Investigating the latent dimensions of posttraumatic stress disorder and the role of anxiety sensitivity in combat-exposed Filipino soldiers

Mordeno, Imelu G.; Luzano, Jelli Grace C.; Mordeno, Emelyn R.; Ferolino, Michelle Anne L.

doi:10.1080/08995605.2020.1724594

Cited by 4 publications

(5 citation statements)

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“…Research on PTSD shows that specific symptom clusters are differentially associated with poorer outcomes, although these symptoms rarely conform to the 4‐factor structure suggested by the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM‐5; APA, 2013). Instead, alternate models have been tested and found to have superior fit in study samples, such as the 5‐Factor Dysphoric Arousal Model (Elhai et al, 2011), 6‐Factor Anhedonia Model (Blai et al, 2018; Frankfurt et al, 2016; Liu et al, 2014; Mordeno et al, 2020), 6‐Factor Externalizing Behavior Model (Tsai et al, 2015), and 7‐Factor Hybrid Model (Armour et al, 2015; Frankfurt et al, 2016). While all factor structure models maintain the intrusive and avoidance factors of the DSM‐5 Model, they differ in factor structure organization with the remaining 13 symptoms.…”

Section: Introductionmentioning

confidence: 99%

Gender as a moderator of the association of military sexual trauma and posttraumatic stress symptoms

et al. 2021

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Objective: The current study examined the moderating role of gender on the association of military sexual trauma (MST) type (harassment-only vs. assault) and posttraumatic stress symptoms (PTSS) using the 6-factor Anhedonia Model.Methods: Participants were 1321 service members/ veterans. Two-part hurdle models assessed the moderating role of gender on the association of MST type with the presence (at least "moderate" symptoms endorsed within each cluster) or severity of PTSS and symptom clusters.Results: Among those who experienced assault MST, women were at higher risk for the presence of intrusive, avoidance, negative affect, and anhedonia symptoms, and higher risk for more severe negative affect symptoms.Among those who experienced harassment-only MST, men were at higher risk of more severe PTSS symptoms overall and in the intrusive and dysphoric arousal symptom clusters. No other significant differences were observed.Conclusions: Gathering information on MST type may be helpful in treatment planning.

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Section: Introductionmentioning

confidence: 99%

Gender as a moderator of the association of military sexual trauma and posttraumatic stress symptoms

et al. 2021

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“…In this regard, although the current review indicates that the current DSM–5 Model may not optimally represent PTSD’s latent structure, we need to acknowledge the feasibility/utility of its clinical applications and its parsimony when making decisions about what diagnostic structure to use. Complicating this issue, our review findings identified the Anhedonia Model as an equally well-performing model across multiple studies (Blevins et al, 2015; Bovin et al, 2016; Mordeno et al, 2020; Shevlin et al, 2017; Van Praag et al, 2020); this model may be optimal due to parsimony and having fewer latent factors identified by a small number of items. Beyond the need for future research on PCL–5’s optimal latent structure, studies may also benefit from considering bifactor modeling to examine the factor structure of the PCL–5; bifactor modeling is a multilevel approach that includes a general factor to represent the shared variance and separate unique factors to represent the variance unexplained by the general factor.…”

Section: Discussionmentioning

confidence: 91%

The Posttraumatic Stress Disorder (PTSD) Checklist for DSM–5: A systematic review of existing psychometric evidence.

