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Assessing the Latent Factor Association Between the Dysphoria Model of PTSD and Positive and Negative Affect in Trauma Victims from India

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Abstract

The recent release of the DSM-5 comes with the division of posttraumatic stress disorder (PTSD) symptoms across four symptom clusters (American Psychiatric Association, 2013). This division is based on the support garnered by two four-factor models; Emotional Numbing (King et al., 1998) and Dysphoria (Simms et al., 2002) and a five-factor model; Dysphoric Arousal (Elhai et al., 2011). Much debate centered on the validity of the Dysphoria factor as a non-specific factor of PTSD within the Dysphoria model. In line with this, we assessed relations between the four factors of the Dysphoria model (Simms et al., 2002) and positive (PA) and negative affect (NA) in natural disaster victims (N = 200) from Leh, India, using the PTSD checklist (PCL-S) and Positive and Negative Affect Schedule (PANAS short form). Confirmatory factor analysis was implemented to assess the best-fitting model for both the PCL (PTSD) and the PANAS (affect). Two optimal models (the Dysphoria model and a two-factor model for affect) were subsequently used to assess latent variable associations across constructs. It was hypothesized that differential associations between latent factors would be evident with the Dysphoria factor being highly correlated with negative affect compared to alternative PTSD factors. Significant correlations were found between factors of the Dysphoria model and NA (0.52–0.65, p < 0.001). Comparing the association of pairs of PTSD factors with NA and PA, Wald’s tests revealed that no single PTSD factor was more related to NA than the other. Avoidance and Hyperarousal factors were correlated with PA. Results are discussed in line with literature questioning Dysphoria factor’s unique association with general distress.

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Notes

  1. As recommended we assessed for the PANAS model as a two-factor correlated model [Y-Bc2 (34, N = 200) = 54.25, p < 0.001, CFI = 0.95, TLI = 0.93, RMSEA = 0.05 [90 % CI 0.02–0.08], SRMR = 0.05], and found that PA and NA were not significantly associated with each other (r = −0.09, p > 0.05). On comparing the fit indices of two-factor correlated model with the orthogonal two-factor model, no difference in fit indices was found. Since the orthogonal two-factor model is in line with literature demonstrating PA and NA being two pure dimensions (Kercher, 1992; Mackinnon et al., 1999; Watson, Clark, & Tellegen, 1988) we decided to retain it.

References

  • American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington: Author.

    Google Scholar 

  • American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders, (4th edn. text revision). Washington, DC: Author.

  • American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders, (5th edn.). Washington, DC: Author.

  • Armour, C., Carragher, N., & Elhai, J. D. (2013). Assessing the fit of the dysphoric arousal model across two nationally representative epidemiological surveys: the Australian NSMHWB and the United States NESARC. Journal of Anxiety Disorders, 27, 109–115.

    Article  PubMed  Google Scholar 

  • Armour, C., Elhai, J. D., Richardson, D., Ractliffe, K., Wang, L., & Elklit, A. (2012). Assessing a five factor model of PTSD: is dysphoric arousal a unique PTSD construct showing differential relationships with anxiety and depression? Journal of Anxiety Disorders, 26, 368–376.

    Article  PubMed  Google Scholar 

  • Armour, C., McBride, O., Shevlin, M., & Adamson, G. (2011). Testing the robustness of the dysphoria factor of the Simms et al. (2002) model of PTSD. Psychological trauma: theory, research. Practice and Policy, 3, 139–147.

    Google Scholar 

  • Armour, C., O’Connor, M., Elklit, A., & Elhai, J. D. (2013). Assessing PTSD’s latent structure in elderly bereaved European trauma victims: evidence for a five factor dysphoric and anxious arousal model. Journal of Nervous and Mental Disease, 201, 901–906.

    Article  PubMed  Google Scholar 

  • Blanchard, E. B., Jones-Alexander, J., Buckley, T. C., & Forneris, C. A. (1996). Psychometric properties of the PTSD checklist (PCL). Behavioral Research and Therapy, 34, 669–673.

    Article  Google Scholar 

  • Elhai, J. D., Biehn, T. L., Armour, C., Klopper, J. J., Fruench, B. C., & Palmiere, P. A. (2011). Evidence for a unique PTSD construct represented by PTSD’s D1-D3 symptoms. Journal of Anxiety Disorders, 25, 340–345.

    Article  PubMed  Google Scholar 

  • Elhai, J. D., Carvalho, L. F., Miguel, F. K., Palmieri, P. A., Primi, R., & Frueh, B. C. (2011). Testing whether posttraumatic stress disorder and major depressive disorder are similar or unique constructs. Journal of Anxiety Disorders, 25, 404–410.

