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Dimensional structure of DSM-5 posttraumatic stress symptoms in Spanish trauma victims

BACKGROUND: Confirmatory factor analytic studies have shown that posttraumatic stress disorder (PTSD) symptoms included in the fifth edition of the Diagnostic and Statistical Manual Disorders (DSM-5) may be better explained by two 6-factor models (the Externalizing Behaviours model and the Anhedonia...

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Autores principales: Soberón, Carmen, Crespo, María, del Mar Gómez-Gutiérrez, María, Fernández-Lansac, Violeta, Armour, Cherie
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Co-Action Publishing 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5156862/
https://www.ncbi.nlm.nih.gov/pubmed/27974133
http://dx.doi.org/10.3402/ejpt.v7.32078
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author Soberón, Carmen
Crespo, María
del Mar Gómez-Gutiérrez, María
Fernández-Lansac, Violeta
Armour, Cherie
author_facet Soberón, Carmen
Crespo, María
del Mar Gómez-Gutiérrez, María
Fernández-Lansac, Violeta
Armour, Cherie
author_sort Soberón, Carmen
collection PubMed
description BACKGROUND: Confirmatory factor analytic studies have shown that posttraumatic stress disorder (PTSD) symptoms included in the fifth edition of the Diagnostic and Statistical Manual Disorders (DSM-5) may be better explained by two 6-factor models (the Externalizing Behaviours model and the Anhedonia model) and a 7-factor Hybrid model. The latter model comprises the symptom clusters of intrusion, avoidance, negative affect, anhedonia, externalizing behaviours, and anxious and dysphoric arousal. This model has received empirical support mainly in American samples. Of note, there have been a limited number of studies conducted on samples from other countries. OBJECTIVE: This study aimed to examine the underlying dimensionality of DSM-5 PTSD symptoms in a Spanish clinical sample exposed to a range of traumatic events. METHOD: Participants included 165 adults (78.8% females) seeking treatment in trauma services in the Madrid area (Spain). PTSD was assessed using the Global Assessment of Posttraumatic Stress Scale 5, a Spanish self-report instrument assessing posttraumatic symptoms according to the DSM-5 criteria. Confirmatory factor analyses were conducted in Mplus. RESULTS: Both the 7-factor Hybrid model and the 6-factor Anhedonia model demonstrated good and equivalent fit to the data. CONCLUSIONS: The findings of this study replicate and extend previous research by providing support for both the 7-factor Hybrid model and the 6-factor Anhedonia model in a clinical sample of Spanish trauma survivors. Given equivalent fit for these two models and the fewer number of latent factors in the Anhedonia model, it was selected as optimal in a traumatized Spanish sample. Implications and future research directions are discussed. HIGHLIGHTS OF THE ARTICLE: The 7-factor Hybrid model (which comprises the intrusion, avoidance, negative affect, anhedonia, externalizing behaviours, and anxious and dysphoric arousal symptoms clusters) and the 6-factor Anhedonia model (in which the externalizing behaviour symptoms are part of the dysphoric arousal symptom cluster) provided equivalent fit to the data. The Anhedonia model is the most parsimonious and thus the optimal-fitting model in the current sample. The findings support the distinctiveness between dysphoric arousal, anxious arousal, negative affect, and anhedonia factors. The separation of the externalizing behaviour symptoms from the dysphoric arousal symptoms does not improve the model fit in the current sample.
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spelling pubmed-51568622016-12-21 Dimensional structure of DSM-5 posttraumatic stress symptoms in Spanish trauma victims Soberón, Carmen Crespo, María del Mar Gómez-Gutiérrez, María Fernández-Lansac, Violeta Armour, Cherie Eur J Psychotraumatol Clinical Research Article BACKGROUND: Confirmatory factor analytic studies have shown that posttraumatic stress disorder (PTSD) symptoms included in the fifth edition of the Diagnostic and Statistical Manual Disorders (DSM-5) may be better explained by two 6-factor models (the Externalizing Behaviours model and the Anhedonia model) and a 7-factor Hybrid model. The latter model comprises the symptom clusters of intrusion, avoidance, negative affect, anhedonia, externalizing behaviours, and anxious and dysphoric arousal. This model has received empirical support mainly in American samples. Of note, there have been a limited number of studies conducted on samples from other countries. OBJECTIVE: This study aimed to examine the underlying dimensionality of DSM-5 PTSD symptoms in a Spanish clinical sample exposed to a range of traumatic events. METHOD: Participants included 165 adults (78.8% females) seeking treatment in trauma services in the Madrid area (Spain). PTSD was assessed using the Global Assessment of Posttraumatic Stress Scale 5, a Spanish self-report instrument assessing posttraumatic symptoms according to the DSM-5 criteria. Confirmatory factor analyses were conducted in Mplus. RESULTS: Both the 7-factor Hybrid model and the 6-factor Anhedonia model demonstrated good and equivalent fit to the data. CONCLUSIONS: The findings of this study replicate and extend previous research by providing support for both the 7-factor Hybrid model and the 6-factor Anhedonia model in a clinical sample of Spanish trauma survivors. Given equivalent fit for these two models and the fewer number of latent factors in the Anhedonia model, it was selected as optimal in a traumatized Spanish sample. Implications and future research directions are discussed. HIGHLIGHTS OF THE ARTICLE: The 7-factor Hybrid model (which comprises the intrusion, avoidance, negative affect, anhedonia, externalizing behaviours, and anxious and dysphoric arousal symptoms clusters) and the 6-factor Anhedonia model (in which the externalizing behaviour symptoms are part of the dysphoric arousal symptom cluster) provided equivalent fit to the data. The Anhedonia model is the most parsimonious and thus the optimal-fitting model in the current sample. The findings support the distinctiveness between dysphoric arousal, anxious arousal, negative affect, and anhedonia factors. The separation of the externalizing behaviour symptoms from the dysphoric arousal symptoms does not improve the model fit in the current sample. Co-Action Publishing 2016-12-13 /pmc/articles/PMC5156862/ /pubmed/27974133 http://dx.doi.org/10.3402/ejpt.v7.32078 Text en © 2016 Carmen Soberón et al. http://creativecommons.org/licenses/by/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 International License, allowing third parties to copy and redistribute the material in any medium or format, and to remix, transform, and build upon the material, for any purpose, even commercially, under the condition that appropriate credit is given, that a link to the license is provided, and that you indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
spellingShingle Clinical Research Article
Soberón, Carmen
Crespo, María
del Mar Gómez-Gutiérrez, María
Fernández-Lansac, Violeta
Armour, Cherie
Dimensional structure of DSM-5 posttraumatic stress symptoms in Spanish trauma victims
title Dimensional structure of DSM-5 posttraumatic stress symptoms in Spanish trauma victims
title_full Dimensional structure of DSM-5 posttraumatic stress symptoms in Spanish trauma victims
title_fullStr Dimensional structure of DSM-5 posttraumatic stress symptoms in Spanish trauma victims
title_full_unstemmed Dimensional structure of DSM-5 posttraumatic stress symptoms in Spanish trauma victims
title_short Dimensional structure of DSM-5 posttraumatic stress symptoms in Spanish trauma victims
title_sort dimensional structure of dsm-5 posttraumatic stress symptoms in spanish trauma victims
topic Clinical Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5156862/
https://www.ncbi.nlm.nih.gov/pubmed/27974133
http://dx.doi.org/10.3402/ejpt.v7.32078
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