Pinciotti Caitlin M, Horvath Gregor, Wetterneck Chad T, Riemann Bradley C
Rogers Behavioral Health System, 34700 Valley Rd, Oconomowoc, WI 53066, USA.
Rogers Behavioral Health System, 34700 Valley Rd, Oconomowoc, WI 53066, USA.
J Anxiety Disord. 2022 Jan;85:102511. doi: 10.1016/j.janxdis.2021.102511. Epub 2021 Dec 8.
OCD and PTSD share many commonalities, including phenotypic and functional overlap in symptoms. Specifically, both disorders are characterized by unwanted, intrusive, anxiety/distress-eliciting intrusive thoughts and evoking behaviors intended to control, neutralize, suppress, or outright avoid intrusive thoughts and associated anxiety/distress. Extant factor analytic research supports a model of PTSD at odds with current DSM-5 criteria, and no examination of the factor structure of comorbid OCD+PTSD currently exists despite the noted overlap in symptomatology and high rates of comorbidity. Using a sample of 4073 patients diagnosed with OCD and/or PTSD enrolled in intensive treatment programs for OCD or PTSD, multigroup confirmatory factor analysis (MGCFA) and measurement invariance tests were run to determine the best fitting model of OCD and PTSD symptoms in patients with OCD+PTSD. Four models were compared across patients with OCD, PTSD, and OCD+PTSD: DSM-5 and 7-factor hybrid PTSD models with OCD symptoms structured as either combined or comorbid constructs. The comorbid hybrid model proved the best fit, and both hybrid models evidenced better fit than DSM-5 models. The current study lends additional support for the hybrid model of PTSD and suggests that there is no existence of a unique factor structure of OCD and PTSD symptoms in individuals with the comorbid conditions.
强迫症（OCD）和创伤后应激障碍（PTSD）有许多共同之处，包括症状在表型和功能上的重叠。具体而言，这两种障碍的特征都是出现不必要的、侵入性的、引发焦虑/痛苦的侵入性思维，以及引发旨在控制、中和、抑制或直接避免侵入性思维及相关焦虑/痛苦的行为。现有的因素分析研究支持一种与当前《精神疾病诊断与统计手册》第五版（DSM-5）标准不一致的创伤后应激障碍模型，而且尽管已注意到症状学上的重叠和高共病率，但目前尚无对强迫症合并创伤后应激障碍共病的因素结构的研究。利用4073名被诊断患有强迫症和/或创伤后应激障碍且参加强迫症或创伤后应激障碍强化治疗项目的患者样本，进行了多组验证性因素分析（MGCFA）和测量不变性检验，以确定强迫症合并创伤后应激障碍患者中强迫症和创伤后应激障碍症状的最佳拟合模型。对强迫症、创伤后应激障碍和强迫症合并创伤后应激障碍患者的四种模型进行了比较：DSM-5模型和7因素混合创伤后应激障碍模型，其中强迫症症状被构建为合并或共病结构。共病混合模型被证明是最佳拟合模型，且两种混合模型都比DSM-5模型拟合得更好。当前的研究为创伤后应激障碍的混合模型提供了更多支持，并表明在共病情况下，个体不存在独特的强迫症和创伤后应激障碍症状因素结构。
