Testing the dimensionality of posttraumatic stress responses in young Chinese adult earthquake survivors: further evidence for “dysphoric arousal” as a unique PTSD construct

Abstract

Background: This study investigated an alternative five-factor diagnostic model for posttraumatic stress disorder (PTSD) symptoms, and tested external convergent and discriminant validity of the model in a young Chinese sample of earthquake survivors. Methods: A total of 938 participants (456 women, 482 men) aged 15-20 years were recruited from a vocational school originally located in Beichuan County Town which was almost completely destroyed by the ''Wenchuan Earthquake.'' The participants were administrated with the PTSD Checklist and the Hopkins Symptoms Checklist-25 12 months after the earthquake. Results: The results of confirmatory factor analysis showed that the five-factor intercorrelated model (intrusion, avoidance, numbing, dysphoric arousal, and anxious arousal) fit the data significantly better than the four-factor numbing model proposed by King et al. (1998: Psychol Assess 10:90-96)

The Factorial Invariance Across Gender of Three Well-Supported Models

“…Previous studies have provided evidence that either the Emotional Numbing or Dysphoria models offer the best representation of the latent factor structure of PTSD symptoms (e.g., Wang et al, 2009Wang et al, , 2011aWang et al, , 2011bWang et al, , 2011creviewed in Elhai and Palmieri, 2011;Gootzeit and Markon, 2011;Yufik and Simms, 2010). We found additional empirical support for these four-factor models of PTSD.…”

“…The internal consistency (Cronbach's alpha) in the current study was 0.89. Although the PCL was primarily validated in adults (ages 18 or older), its applicability in adolescents has been demonstrated by previous studies with both Western and Chinese samples (e.g., Barnes et al, 2005;Calderoni et al, 2006;Wang et al, 2009Wang et al, , 2011aWang et al, , 2011b.…”

“…found that the alternative five-factor model fit the data significantly better than did both the Emotional Numbing and Dysphoria models in a sample of 252 female survivors of domestic violence. More recently, this model was identified to be the best-fitting model in separate samples of Chinese adolescent survivors of earthquakes and riot (Wang et al, , 2011a(Wang et al, , 2011b(Wang et al, , 2011c, Danish bereaved individuals (Armour et al, in press), and Canadian veterans and American primary care patients (Armour et al, 2012).…”

“…Subsequent support has been found for this model over and above the preexistent evidence-based four-factor models in a variety of samples who underwent trauma (cf. Armour et al, 2011b, in press;Pietrzak et al, 2012;Wang et al, 2012Wang et al, , 2011aWang et al, , 2011b. Notably, several studies have tested the factorial invariance of the Emotional Numbing and Dysphoria models across subsamples, for example, samples split by gender or culture (cf.…”

Examining posttraumatic stress disorder's latent structure between treatment-seeking and non-treatment-seeking Filipinos

“…Dysphoric arousal was found to be significantly better than dysphoria model but not with numbing model both in treatment-seeking and non-treatment-seeking samples. This implies that although recent researches, particularly those utilizing Asian respondents, support dysphoric arousal model (Mordeno, 2012;Wang et al, 2011aWang et al, , 2011bWang et al, , 2011cWang et al, , 2013, its superiority over numbing model may not be as convincing as claimed. This finding is consistent with Armour et al (2012) showing no significant difference between numbing and dysphoric arousal models.…”