Top

Journal of Psychopathology and Behavioral Assessment

Gepubliceerd in:

25-06-2016

The Underlying Role of Negative Affect in the Association between PTSD, Major Depressive Disorder, and Generalized Anxiety Disorder

Auteurs: Brianna M. Byllesby, Ruby Charak, Tory A. Durham, Xin Wang, Jon D. Elhai

Gepubliceerd in: Journal of Psychopathology and Behavioral Assessment | Uitgave 4/2016

Abstract

Clinicians and researchers have found differential diagnosis to be difficult, particularly for conceptually similar disorders. One category of particular interest has been distress or internalizing disorders, theorized to be related via an underlying construct of generalized distress or negative affect. The present study attempted to address the comorbidity of three distress disorders - posttraumatic stress disorder (PTSD), major depressive disorder (MDD), and generalized anxiety disorder (GAD) - using latent analyses by controlling for the variance attributable to negative affect. The sample consisted of 265 trauma-exposed individuals who completed self-report measures of PTSD, MDD, GAD, and negative affect. Confirmatory factor analysis was used to test initial model fit. Next, the model was re-computed, controlling for negative affect by regressing negative affectivity at the item-level. Results indicated that a significant amount of variance within and between these diagnostic categories is attributable to negative affect at both the item- and factor-level. The hypothesis that MDD’s non-somatic/affective factor and the GAD factor would have the highest attenuations in factor loadings after controlling for negative affect was supported. Therefore, negative affect significantly influences the co-occurrence of PTSD, MDD, and GAD clinically, emphasizing the need for transdiagnostic interventions for trauma victims.

vorige artikel Perfectionism, Components of Stress Reactivity, and Depressive Symptoms

volgende artikel Association between Sexual Victimization History, Posttraumatic Stress Symptoms, and Women’s Decision Making in Risky Social Situations: the Moderating Effect of Ethnicity

American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington: American Psychiatric Publishing.CrossRef

Angelakis, S., & Nixon, R. D. V. (2015). The comorbidity of PTSD and MDD: implications for clinical practice and future research. Behaviour Change, 32, 1–25. doi:10.1017/bec.2014.26.CrossRef

Armour, C., & Shevlin, M. (2009). Testing the dimensionality of PTSD and the specificity of the dysphoria factor. Journal of Loss and Trauma, 15(1), 11–27. doi:10.1080/15325020903373110.CrossRef

Armour, C., McBride, O., Shevlin, M., & Adamson, G. (2011). Testing the robustness of the dysphoria factor of the Simms et al. (2002) model of posttraumatic stress disorder. Psychological Trauma: Theory, Research, Practice, and Policy, 3(2), 139–147. doi:10.1037/a0020848.CrossRef

Armour, C., Tsai, J., Durham, T. A., Charak, R., Biehn, T. L., Elhai, J. D., & Pietrzak, R. H. (2015). Dimensional structure of DSM-5 posttraumatic stress symptoms: support for a hybrid Anhedonia and externalizing behaviors model. Journal of Psychiatric Research, 61, 106–113. doi:10.1016/j.jpsychires.2014.10.012.CrossRefPubMed

Aroian, L. A. (1947). The probability function of the product of two normally distributed variables. Annals of Mathematical Statistics, 18, 265–271.CrossRef

Baas, K. D., Cramer, A. O. J., Koeter, M. W. J., van de Lisdonk, E. H., van Weert, H. C., & Schene, A. H. (2011). Measurement invariance with respect to ethnicity of the patient health questionnaire-9 (PHQ-9). Journal of Affective Disorders, 129, 229–235. doi:10.1016/j.jad.2010.08.026.CrossRefPubMed

Beck, J. G., Jones, J. M., Reich, C. M., Woodward, M. J., & Cody, M. W. (2015). Understanding the role of dysfunctional post-trauma cognitions in the co-occurrence of posttraumatic stress disorder and generalized anxiety disorder: two trauma samples. Behaviour Research and Therapy, 70, 23–31. doi:10.1016/j.brat.2015.04.011.CrossRefPubMed

