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Jiang W, Tian Y, Fan F, Fu F, Wei D, Tang S, Chen J, Li Y, Zhu R, Wang L, Shi Z, Wang D, Zhang XY. Effects of comorbid posttraumatic stress disorder on cognitive dysfunction in Chinese male methamphetamine patients. Prog Neuropsychopharmacol Biol Psychiatry 2022; 119:110611. [PMID: 35907518 DOI: 10.1016/j.pnpbp.2022.110611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Revised: 07/21/2022] [Accepted: 07/23/2022] [Indexed: 10/16/2022]
Abstract
OBJECTIVES Cognitive dysfunction and posttraumatic stress disorder (PTSD) are common in methamphetamine patients. However, few studies have investigated the cognitive performance of methamphetamine patients with PTSD. The purpose of this study was to investigate the impact of comorbid PTSD on cognitive function in Chinese male methamphetamine patients. METHODS We analyzed 464 methamphetamine patients and 156 healthy volunteers. The PTSD Screening Scale (PCL-5) was used to assess PTSD and the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) was used to assess cognitive function. RESULTS Compared with healthy controls, methamphetamine patients had more cognitive dysfunction in immediate memory, visuospatial/constructional, language, attention and delayed memory. Moreover, methamphetamine patients with PTSD had less cognitive dysfunction in immediate memory, attention, and delayed memory than methamphetamine patients without PTSD. Further stepwise regression analysis showed that PTSD alterations in arousal and reactivity cluster were risk predictors for language, and PTSD negative alteration in cognition and mood cluster were risk predictors for delayed memory. CONCLUSIONS Our results indicate that methamphetamine patients without PTSD have poorer cognitive dysfunction than those with PTSD. Some demographic and PTSD symptom clusters are protective or risk factors for cognitive dysfunction in methamphetamine patients.
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Affiliation(s)
- Wei Jiang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Yang Tian
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Fusheng Fan
- Xin Hua Drug Rehabilitation Center, Sichuan, China
| | - Fabing Fu
- Xin Hua Drug Rehabilitation Center, Sichuan, China
| | - Dejun Wei
- Xin Hua Drug Rehabilitation Center, Sichuan, China
| | | | - Jiajing Chen
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Yuqing Li
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Rongrong Zhu
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Li Wang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Zhanbiao Shi
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China.
| | - Dongmei Wang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China.
| | - Xiang-Yang Zhang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China.
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Li J, Jiang W, Zhu R, Fan F, Fu F, Wei D, Tang S, Tian Y, Chen J, Li Y, Zhou H, Wang L, Wang D, Zhang XY. Depression in Chinese men with methamphetamine dependence: Prevalence, correlates and relationship with alexithymia. J Affect Disord 2022; 319:235-243. [PMID: 36162653 DOI: 10.1016/j.jad.2022.09.064] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 08/10/2022] [Accepted: 09/20/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND The comorbidity between substance use disorder and major depressive disorder is a typical dual diagnosis in the field of substance addiction. However, the prevalence and correlates of depression in methamphetamine addicts and whether it is associated with drug craving and alexithymia have been rarely reported in the Chinese population. METHODS We recruited 585 methamphetamine-dependent males from a drug rehabilitation center in China and 203 healthy controls. Demographic and drug use data were collected. Depression was assessed using the Mini International Neuropsychiatric Interview (M.I.N·I.). Methamphetamine cravings and alexithymia were assessed using the Desire for Drugs Questionnaire (DDQ) and the Toronto Alexithymia Scale (TAS). RESULTS The prevalence rate of depression in methamphetamine-dependent men was 16.58 % (97/585). The scores of DDQ desire and intention, DDQ negative reinforcement, total DDQ, difficulty identifying feelings (DIF), difficulty describing feelings (DDF), and total TAS score of depressed patients were higher than those of non-depressed patients. However, only DDQ negative reinforcement score, DIF, DDF, and total TAS score remained significant after Bonferroni correction. Additionally, logistic regression analysis found that age, DIF score, and DDQ negative reinforcement score were significant factors contributing to depression in methamphetamine-dependent men. CONCLUSION Our findings suggest that the prevalence of depression is significantly higher in methamphetamine-dependent men than in the healthy Chinese population. Furthermore, age, components of alexithymia and drug craving are risk factors for depression in methamphetamine addicts.
