A comparison of the DSM-IV and proposed DSM-V PTSD criteria for youth: factor analyses conducted with a low socioeconomic status, hurricane-exposed sample

Abstract

Hurricane Katrina destroyed much of New Orleans, exposing residents to dangerous storms and significant flooding which resulted in the loss of many families’ homes and possessions. One of the most common psychological disorders experienced by disaster victims, both adult and child, is Posttraumatic Stress Disorder (PTSD). Given the debate over the appropriateness of applying adult DSM-IV-TR criteria to children and the current formulation of DSM-V criteria, this study further explored the presentation of PTSD symptomatology in a sample of 276 youth who experienced Hurricane Katrina. Proposed DSM-V criteria were assessed with participant responses on the UCLA PTSD Index for DSM-IV and the Behavioral Assessment System for Children, Second Edition (BASC-2). Both symptom endorsement and PTSD factor structure (i.e. diagnostic clusters) were assessed. Findings indicated similar PTSD prevalence rates when comparing DSM-IV and proposed DSM-V diagnostic criteria. Based on confirmatory factor analysis findings, current DSM-IV-TR factor structure (i.e. diagnostic cluster presentation) was not found to be appropriate for this sample. Although a newly generated model and the proposed DSM-V model produced some indicators of acceptability for this sample, none of the tested models provided a consistently good fit. Finally, it was found that based on proposed DSM-V diagnostic criteria, PTSD symptoms significantly decreased over time (from 4-7 months post-hurricane to 25-28 months post-hurricane). Results of the analyses and a description of symptom endorsement are discussed in light of the developmental appropriateness of PTSD diagnostic criteria in youth and the implications for DSM-V.