Biehn, T. L., Contractor, A., Elhai, J. D., Tamburrino, M., Fine, T. H., Prescott, M. R., et al. (2013a). Relations between the underlying dimensions of PTSD and major depression using an epidemiological survey of deployed Ohio National Guard soldiers. Journal of Affective Disorders, 144(1–2), 106–111. doi:10.1016/j.jad.2012.06.013.CrossRefPubMed

Biehn, T. L., Elhai, J. D., Seligman, L. D., Tamburrino, M., Armour, C., & Forbes, D. (2013b). Underlying dimensions of DSM-5 posttraumatic stress disorder and major depressive disorder symptoms. Psychological Injury and Law, 6(4), 290–298. doi:10.1007/s12207-013-9177-4.CrossRef

Blevins, C. A., Weathers, F. W., Witte, T. K., Davis, M. T. (2012). The Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5): Preliminary psychometric analysis in trauma-exposed college students. Paper presented at the International Society for Traumatic Stress Studies, Los Angeles, CA.

Brown, T. A. (2007). Temporal course and structural relationships among dimensions of temperament and DSM-IV anxiety and mood disorder constructs. Journal of Abnormal Psychology, 116, 313–328. doi:10.1037/0021-843X.116.2.313.CrossRefPubMed

Brown, T. A., Chorpita, B. F., & Barlow, D. H. (1998). Structural relationships among dimensions of the DSM-IV anxiety and mood disorders and dimensions of negative affect, positive affect, and autonomic arousal. Journal of Abnormal Psychology, 107, 179–192. doi:10.1037/0021-843X.107.2.179.CrossRefPubMed

Bryant, R. A., Moulds, M. L., Guthrie, R. M., Dang, S. T., & Nixon, R. D. V. (2003). Imaginal exposure alone and imaginal exposure with cognitive restructuring in treatment of posttraumatic stress disorder. Journal of Consulting and Clinical Psychology, 71, 706–712. doi:10.1037/0022-006X.71.4.706.CrossRefPubMed

Byllesby, B. M., Durham, T. A., Forbes, D., Armour, C., & Elhai, J. D. (2016). An investigation of PTSD’s core dimensions and relations with anxiety and depression. Psychological Trauma: Theory, Research, Practice, and Policy, 8(2), 214–217. doi:10.1037/tra0000081.CrossRef

Charak, R., Armour, C., Elklit, A., Koot, H. M., & Elhai, J. D. (2014). Assessing the latent factor association between the dysphoria model of PTSD and positive and negative affect in trauma victims from India. Psychological Injury and Law, 7(2), 122–130. doi:10.1007/s12207-014-9192-0.CrossRef

Clark, L. A., & Watson, D. (1991). Tripartite model of anxiety and depression: psychometric evidence and taxonomic implications. Journal of Abnormal Psychology, 100, 316–336. doi:10.1037/0021-843X.100.3.316.CrossRefPubMed

Contractor, A. A., Durham, T. A., Brennan, J. A., Armour, C., Wutrick, H. R., Frueh, B. C., & Elhai, J. D. (2014). DSM-5 PTSD’s symptom dimensions and relations with major depression’s symptom dimensions in a primary care sample. Psychiatry Research, 215(1), 146–153. doi:10.1016/j.psychres.2013.10.015.CrossRefPubMed

Contractor, A. A., Elhai, J. D., Fine, T. H., Tamburrino, M. B., Cohen, G., Shirley, E., et al. (2015). Latent profile analyses of posttraumatic stress disorder, depression and generalized anxiety disorder symptoms in trauma-exposed soldiers. Journal of Psychiatric Research, 68, 19–26. doi:10.1016/j.jpsychres.2015.05.014.CrossRefPubMed

Cook, J. M., Thompson, R., Coyne, J. C., & Sheikh, J. I. (2003). Algorithm versus cut-point derived PTSD in ex-prisoners of war. Journal of Psychopathology and Behavioral Assessment, 25, 267–271. doi:10.1023/A:1025851129948.CrossRef

