The 7-factor hybrid model of DSM-5 PTSD symptoms and alcohol consumption and consequences in a national sample of trauma-exposed veterans

Erwin, Meredith Claycomb; Charak, Ruby; Durham, Tory A.; Armour, Chérie; Lv, Xin; Southwick, Steven M.; Elhai, Jon D.; Pietrzak, Robert H.

doi:10.1016/j.janxdis.2017.08.001

Cited by 63 publications

(9 citation statements)

References 59 publications

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“…Of interest, early childhood adversity may be one of the most critical factors modulating this neurobiological vulnerability. It is remarkable that two studies in this review showed a clear association between anhedonia and substance use severity, specifically in a population of individuals exposed to trauma (21, 23). Given the high prevalence of early childhood adversity within individuals with DUS, future studies need to explore whether this subgroup is associated with anhedonia.…”

Section: Discussionmentioning

confidence: 81%

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Addiction, Anhedonia, and Comorbid Mood Disorder. A Narrative Review

et al. 2019

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Background: Recently, anhedonia has been recognized as an important Research Domain Criterion (RDoC) by the National Institute of Mental Health. Anhedonia is proposed to play an essential role in the pathogenies of both addictive and mood disorders, and possibly their co-occurrence with a single individual. However, up to now, comprehensive information about anhedonia concerning its underlying neurobiological circuitries, the neurocognitive correlates, and their role in addiction, mood disorder, and comorbidity remains scarce. Aim: In this literature review of human studies, we bring together the current state of knowledge with respect to anhedonia in its relationship with disorders in the use of substances (DUS) and the comorbidity with mood disorders. Method: A PubMed search was conducted using the following search terms: (Anhedonia OR Reward Deficiency) AND ((Drug Dependence OR Abuse) OR Alcohol OR Nicotine OR Addiction OR Gambling OR (Internet Gaming)). Thirty-two articles were included in the review. Results: Anhedonia is associated with substance use disorders, and their severity is especially prominent in DUS with comorbid depression. Anhedonia may be both a trait and a state dimension in its relation to DUS and tends to impact DUS treatment outcome negatively.

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Section: Discussionmentioning

confidence: 81%

“…A sample of 916 trauma-exposed US military veterans was drawn from a larger dataset from the National Health and Resilience in Veterans Study (NHRVS, 21). A subsample was chosen that endorsed a “worst” traumatic event on the Traumatic History Screen.…”

Section: Resultsmentioning

confidence: 99%

Addiction, Anhedonia, and Comorbid Mood Disorder. A Narrative Review

et al. 2019

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“…However, this idea requires further elaboration since only limited externalizing symptoms had been assessed in this study. In particular there is no information about alcohol consumption (Claycomb Erwin et al, 2017) or aggression (Durham et al, 2016), which could be relevant for traumatized populations and would be required to test the relation of the factors to externalizing symptoms. This finding is also in line with previous studies (Armour et al, 2011, 2012, 2013; Ross et al, 2018) that also found a strong association between the dysphoric arousal factor and symptoms of depression.…”

Section: Discussionmentioning

confidence: 99%

Dimensional Structure and Cultural Invariance of DSM V Post-traumatic Stress Disorder Among Iraqi and Syrian Displaced People

et al. 2019

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While the factor structure of post-traumatic stress disorder (PTSD) symptoms has been investigated among various traumatized populations in Western and high-income countries, knowledge regarding the validity of factor structure of PTSD among culturally diverse populations in low-and-middle-income countries is limited. The current study examined the factor structure and cultural invariance of PTSD in 521 Iraqi and 993 Syrian war-affected displaced people who were living in the Kurdistan Region of Iraq. Results from confirmatory factor analyses demonstrated that alternative factor models for PTSD, including a new model derived from this population (anhedonia and affect model) resulted in a better fit than the current DSM V models. Taken together, the results showed that a good fit, as well as the measurement invariance of PTSD factors, could be obtained by applying the anhedonia and hybrid model. This study provides further support for the anhedonia and hybrid model of PTSD and fills an important gap in knowledge about the validity of PTSD symptom clusters among Arab and Kurdish populations.

