Evaluating a novel 8-factor dimensional model of PTSD in U.S. military veterans: Results from the National Health and Resilience in Veterans Study.
Evaluating a novel 8-factor dimensional model of PTSD in U.S. military veterans: Results from the National Health and Resilience in Veterans Study.
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评估美国退伍军人创伤后应激障碍 (PTSD) 的新型 8 因素维度模型：退伍军人国家健康和复原力研究的结果。
DOI：
10.1016/j.jad.2023.11.041
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发表时间：
2024
影响因子：
6.6
通讯作者：
Pietrzak,RobertH
中科院分区：
文献类型：
--
作者：
Stiltner,Brendan;Fischer,IanC;Duek,Or;Polimanti,Renato;Harpaz-Rotem,Ilan;Pietrzak,RobertH
背景：越来越多的数据表明，创伤后应激障碍（PTSD）症状的结构可能比流行的疾病分类模型所提出的更为微妙。新兴的理论进一步表明，一个8因素模型与单独的内部-（例如，闪回）和外部（例如，创伤线索相关的情绪反应）产生的侵入性症状可能最能代表PTSD症状。然而，到目前为止，缺乏研究已经评估了这个模型的拟合和指数创伤是否与它在人群中的高风险的创伤exposure，如military veterans.MethodsData进行了分析，从一个具有全国代表性的样本3847创伤暴露的美国退伍军人谁参加了国家健康和恢复力的退伍军人研究。进行了验证性因素分析，以评估一个新的8因素模型的PTSD症状的适合4-因素DSM-5和vacuically-supported 7-factor hybrid models.ResultsThe 8-factor model fit the data significantly better than the 7-factor hybrid and 4-factor DSM-5 models.战斗暴露和伤害他人与内部产生的入侵有更强的相关性，而人际暴力和灾难/事故与外部产生的入侵有更强的显著性相关性。以及与临床医生管理的访谈。结论这项研究的结果提供了一个新的8-创伤后应激障碍症状的因素模型，其特征在于独立的内部和外部产生的入侵。他们还认为，某些指数创伤可能导致这些症状的差异表达。
BackgroundAccumulating data suggest that the structure of posttraumatic stress disorder (PTSD) symptoms may be more nuanced than proposed by prevailing nosological models. Emerging theory further suggests that an 8-factor model with separate internally- (e.g., flashbacks) and externally- (e.g., trauma cue-related emotional reactivity) generated intrusive symptoms may best represent PTSD symptoms. To date, however, scarce research has evaluated the fit of this model and whether index traumas are differentially associated with it in populations at high risk for trauma exposure, such as military veterans.MethodsData were analyzed from a nationally representative sample of 3847 trauma-exposed U.S. veterans who participated in the National Health and Resilience in Veterans Study. Confirmatory factor analyses were conducted to evaluate the fit of a novel 8-factor model of PTSD symptoms relative to 4-factor DSM-5 and empirically-supported 7-factor hybrid models.ResultsThe 8-factor model fit the data significantly better than the 7-factor hybrid and 4-factor DSM-5 models. Combat exposure and harming others were more strongly associated with internally-generated intrusions, while interpersonal violence and disaster/accident showed stronger significant associations with externally-generated intrusions.LimitationsThe 8-factor model requires validation in non-veteran and more diverse trauma-exposed populations, as well as with clinician-administered interviews.ConclusionsResults of this study provide support for a novel 8-factor model of PTSD symptoms that is characterized by separate internally- and externally-generated intrusions. They also suggest that certain index traumas may lead to differential expression of these symptoms.