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Type: Journal article
Title: Latent structure of the proposed ICD-11 post-traumatic stress disorder symptoms: Implications for the diagnostic algorithm
Author: Forbes, D.
Lockwood, E.
Creamer, M.
Bryant, R.
McFarlane, A.
Silove, D.
Nickerson, A.
O'Donnell, M.
Citation: British Journal of Psychiatry, 2015; 206(3):245-251
Publisher: Royal College of Psychiatrists
Issue Date: 2015
ISSN: 0007-1250
Statement of
David Forbes, Emma Lockwood, Mark Creamer, Richard A. Bryant, Alexander C. McFarlane, Derrick Silove, Angela Nickerson and Meaghan O, Donnell
Abstract: BACKGROUND: The latent structure of the proposed ICD-11 post-traumatic stress disorder (PTSD) symptoms has not been explored. AIMS: To investigate the latent structure of the proposed ICD-11 PTSD symptoms. METHOD: Confirmatory factor analyses using data from structured clinical interviews administered to injury patients (n = 613) 6 years post-trauma. Measures of disability and psychological quality of life (QoL) were also administered. RESULTS: Although the three-factor model implied by the ICD-11 diagnostic criteria fit the data well, a two-factor model provided equivalent, if not superior, fit. Whereas diagnostic criteria based on this two-factor model resulted in an increase in PTSD point prevalence (5.1% v. 3.4%; z = 2.32, P<0.05), they identified individuals with similar levels of disability (P = 0.933) and QoL (P = 0.591) to those identified by the ICD-11 criteria. CONCLUSIONS: Consistent with theorised reciprocal relationships between re-experiencing and avoidance in PTSD, these findings support an alternative diagnostic algorithm requiring at least two of any of the four re-experiencing/avoidance symptoms and at least one of the two hyperarousal symptoms.
Keywords: Humans
Disability Evaluation
Factor Analysis, Statistical
Mental Disorders
Stress Disorders, Post-Traumatic
Models, Psychological
Quality of Life
Diagnostic and Statistical Manual of Mental Disorders
International Classification of Diseases
Middle Aged
Young Adult
Rights: Copyright © 2015 The Royal College of Psychiatrists, unless otherwise stated
DOI: 10.1192/bjp.bp.114.150078
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