Crawford, J. R., & Henry, J. D. (2004). The positive and negative affect schedule (PANAS): construct validity, measurement properties and normative data in a large non-clinical sample. British Journal of Clinical Psychology, 43, 245–265.CrossRefPubMed

Dear, B. F., Titov, N., Sunderland, M., McMillan, D., Anderson, T., Lorian, C., & Robinson, E. (2011). Psychometric comparison of the generalized anxiety disorder scale-7 and the Penn State worry questionnaire for measuring response during treatment of generalized anxiety disorder. Cognitive Behaviour Therapy, 40, 216–227. doi:10.1080/16506073.2011.582138.CrossRefPubMed

Durham, T. A., Elhai, J. D., Fine, T. H., Tamburrino, M., Cohen, G., Shirley, E., & Calabrese, J. R. (2015). Posttraumatic stress disorders dysphoria dimension and relations with generalized anxiety disorder symptoms. Psychiatry Research, 228(1), 150–155. doi:10.1016/j.psychres.2015.04.034.CrossRefPubMed

Elhai, J. D., Grubaugh, A. L., Kashdan, T. B., & Frueh, B. C. (2008a). Empirical examination of a proposed refinement to DSM-IV posttraumatic stress disorder symptom criteria using the National Comorbidity Survey Replication data. Journal of Clinical Psychiatry, 69, 597–602. doi:10.4088/JCP.v69n0411.CrossRefPubMed

Elhai, J. D., Franklin, C. L., & Gray, M. J. (2008b). The SCID PTSD module’s trauma screen: validity with two samples in detecting trauma history. Depression and Anxiety, 25(9), 737–741. doi:10.1002/da.20318.CrossRefPubMed

Elhai, J. D., Biehn, T. L., Armour, C., Klopper, J. J., Frueh, B. C., & Palmieri, P. A. (2011). Evidence for a unique PTSD construct represented by PTSD’s D1-D3 symptoms. Journal of Anxiety Disorders, 25(3), 340–345. doi:10.1016/j.janxdis.2010.10.007.CrossRefPubMed

Elhai, J. D., Miller, M. E., Ford, J. D., Biehn, T. L., Palmieri, P. A., & Frueh, B. C. (2012). Posttraumatic stress disorder in DSM-5: estimates of prevalence and symptom structure in a nonclinical sample of college students. Journal of Anxiety Disorders, 26(1), 58–64. doi:10.1016/j.janxdis.2011.08.013.CrossRefPubMed

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(1), 147–154. doi:10.1016/j.janxdis.2009.10.002.CrossRefPubMed

First, M. B., Spitzer, R. L., Gibbon, M., Williams, J. B. W. (2002). Structural Clinical Interview for DSM-IV-TR, Research Version, Non-patient Edition. Biometrics Research, New York State Psychiatric Institute: New York.

Foa, E. B., Rothbaum, B. O., Riggs, D. S., & Murdock, T. B. (1991). Treatment for posttraumatic stress disorder in rape victims: a comparison between cognitive-behavioral procedures and counseling. Journal of Consulting and Clinical Psychology, 59, 715–723. doi:10.1037/0022-006X.59.5.715.CrossRefPubMed

Ford, J. D., Elhai, J. D., Ruggiero, K. J., & Frueh, B. C. (2009). Refining the posttraumatic stress disorder diagnosis: evaluation of symptom criteria with the National Survey of adolescents. Journal of Clinical Psychiatry, 70, 748–755. doi:10.4088/JCP.08m04692.CrossRefPubMed

Ginzburg, K., Ein-Dor, T., & Solomon, Z. (2010). Comorbidity of posttraumatic stress disorder, anxiety and depression: a 20-year longitudinal study of war veterans. Journal of Affective Disorders, 123(1–3), 249–257. doi:10.1016/j.jad.2009.08.006.CrossRefPubMed

