Functional significance of a novel 7-factor model of DSM-5 PTSD symptoms: Results from the National Health and Resilience in Veterans Study

Robert H. Pietrzak*, Jack Tsai, Cherie Armour, Natalie Mota, Ilan Harpaz-Rotem, Steven M. Southwick

*Corresponding author for this work

Research output: Contribution to journalArticle

79 Citations (Scopus)

Abstract

Background While posttraumatic stress disorder (PTSD) symptoms in the recently published Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) are clustered into four factors, emerging confirmatory factor analytic studies suggest that this disorder is best characterized by seven symptom clusters, including re-experiencing, avoidance, negative affect, anhedonia, externalizing behaviors, and anxious and dysphoric arousal symptoms. To date, however, data are lacking regarding the relation between this novel model of DSM-5 PTSD symptoms and measures of clinical significance in this population (e.g., functioning).

Methods Using data from the National Health and Resilience in Veterans Study (NHRVS), a contemporary, nationally representative sample of 1484 U.S. veterans, we evaluated clinical and functional correlates of a novel 7-factor model of DSM-5 PTSD symptoms.

Results Differential patterns of associations were observed between DSM-5 PTSD symptom clusters, and psychiatric comorbidities, suicidal ideation, hostility, and functioning and quality of life. Anhedonia symptoms, in particular, were strongly related to current depression, as well as reduced mental functioning and quality of life. Externalizing behaviors were most strongly related to hostility, supporting the convergent validity of this construct. Limitations Cross-sectional design and employment of self-report measures.

Conclusions These results suggest that a more refined 7-factor model of DSM-5 PTSD symptoms may provide greater specificity in understanding associations with comorbid psychopathology, suicidal ideation, and functioning and quality of life in U.S. veterans. They further suggest that prevention and treatment efforts that target distinct aspects of the PTSD phenotype may be more effective in mitigating key clinical and functional outcomes in this population.

Original languageEnglish
Pages (from-to)522-526
Number of pages5
JournalJournal of Affective Disorders
Volume174
Early online date13 Dec 2014
DOIs
Publication statusPublished - 15 Mar 2015
Externally publishedYes

Keywords

  • Functioning
  • Posttraumatic stress disorder
  • Symptomatology
  • Trauma
  • Veterans

ASJC Scopus subject areas

  • Clinical Psychology
  • Psychiatry and Mental health

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