Citation

Forbes D, Lockwood E, Creamer M, Bryant RA, McFarlane AC, Silove D, Nickerson A, O'Donnell M. Br. J. Psychiatry 2015; 206(3): 245-251.

Affiliation

David Forbes, PhD, Emma Lockwood, PGDipPsych, Mark Creamer, PhD, Australian Centre For Posttraumatic Mental Health and Department of Psychiatry, University of Melbourne, Victoria; Richard A. Bryant, PhD, School of Psychology, University of New South Wales, New South Wales; Alexander C. McFarlane, MD, Centre for Traumatic Stress Studies, University of Adelaide, South Australia; Derrick Silove, MD, School of Psychiatry, University of New South Wales, New South Wales; Angela Nickerson, PhD, School of Psychology, University of New South Wales, New South Wales; Meaghan O'Donnell, PhD, Australian Centre for Posttraumatic Mental Health and Department of Psychiatry, University of Melbourne, Victoria, Australia.

Copyright

(Copyright © 2015, Royal College of Psychiatry)

DOI

10.1192/bjp.bp.114.150078

PMID

25573397

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.

Language: en