Goodman, L. A., Corcoran, C., Turner, K., Yuan, N., & Green, B. L. (1998). Assessing traumatic event exposure: general issues and preliminary findings for the stressful life events screening questionnaire. Journal of Traumatic Stress, 11(3), 521–542. doi:10.1023/A:1024456713321.CrossRefPubMed

Gorman, J. M. (1996). Comorbid depression and anxiety spectrum disorders. Depression and Anxiety, 4, 160–168.CrossRefPubMed

Grant, D. M., Beck, J. G., Marques, L., Palyo, S. A., & Clapp, J. D. (2008). The structure of distress following trauma: posttraumatic stress disorder, major depressive disorder, and generalized anxiety disorder. Journal of Abnormal Psychology, 117(3), 662–672. doi:10.1037/a0012591.CrossRefPubMed

Grubaugh, A. L., Long, M. E., Elhai, J. D., Frueh, B. C., & Magruder, K. M. (2010). An examination of the construct validity of posttraumatic stress disorder with veterans using a revised criterion set. Behaviour Research and Therapy, 48(9), 909–914. doi:10.1016/j.brat.2010.05.019.CrossRefPubMed

Hofmann, S. G., Schulz, S. M., Heering, S., Muench, F., & Bufka, L. F. (2010). Psychophysiological correlates of generalized anxiety disorder with or without comorbid depression. International Journal of Psychophysiology, 78, 35–41. doi:10.1016/j.ijpsycho.2009.12.016.CrossRefPubMedPubMedCentral

Holm, S. (1979). A simple sequentially rejective multiple test procedure. Scandinavian Journal of Statistics, 6, 65–70.

Hu, L., & Bentler, P. M. (1999). Cutoff criteria for fit indexes in covariance structure analysis: conventional criteria versus new alternatives. Structural Equation Modeling, 6, 1–55. doi:10.1080/10705519909540118.CrossRef

Kessler, R. C., Sonnega, A., Bromet, E., Hughes, M., & Nelson, C. B. (1995). Posttraumatic stress disorder in the National Comorbidity Survey. Archives of General Psychiatry, 52, 1048–1060. doi:10.1001/archpsyc.1995.03950240066012.CrossRefPubMed

Kessler, R. C., Berglund, P., Demler, O., Jin, R., Merikangas, K. R., & Walters, E. E. (2005). Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62, 593–602. doi:10.1001/archpsyc.62.6.593.CrossRefPubMed

King, D. W., Leskin, G. A., King, L. A., & Weathers, F. W. (1998). Confirmatory factor analysis of the clinician-administered PTSD scale: evidence for the dimensionality of posttraumatic stress disorder. Psychological Assessment, 10, 90–96. doi:10.1037/1040-3590.10.2.90.CrossRef

Kroenke, K., Spitzer, R. L., & Williams, J. B. W. (2001). The PHQ-9: validity of a brief depression severity measure. Journal of General Internal Medicine, 16, 606–613. doi:10.1046/j.1525-1497.2001.016009606.CrossRefPubMedPubMedCentral

Liu, P., Wang, L., Cao, C., Wang, R., Zhang, J., Zhang, B., et al. (2014). The underlying dimensions of DSM-5 posttraumatic stress disorder symptoms in an epidemiological sample of Chinese earthquake survivors. Journal of Anxiety Disorders, 28, 345–351. doi:10.1016/j.janxdis.2014.03008.CrossRefPubMed

Lockwood, E., & Forbes, D. (2014). Posttraumatic stress disorder and comorbidity: untangling the Gordian knot. Psychological Injury and Law, 7(2), 108–121. doi:10.1007/s12207-014-9189-8.CrossRef

Lowe, B., Decker, O., Muller, S., Brahler, E., Schelberg, D., Herzog, W., & Herzberg, P. Y. (2008). Validation and standardization of the generalized anxiety disorder screener (GAD-7) in the general population. Medical Care, 46, 266–274. doi:10.1097/MLR.0b013e318160d093.CrossRefPubMed