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Affiliation(s)
- Jiaxin Li
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Wei Jiang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Rongrong Zhu
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Fusheng Fan
- Xin Hua Drug Rehabilitation Center, Sichuan, China
| | - Fabing Fu
- Xin Hua Drug Rehabilitation Center, Sichuan, China
| | - Dejun Wei
- Xin Hua Drug Rehabilitation Center, Sichuan, China
| | | | - Yang Tian
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Jiajing Chen
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Yuqing Li
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Huixia Zhou
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Li Wang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Dongmei Wang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China.
| | - Xiang-Yang Zhang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China.
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Prevalence of Posttraumatic Stress Disorder Symptoms Following Traumatic Spinal Cord Injury: A Systematic Review and Meta-analysis. Harv Rev Psychiatry 2022; 30:271-282. [PMID: 36103682 DOI: 10.1097/hrp.0000000000000340] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND Limited evidence is currently available on the prevalence of posttraumatic stress disorder (PTSD) following traumatic spinal cord injury (SCI). This systematic review and meta-analysis aims to assess the prevalence and geographic distribution of PTSD symptoms after SCI. METHODS After a search in the MEDLINE, Embase, Scopus, and Web of Science databases, two reviewers independently summarized relevant studies published through 20 October 2021. Observational studies were included. The studies were eligible if they assessed PTSD symptoms using standard self-report or clinician-based instruments. Data and results were reported using the overall prevalence and the odds ratio (OR), with 95% confidence intervals (CIs). RESULTS 24 articles (5646 patients) met the inclusion criteria. The prevalence of PTSD symptoms ranged from 6.33% (95% CI, 2.73-13.97) to 61.76% (95% CI, 52.07-70.61). Pooled analysis demonstrated that the overall prevalence of PTSD symptoms in SCI patients was significantly higher in developing countries (41.64%; 95% CI, 31.11-52.55) than in developed countries (19.35%; 95% CI, 14.66-24.51) (OR = 1.24; 95% CI, 1.08-1.42; p = .003). The highest prevalence of PTSD symptoms was reported in South Africa (56.25%; 95% CI, 47.01-65.08), followed by Sri Lanka (45.71%; 95% CI, 30.47-61.81), and Greece (43.55%; 95% CI, 31.94-55.91). By contrast, Norway (6.33%; 95% CI, 2.73-13.97), Switzerland/Germany (8.65%; 95% CI, 4.8-13.42), and Denmark (10.71%; 95% CI, 6.89-16.30) were found to have the lowest prevalence of PTSD symptoms after SCI. CONCLUSION Many traumatic SCI patients suffer from PTSD symptoms, and their prevalence seems to be higher in developing countries than in developed countries. These findings underscore the need to consider the psychological aspects of traumatic SCI.
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Jiang W, Ren Z, Yu L, Tan Y, Shi C. A Network Analysis of Post-traumatic Stress Disorder Symptoms and Correlates During the COVID-19 Pandemic. Front Psychiatry 2020; 11:568037. [PMID: 33240124 PMCID: PMC7683419 DOI: 10.3389/fpsyt.2020.568037] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Accepted: 09/29/2020] [Indexed: 12/14/2022] Open
Abstract
Background and Objective: The coronavirus disease 2019 (COVID-19) outbreak has been suggested as a collective trauma, which presents a continuing crisis. However, the specific post-traumatic implication of this crisis has not been adequately studied yet. The current study was aimed to ascertain the most central symptom and the strong connections between symptoms of post-traumatic stress disorder (PTSD). At the same time, exploring the relationship between covariates and the network of PTSD symptoms, by taking sex, anxiety, depression, suicidal ideation, quality of life, and social support as covariates, may help us to know the arise and maintenance of PTSD symptoms and give specified suggestions to people under the shadow of COVID-19. Method: The Post-traumatic Stress Disorder Checklist for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), was used to assess the PTSD symptoms extent of 338 healthy participants over the past month. Networks were analyzed using state-of-the-art regularized partial correlation models. In addition, the centrality of the symptoms and the robustness of the results were analyzed. Results: The network analysis revealed that the especially strong connections emerged between avoidance of thoughts and avoidance of reminders, hypervigilance and exaggerated startle response, intrusive thoughts and nightmares, flashbacks and emotional cue reactivity, and detachment and restricted affect. The most central symptoms were self-destructive/reckless behavior. Incorporation of covariates into the network revealed the strong connections path between self-destructive/reckless behavior and loss of interest and depression. Conclusion: Self-destructive/reckless behavior was the most central symptom in the network of PTSD symptoms related to the COVID-19 pandemic, which as an important target of interfere may have great benefits.
