A systematic literature review of PTSD's latent structure in the Diagnostic and Statistical Manual of Mental Disorders: DSM-IV to DSM-5

Background: Posttraumatic stress symptoms are interconnected. Knowledge about which symptoms of posttraumatic stress are more strongly interconnected or central than others may have implications for the targeting of clinical interventions. Exploring whether symptoms of posttraumatic stress may be differentially related to covariates can contribute to our knowledge on how posttraumatic stress symptoms arise and are maintained. Objective: This study aimed to identify the most central symptoms of posttraumatic stress and their interconnections, and to explore how covariates such as exposure, sex, neuroticism, and social support are related to the network of symptoms of posttraumatic stress. Method: This study used survey data from ministerial employees collected approximately 10 months after the 2011 Oslo bombing that targeted the governmental quarters (n = 190). We conducted network analyses using Gaussian graphical models and the lasso regularization. Results: The network analysis revealed reliably strong connections between intrusive thoughts and nightmares, feeling easily startled and overly alert, and between feeling detached and emotionally numb. The most central symptom in the symptom network was feeling emotionally numb. The covariates were generally not found to have high centrality in the symptom network. An exception was that being female was connected to a high physiological reactivity to reminders of the trauma. Conclusions: Ten months after a workplace terror attack emotional numbness appears to be of high centrality in the symptom network of posttraumatic stress. Fear circuitry and dysphoric symptoms may constitute two functional entities in chronic posttraumatic stress. Clinical interventions targeting numbness may be beneficial in the treatment of posttraumatic stress, at least after workplace terrorism.

Section: Introductionmentioning

confidence: 99%

Making connections: exploring the centrality of posttraumatic stress symptoms and covariates after a terrorist attack

Birkeland

Heir

2017

“…Symptoms were categorized into four clusters: re-experiencing, avoidance, negative alterations in cognitions and mood, alterations in arousal and reactivity. Many studies have been conducted to determine the symptom structure of DSM-5 PTSD (Armour, Műllerová, & Elhai, 2016), among which a seven-factor hybrid model consisting of intrusion symptoms, avoidance, negative affect, anhedonia, externalizing behaviours, anxious arousal, and dysphoric arousal (Armour et al, 2015) was found to best capture dimensions of DSM-5 PTSD symptoms across adults (most recently in Mordeno, Go, & Yangson-Serondo, 2017) and youth (most recently in Wang et al, 2017) exposed to various trauma types. The intrusion factor contains all current Criterion B symptoms (intrusive thoughts, nightmares, flashbacks, emotional cue reactivity, physiological cue reactivity), and avoidance factor contains all current Criterion C symptoms (avoidance of thoughts and reminders).…”

Section: Introductionmentioning

confidence: 99%

DSM-5 posttraumatic stress symptom dimensions and health-related quality of life among Chinese earthquake survivors

Wang

Cao

et al. 2018

Self Cite

It has been well-documented that posttraumatic stress symptoms cause impairments in health-related quality of life (HRQoL). Until now we have little data on how DSM-5 PTSD symptom dimensions relate to different aspects of HRQoL. Clarifying this question would be informative to improve the quality of life of PTSD patients. This study aimed to investigate the effects of dimensions of a well-supported seven-factor model of DSM-5 PTSD symptoms on physical and psychosocial HRQoL. A total of 1063 adult survivors of the 2008 Wenchuan earthquake took part in this study nine years after the disaster. PTSD symptoms were measured by the PTSD Checklist for DSM-5 (PCL-5). HRQoL was measured by the Medical Outcomes Survey Short Form-36 (SF-36). The associations between PTSD symptom dimensions and HRQoL were examined using structural equation models. Dysphoric arousal symptoms were found to significantly relate to physical HRQoL. Other symptom dimensions were not associated with HRQoL. Our findings contribute to the relationship between DSM-5 PTSD and HRQoL, and carry implications for further clinical practice and research on trauma-exposed individuals.

“…Armour, Műllerová, & Elhai, 2015; Colvonen et al, 2017; Kassam-Adams, 2014; Kehle-Forbes & Kimerling, 2017; Molnar et al, 2017; Olff, Van Zuiden, & Bakker, 2015; Wisco et al, 2016). This has led to important discoveries and has inspired some work on improving prevention and intervention strategies for trauma-affected individuals (Brief et al, 2013; Hilton et al, 2017; Horn, Charney, & Feder, 2016; Markowitz et al, 2015; Olff, Armour et al, 2015).…”

Section: Introductionmentioning

confidence: 99%

PTSD symptomics: network analyses in the field of psychotraumatology

Armour¹,

Fried

Olff

2017

Self Cite

Recent years have seen increasing attention on posttraumatic stress disorder (PTSD) research. While research has largely focused on the dichotomy between patients diagnosed with mental disorders and healthy controls — in other words, investigations at the level of diagnoses — recent work has focused on psychopathology symptoms. Symptomics research in the area of PTSD has been scarce so far, although several studies have focused on investigating the network structures of PTSD symptoms. The present special issue of EJPT adds to the literature by curating additional PTSD network studies, each looking at a different aspect of PTSD. We hope that this special issue encourages researchers to conceptualize and model PTSD data from a network perspective, which arguably has the potential to inform and improve the efficacy of therapeutic interventions.