are discussed in the context of structural models of PTSD and implications for the diagnostic nosology.