TY - JOUR
T1 - Functional significance of a novel 7-factor model of DSM-5 PTSD symptoms
T2 - Results from the National Health and Resilience in Veterans Study
AU - Pietrzak, Robert H.
AU - Tsai, Jack
AU - Armour, Cherie
AU - Mota, Natalie
AU - Harpaz-Rotem, Ilan
AU - Southwick, Steven M.
N1 - Funding Information:
The National Health and Resilience in Veterans Study (NHRVS) and preparation of this report was supported by the U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder and a private donation.
PY - 2015/3/15
Y1 - 2015/3/15
N2 - Background While posttraumatic stress disorder (PTSD) symptoms in the recently published Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) are clustered into four factors, emerging confirmatory factor analytic studies suggest that this disorder is best characterized by seven symptom clusters, including re-experiencing, avoidance, negative affect, anhedonia, externalizing behaviors, and anxious and dysphoric arousal symptoms. To date, however, data are lacking regarding the relation between this novel model of DSM-5 PTSD symptoms and measures of clinical significance in this population (e.g., functioning).Methods Using data from the National Health and Resilience in Veterans Study (NHRVS), a contemporary, nationally representative sample of 1484 U.S. veterans, we evaluated clinical and functional correlates of a novel 7-factor model of DSM-5 PTSD symptoms.Results Differential patterns of associations were observed between DSM-5 PTSD symptom clusters, and psychiatric comorbidities, suicidal ideation, hostility, and functioning and quality of life. Anhedonia symptoms, in particular, were strongly related to current depression, as well as reduced mental functioning and quality of life. Externalizing behaviors were most strongly related to hostility, supporting the convergent validity of this construct. Limitations Cross-sectional design and employment of self-report measures.Conclusions These results suggest that a more refined 7-factor model of DSM-5 PTSD symptoms may provide greater specificity in understanding associations with comorbid psychopathology, suicidal ideation, and functioning and quality of life in U.S. veterans. They further suggest that prevention and treatment efforts that target distinct aspects of the PTSD phenotype may be more effective in mitigating key clinical and functional outcomes in this population.
AB - Background While posttraumatic stress disorder (PTSD) symptoms in the recently published Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) are clustered into four factors, emerging confirmatory factor analytic studies suggest that this disorder is best characterized by seven symptom clusters, including re-experiencing, avoidance, negative affect, anhedonia, externalizing behaviors, and anxious and dysphoric arousal symptoms. To date, however, data are lacking regarding the relation between this novel model of DSM-5 PTSD symptoms and measures of clinical significance in this population (e.g., functioning).Methods Using data from the National Health and Resilience in Veterans Study (NHRVS), a contemporary, nationally representative sample of 1484 U.S. veterans, we evaluated clinical and functional correlates of a novel 7-factor model of DSM-5 PTSD symptoms.Results Differential patterns of associations were observed between DSM-5 PTSD symptom clusters, and psychiatric comorbidities, suicidal ideation, hostility, and functioning and quality of life. Anhedonia symptoms, in particular, were strongly related to current depression, as well as reduced mental functioning and quality of life. Externalizing behaviors were most strongly related to hostility, supporting the convergent validity of this construct. Limitations Cross-sectional design and employment of self-report measures.Conclusions These results suggest that a more refined 7-factor model of DSM-5 PTSD symptoms may provide greater specificity in understanding associations with comorbid psychopathology, suicidal ideation, and functioning and quality of life in U.S. veterans. They further suggest that prevention and treatment efforts that target distinct aspects of the PTSD phenotype may be more effective in mitigating key clinical and functional outcomes in this population.
KW - Functioning
KW - Posttraumatic stress disorder
KW - Symptomatology
KW - Trauma
KW - Veterans
UR - https://www.scopus.com/pages/publications/84920154184
U2 - 10.1016/j.jad.2014.12.007
DO - 10.1016/j.jad.2014.12.007
M3 - Article
C2 - 25556669
AN - SCOPUS:84920154184
SN - 0165-0327
VL - 174
SP - 522
EP - 526
JO - Journal of Affective Disorders
JF - Journal of Affective Disorders
ER -