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DSM-5 posttraumatic stress disorder: factor structure and rates of diagnosis.

Publication ,  Journal Article
Gentes, EL; Dennis, PA; Kimbrel, NA; Rissling, MB; Beckham, JC; VA Mid-Atlantic MIRECC Workgroup; Calhoun, PS
Published in: J Psychiatr Res
December 2014

Posttraumatic stress disorder (PTSD) is a significant problem among Iraq/Afghanistan-era veterans. To date, however, there has been only limited research on how the recent changes in DSM-5 influence the prevalence and factor structure of PTSD. To address this key issue, the present research used a modified version of a gold-standard clinical interview to assess PTSD among a large sample of Iraq/Afghanistan-era veterans (N = 414). Thirty-seven percent of the sample met DSM-5 criteria for PTSD compared to a rate of 38% when DSM-IV diagnostic criteria were used. Differences in rates of diagnosis between DSM-IV and DSM-5 were primarily attributable to changes to Criterion A and the separation of the "avoidance" and "numbing" symptoms into separate clusters. Confirmatory factor analysis (CFA) was used to compare the fit of the previous 3-factor DSM-IV model of PTSD to the 4-factor model specified in DSM-5, a 4-factor "dysphoria" model, and a 5-factor model. CFA demonstrated that the 5-factor model (re-experiencing, active avoidance, emotional numbing, dysphoric arousal, anxious arousal) provided the best overall fit to the data, although substantial support was also found for the 4-factor DSM-5 model. Low factor loadings were noted for two of the symptoms in the DSM-5 model (psychogenic amnesia and reckless/self-destructive behavior), raising questions regarding the adequacy of fit between these symptoms and the other core features of PTSD. Overall, findings suggest the DSM-5 model of PTSD is an improvement over the previous DSM-IV model of PTSD, but still may not represent the true underlying factor structure of PTSD.

Duke Scholars

Published In

J Psychiatr Res

DOI

EISSN

1879-1379

Publication Date

December 2014

Volume

59

Start / End Page

60 / 67

Location

England

Related Subject Headings

  • Young Adult
  • Veterans
  • United States
  • Stress Disorders, Post-Traumatic
  • Psychiatry
  • Middle Aged
  • Male
  • Humans
  • Female
  • Factor Analysis, Statistical
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Gentes, E. L., Dennis, P. A., Kimbrel, N. A., Rissling, M. B., Beckham, J. C., VA Mid-Atlantic MIRECC Workgroup, & Calhoun, P. S. (2014). DSM-5 posttraumatic stress disorder: factor structure and rates of diagnosis. J Psychiatr Res, 59, 60–67. https://doi.org/10.1016/j.jpsychires.2014.08.014
Gentes, Emily L., Paul A. Dennis, Nathan A. Kimbrel, Michelle B. Rissling, Jean C. Beckham, VA Mid-Atlantic MIRECC Workgroup, and Patrick S. Calhoun. “DSM-5 posttraumatic stress disorder: factor structure and rates of diagnosis.J Psychiatr Res 59 (December 2014): 60–67. https://doi.org/10.1016/j.jpsychires.2014.08.014.
Gentes EL, Dennis PA, Kimbrel NA, Rissling MB, Beckham JC, VA Mid-Atlantic MIRECC Workgroup, et al. DSM-5 posttraumatic stress disorder: factor structure and rates of diagnosis. J Psychiatr Res. 2014 Dec;59:60–7.
Gentes, Emily L., et al. “DSM-5 posttraumatic stress disorder: factor structure and rates of diagnosis.J Psychiatr Res, vol. 59, Dec. 2014, pp. 60–67. Pubmed, doi:10.1016/j.jpsychires.2014.08.014.
Gentes EL, Dennis PA, Kimbrel NA, Rissling MB, Beckham JC, VA Mid-Atlantic MIRECC Workgroup, Calhoun PS. DSM-5 posttraumatic stress disorder: factor structure and rates of diagnosis. J Psychiatr Res. 2014 Dec;59:60–67.
Journal cover image

Published In

J Psychiatr Res

DOI

EISSN

1879-1379

Publication Date

December 2014

Volume

59

Start / End Page

60 / 67

Location

England

Related Subject Headings

  • Young Adult
  • Veterans
  • United States
  • Stress Disorders, Post-Traumatic
  • Psychiatry
  • Middle Aged
  • Male
  • Humans
  • Female
  • Factor Analysis, Statistical