    Article  PubMed  Google Scholar 

  • Elhai, J. D., Contractor, A. A., Palmieri, P. A., Forbes, D., & Richardson, J. D. (2011). Exploring the relationship between underlying dimensions of posttraumatic stress disorder and depression in a national, trauma exposed military sample. Journal of Affective Disorders, 133, 477–480.

    Article  PubMed  Google Scholar 

  • Elklit, A., Armour, C., & Shevlin, M. (2010). Testing alternative factor models of PTSD and the robustness of the dysphoria factor. Journal of Anxiety Disorders, 24, 147–154.

    Article  PubMed  Google Scholar 

  • Elklit, A., & Shevlin, M. (2007). The structure of PTSD symptoms: a test of alternative models using confirmatory factor analysis. British Journal of Clinical Psychology, 46, 299–313.

    Article  PubMed  Google Scholar 

  • Forbes, D., Creamer, M., & Biddle, D. (2001). The validity of the PTSD checklist as a measure of symptomatic change in combat-related PTSD. Behaviour Research and Therapy, 39, 977–986.

    Article  PubMed  Google Scholar 

  • Forbes, D., Elhai, J. D., Lockwood, E., Creamer, M., Frueh, C. B., & Magruder, K. M. (2012). The structure of posttraumatic psychopathology in veterans attending primary care. Journal of Anxiety Disorders, 26, 95–101.

    Article  PubMed  Google Scholar 

  • Forbes, D., Parslow, R., Creamer, M., O’Donnell, M., Bryant, R., McFarlane, A., et al. (2010). A longitudinal analysis of posttraumatic stress disorder symptoms and their relationship with fear and anxious-misery disorders: implications for DSM-V. Journal of Affective Disorders, 127, 147–152.

    Article  PubMed  Google Scholar 

  • Gohil, E., & Charak, R. (2013). Meaning in life, life satisfaction and positive and negative affect in older adults: effect of gender and type of residence. Indian Journal of Positive Psychology, 4(1), 55–59.

    Google Scholar 

  • Grant, D. M., Beck, J. G., Marques, L., Palyo, S. A., & Clapp, J. D. (2008). The structure of distress following trauma: posttraumtic stress disorder, major depressive disorder, and generalized anxiety disorder. Journal of Abnormal Psychology, 117, 662–672.

    Article  PubMed  Google Scholar 

  • Gros, D. F., Simms, L. J., & Acierno, R. (2010). Specificity of posttraumatic stress disorder symptoms: an investigation of comorbidity between posttraumatic stress disorder symptoms and depression in treatment-seeking veterans. Journal of Nervous and Mental Diseases, 198, 885–890.

    Article  Google Scholar 

  • Hu, L., & Bentler, P. M. (1999). Cutoff criteria versus new alternatives. Structural Equation Modeling, 6, 1–55.

    Article  Google Scholar 

  • IBM Corp. (2011). IBM SPSS Statistics for Windows, version 20.0. Armonk: IBM Corp.

    Google Scholar 

  • Kercher, K. (1992). Assessing subjective well-being in the old-old: the PANAS as a measure of orthogonal dimensions of positive and negative affect. Research on Aging, 14, 131–168.

    Article  Google Scholar 

  • King, D. W., Leskin, G. A., King, L. A., & Weathers, F. W. (1998). Confirmatory factor analysis of the clinical-administered PTSD scale: evidence for the dimensionality of posttraumatic stress disorder. Psychological Assessment, 10, 90–96.

    Article  Google Scholar 

  • Larsen, R. J., & Diener, E. (1992). Promises and problems with the circumplex model of emotions. In M. S. Clark (vol. ed.), Review of personality and social psychology (volume 13). Newbury Park, CA: Sage.

    Google Scholar 

  • Mackinnon, A., Jorm, A. F., Christensen, H., Korten, A. E., Jacomb, P. A., & Rodgers, B. (1999). A short form of the positive and negative affect schedule: evaluation of the factorial validity and invariance across demographic variables in a community sample. Personality and Individual Differences, 27, 405–416.

    Article  Google Scholar 

  • Marshall, G. N., Schell, T. L., & Miles, J. N. V. (2010). All PTSD symptoms are highly associated with general distress: ramifications for the dysphoria symptom cluster. Journal of Abnormal Psychology, 119, 126–135.

    Article  PubMed Central  PubMed  Google Scholar 

  • Miller, M. W., Wolf, E. J., Harrington, K. M., Brown, T. A., Kaloupek, D. G., & Keane, T. M. (2010). An evaluation of competing models for the structure of PTSD symptoms using external measures of comorbidity. Journal of Traumatic Stress, 23, 631–638.

