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Factor Structure of the PTSD Checklist for DSM-5: Relationships Among Symptom Clusters, Anger, and Impulsivity

Armour, Cherie PhD; Contractor, Ateka MA; Shea, Tracie PhD; Elhai, Jon D. PhD; Pietrzak, Robert H. PhD, MPH

The Journal of Nervous and Mental Disease: February 2016 - Volume 204 - Issue 2 - p 108–115
doi: 10.1097/NMD.0000000000000430
Original Articles
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Scarce data are available regarding the dimensional structure of Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) posttraumatic stress disorder (PTSD) symptoms and how factors relate to external constructs. We evaluated six competing models of DSM-5 PTSD symptoms, including Anhedonia, Externalizing Behaviors, and Hybrid models, using confirmatory factor analyses in a sample of 412 trauma-exposed college students. We then examined whether PTSD symptom clusters were differentially related to measures of anger and impulsivity using Wald chi-square tests. The seven-factor Hybrid model was deemed optimal compared with the alternatives. All symptom clusters were associated with anger; the strongest association was between externalizing behaviors and anger (r = 0.54). All symptom clusters, except reexperiencing and avoidance, were associated with impulsivity, with the strongest association between externalizing behaviors and impulsivity (r = 0.49). A seven-factor Hybrid model provides superior fit to DSM-5 PTSD symptom data, with the externalizing behaviors factor being most strongly related to anger and impulsivity.

*School of Psychology, University of Ulster, Coleraine, Northern Ireland, UK; †Department of Psychology, University of Toledo, OH; ‡Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, and §Veterans Affairs Medical Center, Providence, RI; ∥Department of Psychiatry, University of Toledo, OH; and ¶Department of Psychiatry, Yale University School of Medicine, New Haven, and US Department of Veterans Affairs, National Center for Posttraumatic Stress Disorder, Clinical Neurosciences Division, VA Connecticut Healthcare System, West Haven, CT.

Send reprint requests to Cherie Armour, PhD, School of Psychology, Coleraine Campus, University of Ulster, Coleraine, Northern Ireland, UK BT52 1SA. E-mail: armour.cherie@gmail.com.

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