Testing the robustness of the dysphoria factor of the Simms et al. (2002) model of posttraumatic stress disorder

The Simms et al. (2002) four-factor structure of posttraumatic stress disorder (PTSD) has been supported in many factor analytic studies, and the specificity of the dysphoria factor has been questioned because of its strong associations with measures of depression and anxiety. This study addressed this issue by conducting a confirmatory factor analysis while controlling for the symptoms of major depression (MD) and generalized anxiety disorder (GAD). Data from individuals who satisfied Criterion A of the diagnostic criteria for a Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) diagnosis of PTSD (n = 12,467) in the 2004-2005 National Epidemiologic Study on Alcohol and Related Conditions (NESARC) were used in the analysis. The results showed that after controlling for MD and GAD, the factor loadings for dysphoria items were significantly attenuated, although they remained relatively high and statistically significant. The present findings contribute to the debate regarding how PTSD should be conceptualized and assessed in future issues of the DSM.