Latent typologies of DSM-5 PTSD symptoms in US military veterans

被引:23
作者
Byrne, Simon P. [1 ]
Harpaz-Rotem, Ilan [2 ,3 ]
Tsai, Jack [3 ,4 ]
Southwick, Steven M. [2 ,3 ]
Pietrzak, Robert H. [2 ,3 ]
机构
[1] Yale Univ, Sch Med, Yale Child Study Ctr, New Haven, CT USA
[2] Natl Ctr PTSD, Dept Vet Affairs, Clin Neurosci Div, West Haven, CT USA
[3] Yale Univ, Dept Psychiat, Sch Med, New Haven, CT 06520 USA
[4] US Dept Vet Affairs New England, Mental Illness Res Educ & Clin Ctr, West Haven, CT USA
关键词
Posttraumatic stress disorder; Latent class analysis; Typology; Dysphoric; Threat; High symptom; POSTTRAUMATIC-STRESS-DISORDER; TRAUMA; PSYCHOPATHOLOGY; DEPRESSION;
D O I
10.1016/j.psychres.2018.12.094
中图分类号
R749 [精神病学];
学科分类号
100205 ;
摘要
Posttraumatic stress disorder (PTSD) is a heterogeneous condition that can be characterized by unique typologies of symptoms. To date, no study has examined predominant PTSD typologies using DSM-5 criteria. We used latent class analysis (LCA) to identify typologies of DSM-5 PTSD symptoms in 158 U.S. veterans who screened positive for this condition. A three-class solution provided the best fit to the data, described as Dysphoric (36.2%), High Symptom (34.0%) and Threat (29.8%). The Threat class had higher probabilities of intrusions and avoidance compared to the Dysphoric class; the Dysphoric class had higher probabilities of negative affect, anhedonia and externalizing behavior relative to Threat; the High Symptom class had high probabilities of all symptoms. Compared to the Threat class, the Dysphoric class was more likely to have a lifetime history of major depressive, alcohol and drug use disorders; the High Symptom class was more likely to have a lifetime history of alcohol, drug, and nicotine use disorder, current generalized anxiety, or to have attempted or currently contemplated suicide. The High Symptom class reported greater mental, physical and cognitive impairment and lower quality of life. These findings underscore the importance of a personalized approach to the assessment and treatment of DSM-5 PTSD.
引用
收藏
页码:266 / 273
页数:8
相关论文
共 30 条
[1]  
[Anonymous], J CLIN PSYCHIAT S20
[2]   Dimensional structure of DSM-5 posttraumatic stress symptoms: Support for a hybrid Anhedonia and Externalizing Behaviors model [J].
Armour, Cherie ;
Tsai, Jack ;
Durham, Tory A. ;
Charak, Ruby ;
Biehn, Tracey L. ;
Elhai, Jon D. ;
Pietrzak, Robert H. .
JOURNAL OF PSYCHIATRIC RESEARCH, 2015, 61 :106-113
[3]  
Asparouhov T., 2015, Auxiliary variables in mixture modeling: Using the BCH method in Mplus to estimate a distal outcome model and an arbitrary secondary model (Mplus Web Note #21), DOI DOI 10.1080/10705511.2014.915181
[4]  
Babor T.F., 2001, Primary Care, V2nd
[5]   Psychometric Properties of the PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition (PCL-5) in Veterans [J].
Bovin, Michelle J. ;
Marx, Brian P. ;
Weathers, Frank W. ;
Gallagher, Matthew W. ;
Rodriguez, Paola ;
Schnurr, Paula P. ;
Keane, Terence M. .
PSYCHOLOGICAL ASSESSMENT, 2016, 28 (11) :1379-1391
[6]   The structure of posttraumatic stress disorder - Latent class analysis in 2 community samples [J].
Breslau, N ;
Reboussin, BA ;
Anthony, JC ;
Storr, CL .
ARCHIVES OF GENERAL PSYCHIATRY, 2005, 62 (12) :1343-1351
[7]   Development and Validation of a Brief Self-Report Measure of Trauma Exposure: The Trauma History Screen [J].
Carlson, Eve B. ;
Smith, Steve R. ;
Palmieri, Patrick A. ;
Dalenberg, Constance ;
Ruzek, Josef I. ;
Kimerling, Rachel ;
Burling, Thomas A. ;
Spain, David A. .
PSYCHOLOGICAL ASSESSMENT, 2011, 23 (02) :463-477
[8]   Empirically derived lifespan polytraumatization typologies: A systematic review [J].
Contractor, Ateka A. ;
Caldas, Stephanie ;
Fletcher, Shelley ;
Shea, M. Tracie ;
Armour, Cherie .
JOURNAL OF CLINICAL PSYCHOLOGY, 2018, 74 (07) :1137-1159
[9]  
Derogatis L.R., 2001, BSI 18, Brief Symptom Inventory 18: Administration, scoring and procedures manual
[10]   Predominant typologies of psychopathology in the United States: A latent class analysis [J].
El-Gabalawy, Renee ;
Tsai, Jack ;
Harpaz-Rotem, Ilan ;
Hoff, Rani ;
Sareen, Jitender ;
Pietrzak, Robert H. .
JOURNAL OF PSYCHIATRIC RESEARCH, 2013, 47 (11) :1649-1657