Dimensional structure of DSM-5 posttraumatic stress symptoms: Support for a hybrid Anhedonia and Externalizing Behaviors model
Dimensional structure of DSM-5 posttraumatic stress symptoms: Support for a hybrid Anhedonia and Externalizing Behaviors model
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DOI：
10.1016/j.jpsychires.2014.10.012
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发表时间：
2015-02-01
影响因子：
4.8
通讯作者：
Pietrzak, Robert H.
中科院分区：
文献类型：
--
作者：
Armour, Cherie;Tsai, Jack;Pietrzak, Robert H.
第5版《精神疾病诊断与统计手册》（DSM-5）对创伤后应激障碍（PTSD）的症状群进行了几次修订。这项研究的重点是修订的创伤后应激障碍的三重结构在DSM-IV到DSM-5的四个症状群。新兴的验证性因素分析（CFA）研究表明，DSM-5 PTSD症状可能最好由两个6因素模型之一表示：（1）外部化行为模型，其特征在于将易怒/愤怒和自我毁灭/鲁莽行为项目结合起来的因素;（2）快感缺失模型，其特征在于失去兴趣，分离和限制性影响。目前的研究使用DSM-5（PCL-5）的PTSD检查表在两个独立和不同的创伤暴露样本中进行了DSM-5 PTSD症状的CFA评估，这些样本来自全国代表性的1484名美国退伍军人和497名美国中西部大学本科生。DSM-5模型，DSM-5 Dysophoria模型，DSM-5 Dysophoric Arousal模型，两个6因素模型，和一个新提出的7因素混合模型，它巩固了两个6因素模型的相对拟合进行了评价。结果显示，在两个样本中，两个6因素模型提供了显着更好的拟合比4因素DSM-5模型，DSM-5 Dysophoria模型和DSM-5 Dysophoric Arousal模型。此外，7因素混合模型，它结合了两个6因素模型的关键特征，并包括重新体验，回避，负面影响，快感缺乏，外化行为，焦虑和烦躁的觉醒症状集群，提供了上级适合两个样本中的数据。结果进行了讨论，在DSM-5 PTSD症状的潜在结构的理论和实证支持。(C)2014爱思唯尔有限公司版权所有。
Several revisions to the symptom clusters of posttraumatic stress disorder (PTSD) have been made in the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Central to the focus of this study was the revision of PTSD's tripartite structure in DSM-IV into four symptom clusters in DSM-5. Emerging confirmatory factor analytic (CFA) studies have suggested that DSM-5 PTSD symptoms may be best represented by one of two 6-factor models: (1) an Externalizing Behaviors model characterized by a factor which combines the irritability/anger and self-destructive/reckless behavior items; and (2) an Anhedonia model characterized by items of loss of interest, detachment, and restricted affect. The current study conducted CFAs of DSM-5 PTSD symptoms assessed using the PTSD Checklist for DSM-5 (PCL-5) in two independent and diverse trauma-exposed samples of a nationally representative sample of 1484 U.S. veterans and a sample of 497 Midwestern U.S. university undergraduate students. Relative fits of the DSM-5 model, the DSM-5 Dysphoria model, the DSM-5 Dysphoric Arousal model, the two 6-factor models, and a newly proposed 7-factor Hybrid model, which consolidates the two 6-factor models, were evaluated. Results revealed that, in both samples, both 6-factor models provided significantly better fit than the 4-factor DSM-5 model, the DSM-5 Dysphoria model and the DSM-5 Dysphoric Arousal model. Further, the 7-factor Hybrid model, which incorporates key features of both 6-factor models and is comprised of re-experiencing, avoidance, negative affect, anhedonia, externalizing behaviors, and anxious and dysphoric arousal symptom clusters, provided superior fit to the data in both samples. Results are discussed in light of theoretical and empirical support for the latent structure of DSM-5 PTSD symptoms. (C) 2014 Elsevier Ltd. All rights reserved.