Confirmatory factor analyses of DSM-5 posttraumatic stress disorder symptoms in psychiatric samples differing in Criterion A status

Abstract

We examined the symptom structure of posttraumatic stress disorder (PTSD), as defined by American Psychiatric Association (2013. Diagnostic and statistical manual of mental disorders (DSM-5) (5th ed.). Washington, DC: Author). DSM-5 introduced notable changes to PTSD criteria, and the structural impact of these changes is unclear. We conducted confirmatory factor analyses comparing seven commonly investigated or recently proposed PTSD models in a large sample of interviewed psychiatric outpatients reporting a Criterion A trauma (n=310) or a sub-threshold (non-Criterion A) stressful life event (n=284). A novel six-factor dysphoria model and recently proposed seven-factor hybrid model outperformed other models and fit the data equally well in both groups. Our results suggest equal fit for both models, although the six-factor model is more parsimonious. These results have implications for research regarding the mechanisms underlying and the treatments targeting PTSD.