Michael E Reichenheim1, Aline G Oliveira1, Claudia L Moraes1,2, Evandro S Coutinho1,3, Ivan Figueira4, Gustavo Lobato5. 1. Departamento de Epidemiologia, Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, RJ, Brazil. 2. Programa de Mestrado em Saúde da Família, Universidade Estácio de Sá, Rio de Janeiro, RJ, Brazil. 3. Departamento de Epidemiologia, Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz (Fiocruz), Rio de Janeiro, RJ, Brazil. 4. Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil. 5. Instituto Fernandes Figueira, Fiocruz, Rio de Janeiro, RJ, Brazil.
Abstract
OBJECTIVE: The dimensional structure of posttraumatic stress disorder (PTSD) has been extensively debated, but the literature is still inconclusive and contains gaps that require attention. This article sheds light on hitherto unvisited methodological issues, reappraising several key models advanced for the DSM-IV-based civilian version of the PTSD Checklist (PCL-C) as to their configural and metric structures. METHODS: The sample comprised 456 women, interviewed at 6-8 weeks postpartum, who attended a high-complexity facility in Rio de Janeiro, Brazil. Confirmatory factor analysis (CFA) and exploratory structural equation models (ESEM) were used to evaluate the dimensional structure of the PCL-C. RESULTS: The original three-factor solution was rejected, along with the four-factor structures most widely endorsed in the literature (PTSD-dysphoria and PTSD-numbing models). Further exploration supported a model comprised of two factors (re-experience/avoidance and numbing/hyperarousal). CONCLUSION: These findings are at odds with the dimensional structure proposed in both DSM-IV and DSM-5. This also entails a different presumption regarding the latent structure of PTSD and how the PCL should be operationalized.
OBJECTIVE: The dimensional structure of posttraumatic stress disorder (PTSD) has been extensively debated, but the literature is still inconclusive and contains gaps that require attention. This article sheds light on hitherto unvisited methodological issues, reappraising several key models advanced for the DSM-IV-based civilian version of the PTSD Checklist (PCL-C) as to their configural and metric structures. METHODS: The sample comprised 456 women, interviewed at 6-8 weeks postpartum, who attended a high-complexity facility in Rio de Janeiro, Brazil. Confirmatory factor analysis (CFA) and exploratory structural equation models (ESEM) were used to evaluate the dimensional structure of the PCL-C. RESULTS: The original three-factor solution was rejected, along with the four-factor structures most widely endorsed in the literature (PTSD-dysphoria and PTSD-numbing models). Further exploration supported a model comprised of two factors (re-experience/avoidance and numbing/hyperarousal). CONCLUSION: These findings are at odds with the dimensional structure proposed in both DSM-IV and DSM-5. This also entails a different presumption regarding the latent structure of PTSD and how the PCL should be operationalized.
Authors: Peng Nie; Lanlin Ding; Zhuo Chen; Shiyong Liu; Qi Zhang; Zumin Shi; Lu Wang; Hong Xue; Gordon G Liu; Youfa Wang Journal: Int J Equity Health Date: 2021-04-26
Authors: Wanying Mao; Medard Adu; Ejemai Eboreime; Reham Shalaby; Nnamdi Nkire; Belinda Agyapong; Hannah Pazderka; Gloria Obuobi-Donkor; Ernest Owusu; Folajinmi Oluwasina; Yanbo Zhang; Vincent I O Agyapong Journal: Int J Environ Res Public Health Date: 2022-08-08 Impact factor: 4.614