The Underlying Role of Negative Affect in the Association between PTSD, Major Depressive Disorder, and Generalized Anxiety Disorder
The Underlying Role of Negative Affect in the Association between PTSD, Major Depressive Disorder, and Generalized Anxiety Disorder
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DOI：
10.1007/s10862-016-9555-9
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发表时间：
2016-12-01
影响因子：
1.6
通讯作者：
Elhai, Jon D.
中科院分区：
文献类型：
--
作者：
Byllesby, Brianna M.;Charak, Ruby;Elhai, Jon D.
临床医生和研究人员发现鉴别诊断很困难，特别是对于概念上相似的疾病。特别令人感兴趣的一类是痛苦或内化障碍，理论上与普遍痛苦或负面情绪的潜在结构有关。本研究试图通过控制可归因于负面情绪的方差，使用潜在分析来解决三种痛苦障碍的共病——创伤后应激障碍（PTSD）、重度抑郁症（MDD）和广泛性焦虑障碍（GAD）。样本由 265 名经历过创伤的个体组成，他们完成了 PTSD、MDD、GAD 和负面情绪的自我报告测量。使用验证性因素分析来测试初始模型拟合。接下来，重新计算模型，通过在项目级别回归负面情绪来控制负面情绪。结果表明，这些诊断类别内部和之间的大量差异可归因于项目和因素层面的负面影响。控制负面情绪后，MDD 的非躯体/情感因素和 GAD 因素的因素负荷衰减最高的假设得到了支持。因此，负面情绪在临床上显着影响PTSD、MDD和GAD的同时发生，强调了对创伤受害者进行跨诊断干预的必要性。
Clinicians and researchers have found differential diagnosis to be difficult, particularly for conceptually similar disorders. One category of particular interest has been distress or internalizing disorders, theorized to be related via an underlying construct of generalized distress or negative affect. The present study attempted to address the comorbidity of three distress disorders - posttraumatic stress disorder (PTSD), major depressive disorder (MDD), and generalized anxiety disorder (GAD) - using latent analyses by controlling for the variance attributable to negative affect. The sample consisted of 265 trauma-exposed individuals who completed self-report measures of PTSD, MDD, GAD, and negative affect. Confirmatory factor analysis was used to test initial model fit. Next, the model was re-computed, controlling for negative affect by regressing negative affectivity at the item-level. Results indicated that a significant amount of variance within and between these diagnostic categories is attributable to negative affect at both the item- and factor-level. The hypothesis that MDD's non-somatic/affective factor and the GAD factor would have the highest attenuations in factor loadings after controlling for negative affect was supported. Therefore, negative affect significantly influences the co-occurrence of PTSD, MDD, and GAD clinically, emphasizing the need for transdiagnostic interventions for trauma victims.