Raudales¹,

Rafiuddin²,

Weiss³

et al. 2023

Clinical Psychology: Science and Practice

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The Posttraumatic Stress Disorder (PTSD) Checklist for the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM–5; PCL–5) is a widely used self-rated measure of DSM–5 PTSD symptoms. The goal of this systematic review was to synthesize research on the psychometric properties of the PCL–5 to guide clinical and research applications. We focused on reliability, validity, factor structure, optimal cutoff scores, and sensitivity to clinical change indices. A systematic review of the literature following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was conducted using PubMed, PsycINFO, CINAHL, and PTSDpubs with search terms capturing selected psychometric indices of the PCL–5. The inclusion criteria were: peer-reviewed publication in English; primary focus on the PCL–5 psychometrics; empirical study; and study with adult samples. The search yielded 265 studies; 56 articles (amounting to 64 studies) met inclusion criteria and were reviewed. Findings generally indicated evidence for: acceptable internal consistency and test–retest reliability; construct validity; a seven-factor Hybrid Model; recommended cutoff scores between 31 and 33; and ability to index sensitivity to clinical change. To further advance knowledge and applications of the PCL–5, we need more research on abbreviated versions of the PCL–5, bi-factor modeling as applied to the PCL–5, as well as on PCL–5 item difficulty estimates, discrimination parameters, and clinical change score estimates.

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“…This is based on the notion that anxious arousal represents fear-based symptoms more specific to anxiety disorders, while dysphoric arousal represents mixed anxiety and depression indicators of arousal [ 2 ]. Differentiating dysphoric arousal and anxious arousal factors has received substantial support from previous studies [e.g., 34 , 35 ], particularly among Asians [e.g., 36 , 37 ] and Filipinos [e.g., 20 , 30 ]. Lastly, the hybrid model identifies a unique externalizing behaviors factor of PTSD.…”

Section: Discussionmentioning

confidence: 98%

“…Alternatively, the lack of positive emotions (i.e., anhedonia) does not necessarily mean they will experience negative affect (i.e., anger, guilt). Recent CFA literature supports separating the negative affect factor from the anhedonia factor [e.g., 30 ]. Second, the hybrid model differentiates the dysphoric arousal factor from the anxious arousal factor [ 2 ].…”

Section: Discussionmentioning

confidence: 99%

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Examining specific and non-specific symptoms of the best-fitting posttraumatic stress disorder model in conflict-exposed adolescents

Mordeno,

Luzano

2023

BMC Psychol

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Background The 5th revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) construes PTSD symptoms into 4 clusters (intrusion, avoidance, negative alterations in cognitions and mood, alterations in arousal and reactivity; Model 1). However, recent literature has shown that this symptom structure does not best represent PTSD. Unfortunately, the findings of studies investigating the proposed alternative models are from consensus. Adding to the complexity of the issue of symptom-grouping models is the identification of specific and non-specific symptoms of PTSD. The present study aims to address these gaps by identifying the best-fitting PTSD model and subsequently examining what symptoms are considered specific and non-specific to PTSD in adolescent-survivors of armed political conflict and violence. Methods The study utilized a sample of 641 adolescent victim survivors. We conducted CFA analyses and compared nested models through the scaled χ2 difference test, while comparison of non-nested models was done using the Bayesian information criterion (BIC). The best-fitted model was used in the consequent analysis, where we statistically controlled for the effect of non-specific psychological distress on PTSD by comparing the factor loadings and factor correlations before and after accounting for distress using the Aroian z-test. Results The results provide support for the 7-factor hybrid model of PTSD over other proposed models for the current sample. Moreover, the data reveal that only 7 items could be construed as core symptoms, while the rest of the symptoms can be considered non-PTSD specific. Conclusions Overall, the findings provide support for the validity of the hybrid PTSD model among political conflict-exposed adolescents. The results also show that the DSM-5 PTSD has both specific and non-specific features in the present sample of conflict-exposed adolescents. This has potential implications for theory, practice, and treatment of the disorder.

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Investigating the latent dimensions of posttraumatic stress disorder and the role of anxiety sensitivity in combat-exposed Filipino soldiers

Cited by 4 publications

References 93 publications

Gender as a moderator of the association of military sexual trauma and posttraumatic stress symptoms

Gender as a moderator of the association of military sexual trauma and posttraumatic stress symptoms

The Posttraumatic Stress Disorder (PTSD) Checklist for DSM–5: A systematic review of existing psychometric evidence.

Examining specific and non-specific symptoms of the best-fitting posttraumatic stress disorder model in conflict-exposed adolescents

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