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“…First, to our knowledge, no previous study has investigated PTSD latent models, based on DSM-5, criteria among adolescents with history of childhood maltreatment and trauma exposure. This is relevant because most studies examining PTSD latent structure have been conducted with adult samples (e.g., Contractor et al, 2018;Erwin et al, 2017;Mordeno et al, 2017). The few studies conducted with adolescents have used clinical (Sachser et al, 2018) or community samples (Liu, Wang, Cao, Qing, & Armour, 2016) or youth exposed to natural disasters (Cao et al, 2017;Zhou, Wu, & Zhen, 2017) or accidents (Wang et al, 2017).…”

Section: Discussionmentioning

confidence: 99%

“…Nevertheless, several recent confirmatory factor analysis (CFA) studies have indicated that the seven-factor hybrid model, which incorporates the key features of previous six-factor models, such as the anhedonia (Liu et al, 2014) and externalizing behavior (Tsai et al, 2015) models, has been the model that seems to best represent the DSM-5 PTSD symptoms. For instance, the sevenfactor hybrid model has demonstrated significantly better fit than the alternative PTSD models in samples of traumatized adults exposed to natural disasters (Mordeno, Carpio, Nalipay, & Saavedra, 2017), war (Erwin et al, 2017), and one or multiple traumatic events (Contractor, Caldas, Dolan, Lagdon, & Armour, 2018), as well as in community and traumatized youth samples exposed to high-intensity earthquakes (Cao, Wang, Cao, Zhang, & Elhai, 2017) or one or multiple traumatic events (Murphy et al, 2017).…”

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confidence: 99%

Alternative Models of DSM‐5 Posttraumatic Stress Disorder in Portuguese Adolescents Exposed to Trauma and Childhood Adversity

Correia-Santos

Morgado

Maia

et al. 2019

Journal of Traumatic Stress

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The factor structure of DSM-5 posttraumatic stress disorder (PTSD) has been extensively debated, with evidence supporting the recently proposed seven-factor hybrid model. However, few studies examining PTSD symptom structure have assessed the implications of these proposed models on diagnostic criteria and PTSD prevalence. In the present study, we examined seven alternative DSM-5 PTSD models within a confirmatory factor analysis (CFA), using the Child PTSD Symptom Scale-Self-Report for DSM-5 (CPSS-5). Additionally, we generated prevalence rates for each of the seven models by using a symptom-based diagnostic algorithm and assessed whether substance abuse, depression, anxiety symptoms, and daily functioning were differentially associated with PTSD depending on the model used to derive the diagnosis. Participants were 317 adolescents aged 13-17 years (M = 15.93, SD = 1.23) who had experienced a DSM-5 Criterion A trauma and/or childhood adversity. The CFA results showed good fit indices for all models, with the seven-factor hybrid model presenting the best fit. The rates of PTSD diagnosis varied according to each model. The four-factor DSM-5 model presented the highest rate (30.6%), and the seven-factor hybrid model presented the lowest rate (17.4%). Similar to the CFA analysis, the inclusion criteria for the diagnosis based on the hybrid model also presented the strongest associations with daily functional impairment, odds ratio (OR) = 1.48, 95% CI [1.25, 1.75]; and adverse childhood experiences, OR = 1.46, 95% CI [1.16, 1.82]. Research and clinical implications of these results are discussed, and suggestions for future investigation are presented.

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The 7-factor hybrid model of DSM-5 PTSD symptoms and alcohol consumption and consequences in a national sample of trauma-exposed veterans

Cited by 63 publications

References 59 publications

Addiction, Anhedonia, and Comorbid Mood Disorder. A Narrative Review

Addiction, Anhedonia, and Comorbid Mood Disorder. A Narrative Review

Dimensional Structure and Cultural Invariance of DSM V Post-traumatic Stress Disorder Among Iraqi and Syrian Displaced People

Alternative Models of DSM‐5 Posttraumatic Stress Disorder in Portuguese Adolescents Exposed to Trauma and Childhood Adversity

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