National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW 2052, Australia.
J Anxiety Disord. 2010 Jun;24(5):520-7. doi: 10.1016/j.janxdis.2010.03.009. Epub 2010 Mar 27.
The tripartite model of posttraumatic stress disorder (PTSD) articulated in DSM-IV has received limited empirical support. Over the past decade, a burgeoning literature on PTSD symptom structure has accumulated suggesting several alternative models. Elucidating the latent structure of PTSD has important clinical and theoretical implications. This paper presents the first confirmatory factor analytic investigation of PTSD symptoms in an epidemiologically based trauma-exposed sample from Australia. Data from a subsample of respondents from the 2007 National Survey of Mental Health and Wellbeing (NSMHWB; n=2677) were submitted to confirmatory factor analysis and several alternative conceptual models were tested. Empirical support was found for an intercorrelated four-factor model reflecting re-experiencing, avoidance, dysphoria, and hyperarousal symptoms. Given that the DSM is currently under revision, research addressing structural validity concerns is especially timely. The present findings renew calls in the structural literature suggesting that the structure of PTSD should be revised in DSM-V.
DSM-IV 中阐述的创伤后应激障碍(PTSD)的三方模型得到的实证支持有限。在过去的十年中,关于 PTSD 症状结构的大量文献积累表明了几种替代模型。阐明 PTSD 的潜在结构具有重要的临床和理论意义。本文对来自澳大利亚的基于流行病学的创伤暴露样本中的 PTSD 症状进行了首次确认性因素分析研究。2007 年全国心理健康和福利调查(NSMHWB)中受访者的一个子样本的数据被提交给了确认性因素分析,并测试了几种替代的概念模型。一个反映再体验、回避、苦恼和过度警觉症状的相互关联的四因素模型得到了实证支持。鉴于 DSM 目前正在修订,解决结构有效性问题的研究尤其具有及时性。本研究结果再次呼吁在结构文献中建议在 DSM-V 中修订 PTSD 的结构。