Milanak, M. E., Gros, D. F., Magruder, K. M., Brawman-Mintzer, O., & Frueh, B. C. (2013). Prevalence and features of generalized anxiety disorder in Department of Veteran Affairs primary care settings. Psychiatry Research, 209, 173–179. doi:10.1016/j.psychres.2013.03.031.CrossRefPubMedPubMedCentral

Mineka, S., Watson, D., & Clark, L. A. (1998). Comorbidity of anxiety and unipolar mood disorders. Annual Review of Psychology, 49, 377–412. doi:10.1146/annurev.psych.49.1.377.CrossRefPubMed

Mittal, D., Fortney, J. C., Pyne, J. M., Edlund, M. J., & Wetherell, J. L. (2006). Impact of comorbid anxiety disorders on health-related quality of life among patients with major depressive disorder. Psychiatric Services, 57, 1731–1737. doi:10.1176/appi.ps.57.12.1731.CrossRefPubMed

Naifeh, J. A., Tull, M. T., & Gratz, K. L. (2012). Anxiety sensitivity, emotional avoidance, and PTSD symptom severity among crack/cocaine dependent patients in residential treatment. Cognitive Therapy and Research, 36(3), 247–257. doi:10.1007/s10608-010-9337-8.CrossRefPubMed

Palmieri, P. A., 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(2), 329–341. doi:10.1037/0021-843X.116.2.329.CrossRefPubMed

Price, M., & van Stolk-Cooke, K. (2015). Examination of the interrelations between the factors of PTSD, major depression, and generalized anxiety disorder in a heterogeneous trauma-exposed sample using DSM 5 criteria. Journal of Affective Disorders, 186, 149–155. doi:10.1016/j.jad.2015.06.012.CrossRefPubMed

Resick, P. A., & Schnicke, M. K. (1992). Cognitive processing therapy for sexual assault victims. Journal of Consulting and Clinical Psychology, 60, 748–756. doi:10.1037/0022-006X.60.5.748.CrossRefPubMed

Rosen, G. M., & Lilienfeld, S. O. (2008). Posttraumatic stress disorder: an empirical evaluation of core assumptions. Clinical Psychology Review, 28, 837–868. doi:10.1016/j.cpr.2007.12.002.CrossRefPubMed

Rytwinski, N. K., Scur, M. D., Feeny, N. C., & Youngstrom, E. A. (2013). The co-occurrence of major depressive disorder among individuals with posttraumatic stress disorder: a meta-analysis. Journal of Traumatic Stress, 26(3), 299–309. doi:10.1002/jts.21814.CrossRefPubMed

Sartorius, N., Ustun, T. B., Lecrubier, Y., & Wittchen, H. U. (1996). Depression comorbid with anxiety: results from the WHO study on “psychological disorders in primary health care”. The British Journal of Psychiatry, 168, 38–43.CrossRef

Simms, L. J., Watson, D., & Doebbelling, B. N. (2002). Confirmatory factor analyses of posttraumatic stress symptoms in deployed and nondeployed veterans of the Gulf war. Journal of Abnormal Psychology, 111(4), 637–647. doi:10.1037/0021-843X.111.4.637.CrossRefPubMed

Spinhoven, P., Penninx, B. W., van Hemert, A. M., de Rooij, M., & Elzinga, B. M. (2014). Comorbidity of PTSD in anxiety and depressive disorders: prevalence and shared risk factors. Child Abuse & Neglect, 38(8), 1320–1330. doi:10.1016/j.chiabu.2014.01.017.CrossRef

Spitzer, R. L., Kroenke, K., Williams, J. B. W., & Lowe, B. (2006). A brief measure for assessing generalized anxiety disorder: the GAD-7. Archives of Internal Medicine, 166, 1092–1097. doi:10.1001/archinte.166.10.1092.CrossRefPubMed

Spitzer, R. L., First, M. B., & Wakefield, J. C. (2007). Saving PTSD from itself in DSM-V. Journal of Anxiety Disorders, 21(2), 233–241. doi:10.1016/j.janxdis.2006.09.006.CrossRefPubMed