    Article  PubMed  Google Scholar 

  • Mineka, S., Watson, D., & Clark, L. A. (1998). Comorbidity of anxiety and unipolar mood disorders. Annual Review of Psychology, 49, 377–412.

    Article  PubMed  Google Scholar 

  • Muthén, B. O., & Muthén, L. K. (2013). Mplus (version 7.11). Los Angeles, CA: Author.

    Google Scholar 

  • Palmieri, P., Weathers, F. W., Difede, J., & King, D. W. (2007). Confirmatory factor analysis of the PTSD checklist and the clinician-administered PTSD scale in disaster workers exposed to the World Trade Center Ground Zero. Journal of Abnormal Psychology, 116, 329–341.

    Article  PubMed  Google Scholar 

  • Pietrzak, R. H., Tsai, R., Harpaz-Rotem, I., Whealin, J. M., & Southwick, S. M. (2012). Support for a novel five-factor model of posttraumatic stress symptoms in three independent samples of Iraq/Afghanistan veterans: a confirmatory factor analytic study. Journal of Psychiatric Research, 46, 317–322.

    Article  PubMed  Google Scholar 

  • Rigdon, E. E. (1996). CFI versus RMSEA: a comparison of two indexes for the structural equation modeling. Structural Equation Modeling, 3, 369–379.

    Article  Google Scholar 

  • Shevlin, M., McBride, O., Armour, C., & Adamson, G. (2009). Reconciling the differences between the Kings et al. (1998) and Simms et al. (2002) factor models of PTSD. Journal of Anxiety Disorders, 23, 995–1001.

    Article  PubMed  Google Scholar 

  • Simms, L. J., Watson, D., & Doebbeling, B. N. (2002). Confirmatory factor analyses of posttraumatic stress symptoms in deployed and nondeployed veterans of Gulf War. Journal of Abnormal Psychology, 111, 637–647.

    Article  PubMed  Google Scholar 

  • Semage, S. N., Sivayogan, S., Forbes, D., O’Donnell, M., Monaragala, R. M., Lockwood, E., et al. (2013). Cross-cultural and factorial validity of PTSD checklist military version (PCL-M) in Sinhalese language. European Journal of Psychotraumatology, 4, 16–24. doi:10.3402/ejpt.v4i0.19707

    Article  Google Scholar 

  • Suresh, G., Furr, L. A., & Srikrishnan, A. K. (2009). An assessment of the mental health of street-based sex workers in Chennai, India. Journal of Contemporary Criminal Justice, 25, 186–201.

    Article  Google Scholar 

  • Wang, L., Zhang, J., Shi, Z., Zhou, M., Li, Z., Zhang, K., et al. (2011). Comparing alternative factor models of PTSD symptoms across earthquake victims and violent riot witnesses in China: evidence for a five-factor model proposed by Elhai et al. (2011). Journal of Anxiety Disorders, 25, 771–776.

    Article  PubMed  Google Scholar 

  • Watson, D. (2005). Rethinking the mood and anxiety disorders: a quantitative hierarchical model for DSM-V. Journal of Abnormal Psychology, 114, 522–536.

    Article  PubMed  Google Scholar 

  • Watson, D., & Clark, L. A. (1994). The PANAS-X: manual for the positive and negative affect schedule-expanded form. Ames: The University of Iowa.

    Google Scholar 

  • Watson, D., Clark, L. A., & Stasik, S. M. (2011). Emotions and the emotional disorders: a quantitative hierarchical perspective. International Journal of Clinical and Health Psychology, 11, 429–442.

    Google Scholar 

  • Weather, F. W., Litz, B. T., Herman, D. S., Huska, J. A., & Keane, T. M. (1993). The PTSD Checklist (PCL): reliability, validity, and diagnostic utility. San Antonio, TX: Annual Convention of the International Society for Traumatic Stress Studies.

  • Watson, D., Clark, L. A., & Tellegen, A. (1988). Development and validation of brief measures of positive and negative affect: the PANAS scales. Journal of Personality and Social Psychology, 54, 1063–1070.

    Article  PubMed  Google Scholar 

  • Yuan, K. H., & Bentler, P. M. (2000). Three likelihood-based methods for mean and covariance structure analysis with nonnormal missing data. Sociological Methodology, 30, 165–200.

    Article  Google Scholar 

  • Yufik, T., & Simms, L. J. (2010). A meta-analytic investigation of the structure of posttraumatic stress disorder symptoms. Journal of Abnormal Psychology, 119, 764–776.

    Google Scholar 

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Charak, R., Armour, C., Elklit, A. et al. Assessing the Latent Factor Association Between the Dysphoria Model of PTSD and Positive and Negative Affect in Trauma Victims from India. Psychol. Inj. and Law 7, 122–130 (2014). https://doi.org/10.1007/s12207-014-9192-0

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