John C Moring1, Erica Nason2, Willie J Hale3, Jennifer Schuster Wachen4, Katherine A Dondanville5, Casey Straud5, Brian A Moore3, Jim Mintz6, Brett T Litz7, Jeffrey S Yarvis8, Stacey Young-McCaughan5, Alan L Peterson9, Patricia A Resick10. 1. Department of Psychiatry, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA. Electronic address: moringj@uthscsa.edu. 2. School of Social Work, Texas State University, San Marcos, TX, USA. 3. Department of Psychiatry, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA; Department of Psychology, University of Texas at San Antonio, San Antonio, TX, USA. 4. National Center for PTSD, VA Boston Healthcare System, Boston, MA, USA; Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA. 5. Department of Psychiatry, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA. 6. Department of Psychiatry, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA; Department of Epidemiology and Biostatistics, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA. 7. Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA; Massachusetts Veterans Epidemiological Research and Information Center, VA Boston Healthcare System, Boston, MA, USA; Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA. 8. Department of Behavioral Health, Carl R. Darnall Army Medical Center, Fort Hood, TX, USA. 9. Department of Psychiatry, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA; Department of Psychology, University of Texas at San Antonio, San Antonio, TX, USA; Research and Development Service, South Texas Veterans Health Care System, San Antonio, TX, USA. 10. Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA.
Abstract
BACKGROUND: Among active duty service members and veterans with PTSD, depression is the most commonly diagnosed comorbid psychiatric condition. More research is warranted to investigate the relationship between PTSD and depression to improve treatment approaches. Byllesby et al. (2017) used confirmatory factor analyses in a sample of trauma-exposed combat veterans with PTSD and found that only the general distress factor, and not any specific symptom cluster of PTSD, predicted depression. This study seeks to replicate Byllesby et al. (2017) in a sample of treatment-seeking active duty soldiers. METHODS: Confirmatory factor analyses, bifactor modeling, and structural equation modeling (SEM) were used with data gathered at pretreatment and posttreatment as part of a large randomized clinical trial. RESULTS: Confirmatory factor analyses and bifactor modeling demonstrated that PTSD symptom clusters, Negative Alterations in Cognition and Mood (NACM) and Alterations in Arousal and Reactivity (AAR), as well as the general distress factor significantly predicted depression at pretreatment and posttreatment. LIMITATIONS: The current study was predominantly male, limiting the generalizability to female service members with PTSD. Also, self-report measures were used, which may introduce response-bias. CONCLUSIONS: The current study did not replicate Byllesby et al. (2017). Results demonstrated that the relationship between PTSD and depression among active duty service members can be explained by both transdiagnostic factors and disorder-specific symptoms.
BACKGROUND: Among active duty service members and veterans with PTSD, depression is the most commonly diagnosed comorbid psychiatric condition. More research is warranted to investigate the relationship between PTSD and depression to improve treatment approaches. Byllesby et al. (2017) used confirmatory factor analyses in a sample of trauma-exposed combat veterans with PTSD and found that only the general distress factor, and not any specific symptom cluster of PTSD, predicted depression. This study seeks to replicate Byllesby et al. (2017) in a sample of treatment-seeking active duty soldiers. METHODS: Confirmatory factor analyses, bifactor modeling, and structural equation modeling (SEM) were used with data gathered at pretreatment and posttreatment as part of a large randomized clinical trial. RESULTS: Confirmatory factor analyses and bifactor modeling demonstrated that PTSD symptom clusters, Negative Alterations in Cognition and Mood (NACM) and Alterations in Arousal and Reactivity (AAR), as well as the general distress factor significantly predicted depression at pretreatment and posttreatment. LIMITATIONS: The current study was predominantly male, limiting the generalizability to female service members with PTSD. Also, self-report measures were used, which may introduce response-bias. CONCLUSIONS: The current study did not replicate Byllesby et al. (2017). Results demonstrated that the relationship between PTSD and depression among active duty service members can be explained by both transdiagnostic factors and disorder-specific symptoms.
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