Margo C Hurlocker1, Desirae N Vidaurri1, Lisa-Ann J Cuccurullo2, Kelly Maieritsch3, C Laurel Franklin4. 1. Southeast Louisiana Veterans Health Care System, 2400 Canal St., New Orleans, LA 70119, USA. 2. Southeast Louisiana Veterans Health Care System, 2400 Canal St., New Orleans, LA 70119, USA; South Central VA Healthcare Network Mental Illness Research, Education, and Clinical Center (MIRECC), 2400 Canal Street., New Orleans, LA 70119, USA; Department of Psychiatry and Behavioral Sciences, Tulane University School of Medicine, 1430 Tulane Ave, New Orleans, LA 70112, USA. 3. Edward Hines Jr. VA Hospital, 5000 South 5th Avenue, Hines, IL 60141, USA. 4. Southeast Louisiana Veterans Health Care System, 2400 Canal St., New Orleans, LA 70119, USA; South Central VA Healthcare Network Mental Illness Research, Education, and Clinical Center (MIRECC), 2400 Canal Street., New Orleans, LA 70119, USA; Department of Psychiatry and Behavioral Sciences, Tulane University School of Medicine, 1430 Tulane Ave, New Orleans, LA 70112, USA. Electronic address: laurel.franklin@va.gov.
Abstract
BACKGROUND: Posttraumatic stress disorder (PTSD) is a complex psychiatric illness that can be difficult to diagnose, due in part to its comorbidity with major depressive disorder (MDD). Given that researchers have found no difference in prevalence rates of PTSD and MDD after accounting for overlapping symptoms, the latent structures of PTSD and MDD may account for the high comorbidity. In particular, the PTSD Negative Alterations in Cognition and Mood (NACM) and Hyperarousal factors have been characterized as non-specific to PTSD. Therefore, we compared the factor structures of the Diagnostic and Statistical Manual of Mental Disorders, 5thedition (DSM-5) PTSD and MDD and examined the mediating role of the PTSD NACM and Hyperarousal factors on the relationship between MDD and PTSD symptom severity. METHODS: Participants included 598 trauma-exposed veterans (Mage = 48.39, 89% male) who completed symptom self-report measures of DSM-5 PTSD and MDD. RESULTS: Confirmatory factor analyses indicated an adequate-fitting four-factor DSM-5 PTSD model and two-factor MDD model. Compared to other PTSD factors, the PTSD NACM factor had the strongest relationship with the MDD Affective factor, and the PTSD NACM and Hyperarousal factors had the strongest association with the MDD Somatic factor. Further, the PTSD NACM factor explained the relationship between MDD factors and PTSD symptom severity. More Affective and Somatic depression was related to more NACM symptoms, which in turn were related to increased severity of PTSD. LIMITATIONS: Limitations include the reliance on self-report measures and the use of a treatment-seeking, trauma-exposed veteran sample which may not generalize to other populations. CONCLUSIONS: Implications concerning the shared somatic complaints and psychological distress in the comorbidity of PTSD and MDD are discussed. Published by Elsevier B.V.
BACKGROUND:Posttraumatic stress disorder (PTSD) is a complex psychiatric illness that can be difficult to diagnose, due in part to its comorbidity with major depressive disorder (MDD). Given that researchers have found no difference in prevalence rates of PTSD and MDD after accounting for overlapping symptoms, the latent structures of PTSD and MDD may account for the high comorbidity. In particular, the PTSD Negative Alterations in Cognition and Mood (NACM) and Hyperarousal factors have been characterized as non-specific to PTSD. Therefore, we compared the factor structures of the Diagnostic and Statistical Manual of Mental Disorders, 5thedition (DSM-5) PTSD and MDD and examined the mediating role of the PTSD NACM and Hyperarousal factors on the relationship between MDD and PTSD symptom severity. METHODS:Participants included 598 trauma-exposed veterans (Mage = 48.39, 89% male) who completed symptom self-report measures of DSM-5 PTSD and MDD. RESULTS: Confirmatory factor analyses indicated an adequate-fitting four-factor DSM-5 PTSD model and two-factor MDD model. Compared to other PTSD factors, the PTSD NACM factor had the strongest relationship with the MDD Affective factor, and the PTSD NACM and Hyperarousal factors had the strongest association with the MDD Somatic factor. Further, the PTSD NACM factor explained the relationship between MDD factors and PTSD symptom severity. More Affective and Somatic depression was related to more NACM symptoms, which in turn were related to increased severity of PTSD. LIMITATIONS: Limitations include the reliance on self-report measures and the use of a treatment-seeking, trauma-exposed veteran sample which may not generalize to other populations. CONCLUSIONS: Implications concerning the shared somatic complaints and psychological distress in the comorbidity of PTSD and MDD are discussed. Published by Elsevier B.V.
Entities:
Keywords:
DSM-5; Major Depressive Disorder; Military Veterans; Posttraumatic Stress Disorder
Authors: Murray W Enns; Natalie Mota; Tracie O Afifi; Shay-Lee Bolton; J Don Richardson; Scott B Patten; Jitender Sareen Journal: Can J Psychiatry Date: 2021-01-07 Impact factor: 4.356
Authors: Athena D F Sherman; Sarah Allgood; Kamila A Alexander; Meredith Klepper; Monique S Balthazar; Miranda Hill; Christopher M Cannon; Deborah Dunn; Tonia Poteat; Jacquelyn Campbell Journal: Violence Against Women Date: 2021-06-25