Tsai, J., Elhai, J. D., Pietrzak, R. H., Hoff, R. A., & Harpaz-Rotem, I. (2014). Comparing four competing models of depressive symptomatology: a confirmatory factor analytic study of 986,647 U.S. veterans. Journal of Affective Disorders, 165, 166–169. doi:10.1016/j.jad.2014.04.075.CrossRefPubMed

Tsai, J., Harpaz-Rotem, I., Armour, C., Southwick, S. M., Krystal, J. H., & Pietrzak, R. H. (2015). Dimensional structure of DSM-5 posttraumatic stress disorder symptoms: results from the National Health and resilience in veterans study. Journal of Clinical Psychiatry, 76, 546–553. doi:10.4088/jcp.14m09091.CrossRefPubMed

Watson, D. (2009). Differentiating the mood and anxiety disorders: a quadripatrite model. Annual Review of Clinical Psychology, 5, 221–247. doi:10.1146/annurev.clinpsy.032408.153510.CrossRefPubMed

Watson, D., & Tellegen, A. (1985). Towards a consensual structure of mood. Psychological Bulletin, 98, 219–235. doi:10.1037/0033-2909.98.2.219.CrossRefPubMed

Watson, D., Clark, L. A., & Tellegen, A. (1988). Development and validation of brief measure of positive and negative affect: the PANAS scales. Journal of Personality and Social Psychology, 54, 1063–1070. doi:10.1037/0022-3514.54.6.1063.CrossRefPubMed

Watson, D., O’Hara, M. W., & Stuart, S. (2008). Hierarchical structures of affect and psychopathology and their implications for the classification of emotional disorders. Depression and Anxiety, 25(4), 282–288. doi:10.1002/da.20496.CrossRefPubMed

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. doi:10.1037/t04754-000.

Weathers, F. W., Litz, B. T., Keane, T. M., Palmieri, P. A., Marx, B. P., & Schnurr, P. P. (2013). The PTSD Checklist for DSM-5 (PCL-5). Scale available from the National Center for PTSD at www.ptsd.va.gov.

Wirth, R. J., & Edwards, M. C. (2007). Item factor analysis: current approaches and future directions. Psychological Methods, 12, 58–79. doi:10.1037/1082-989X.12.1.58.CrossRefPubMedPubMedCentral

Zbozinek, T. D., Rose, R. D., Wolitzky-Taylor, K. B., Sherbourne, C., Sullivan, G., Stein, M. B., & Craske, M. G. (2012). Diagnostic overlap of generalized anxiety disorder and major depressive disorder in a primary care sample. Depression and Anxiety, 29, 1065–1071. doi:10.1002/da.22026.CrossRefPubMedPubMedCentral

Titel: The Underlying Role of Negative Affect in the Association between PTSD, Major Depressive Disorder, and Generalized Anxiety Disorder
Auteurs: Brianna M. Byllesby
Ruby Charak
Tory A. Durham
Xin Wang
Jon D. Elhai
Publicatiedatum: 25-06-2016
Uitgeverij: Springer US
Gepubliceerd in: Journal of Psychopathology and Behavioral Assessment / Uitgave 4/2016
Print ISSN: 0882-2689
Elektronisch ISSN: 1573-3505
DOI: https://doi.org/10.1007/s10862-016-9555-9

Bohn Stafleu van Loghum

Deel dit onderdeel of sectie (kopieer de link)

Abstract

Log in om toegang te krijgen

Andere artikelen Uitgave 4/2016

Present Moment Contact and Nonjudgment: Pilot Data on Dismantling Mindful Awareness in Trauma-Related Symptomatology

The Borderline Personality Features Scale for Children (BPFS-C): Factor Structure and Measurement Invariance across Time and Sex in a Community-Based Sample

Validation of a Brief Version of the Difficulties in Emotion Regulation Scale in Five Samples

Bidimensional Emotional Health in College Students: a Comparison of Categorical and Continuous Analytic Approaches

Perfectionism, Components of Stress Reactivity, and Depressive Symptoms

Reconsidering Criterion A for the Diagnosis of Non-Suicidal Self-Injury Disorder