Mindanao State University - Iligan Institute of Technology, Iligan City, Philippines.
BMC Psychol. 2023 Oct 24;11(1):353. doi: 10.1186/s40359-023-01389-8.
The 5th revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) construes PTSD symptoms into 4 clusters (intrusion, avoidance, negative alterations in cognitions and mood, alterations in arousal and reactivity; Model 1). However, recent literature has shown that this symptom structure does not best represent PTSD. Unfortunately, the findings of studies investigating the proposed alternative models are from consensus. Adding to the complexity of the issue of symptom-grouping models is the identification of specific and non-specific symptoms of PTSD. The present study aims to address these gaps by identifying the best-fitting PTSD model and subsequently examining what symptoms are considered specific and non-specific to PTSD in adolescent-survivors of armed political conflict and violence.
The study utilized a sample of 641 adolescent victim survivors. We conducted CFA analyses and compared nested models through the scaled χ difference test, while comparison of non-nested models was done using the Bayesian information criterion (BIC). The best-fitted model was used in the consequent analysis, where we statistically controlled for the effect of non-specific psychological distress on PTSD by comparing the factor loadings and factor correlations before and after accounting for distress using the Aroian z-test.
The results provide support for the 7-factor hybrid model of PTSD over other proposed models for the current sample. Moreover, the data reveal that only 7 items could be construed as core symptoms, while the rest of the symptoms can be considered non-PTSD specific.
Overall, the findings provide support for the validity of the hybrid PTSD model among political conflict-exposed adolescents. The results also show that the DSM-5 PTSD has both specific and non-specific features in the present sample of conflict-exposed adolescents. This has potential implications for theory, practice, and treatment of the disorder.
《精神障碍诊断与统计手册》（DSM-5）的第五次修订版将 PTSD 症状分为 4 个集群（闯入、回避、认知和情绪的负性改变、觉醒和反应性改变；模型 1）。然而，最近的文献表明，这种症状结构不能最好地代表 PTSD。不幸的是，关于替代模型的研究结果是基于共识的。增加 PTSD 症状分组模型问题复杂性的是 PTSD 的特定和非特定症状的识别。本研究旨在通过确定最适合的 PTSD 模型来解决这些差距，然后研究在经历武装政治冲突和暴力的青少年幸存者中，哪些症状被认为是 PTSD 的特定和非特定症状。
本研究使用了 641 名青少年创伤幸存者的样本。我们进行了 CFA 分析，并通过比较嵌套模型的 scaled χ 差异检验来比较嵌套模型，同时使用贝叶斯信息准则（BIC）比较非嵌套模型。使用最适合的模型进行后续分析，通过使用 Aroian z 检验比较在考虑到非特异性心理困扰后，对 PTSD 的因子负荷和因子相关性的影响，统计控制非特异性心理困扰对 PTSD 的影响。
结果为当前样本支持 PTSD 的 7 因素混合模型而不是其他提出的模型提供了支持。此外，数据显示只有 7 项可以被视为核心症状，而其余的症状可以被认为是非 PTSD 特异性的。
总的来说，这些发现支持了 PTSD 混合模型在经历政治冲突的青少年中的有效性。结果还表明，DSM-5 PTSD 在本研究样本中具有特定和非特定的特征。这对该障碍的理论、实践和治疗具有潜在的影响。