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Affiliation(s)
- Wanyue Jiang
- School of Psychology, Central China Normal University, Wuhan, China.,Key Laboratory of Adolescent Cyberpsychology and Behavior, Ministry of Education, Wuhan, China
| | - Zhihong Ren
- School of Psychology, Central China Normal University, Wuhan, China.,Key Laboratory of Adolescent Cyberpsychology and Behavior, Ministry of Education, Wuhan, China
| | - Lixia Yu
- School of Psychology, Central China Normal University, Wuhan, China.,Key Laboratory of Adolescent Cyberpsychology and Behavior, Ministry of Education, Wuhan, China.,Key Laboratory of Human Development and Mental Health of Hubei Province, Wuhan, China
| | - Yafei Tan
- School of Psychology, Central China Normal University, Wuhan, China.,Key Laboratory of Adolescent Cyberpsychology and Behavior, Ministry of Education, Wuhan, China.,Key Laboratory of Human Development and Mental Health of Hubei Province, Wuhan, China
| | - Congrong Shi
- School of Psychology, Central China Normal University, Wuhan, China.,Key Laboratory of Adolescent Cyberpsychology and Behavior, Ministry of Education, Wuhan, China
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Ibrahim H, Catani C, Ismail AA, Neuner F. Dimensional Structure and Cultural Invariance of DSM V Post-traumatic Stress Disorder Among Iraqi and Syrian Displaced People. Front Psychol 2019; 10:1505. [PMID: 31354564 PMCID: PMC6629925 DOI: 10.3389/fpsyg.2019.01505] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Accepted: 06/13/2019] [Indexed: 11/22/2022] Open
Abstract
While the factor structure of post-traumatic stress disorder (PTSD) symptoms has been investigated among various traumatized populations in Western and high-income countries, knowledge regarding the validity of factor structure of PTSD among culturally diverse populations in low-and-middle-income countries is limited. The current study examined the factor structure and cultural invariance of PTSD in 521 Iraqi and 993 Syrian war-affected displaced people who were living in the Kurdistan Region of Iraq. Results from confirmatory factor analyses demonstrated that alternative factor models for PTSD, including a new model derived from this population (anhedonia and affect model) resulted in a better fit than the current DSM V models. Taken together, the results showed that a good fit, as well as the measurement invariance of PTSD factors, could be obtained by applying the anhedonia and hybrid model. This study provides further support for the anhedonia and hybrid model of PTSD and fills an important gap in knowledge about the validity of PTSD symptom clusters among Arab and Kurdish populations.
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Affiliation(s)
- Hawkar Ibrahim
- Department of Psychology, Clinical Psychology and Psychotherapy, Bielefeld University, Bielefeld, Germany.,Department of Clinical Psychology, Koya University, Koya, Iraq.,Vivo International, Konstanz, Germany
| | - Claudia Catani
- Department of Psychology, Clinical Psychology and Psychotherapy, Bielefeld University, Bielefeld, Germany.,Vivo International, Konstanz, Germany
| | - Azad Ali Ismail
- Department of Psychology, Clinical Psychology and Psychotherapy, Bielefeld University, Bielefeld, Germany.,Department of Clinical Psychology, Koya University, Koya, Iraq
| | - Frank Neuner
- Department of Psychology, Clinical Psychology and Psychotherapy, Bielefeld University, Bielefeld, Germany.,Vivo International, Konstanz, Germany
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6
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Pollock K, Dorstyn D, Butt L, Prentice S. Posttraumatic stress following spinal cord injury: a systematic review of risk and vulnerability factors. Spinal Cord 2017; 55:800-811. [PMID: 28485385 DOI: 10.1038/sc.2017.45] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2017] [Revised: 03/22/2017] [Accepted: 03/23/2017] [Indexed: 01/09/2023]
Abstract
OBJECTIVES To summarise quantitatively the available evidence relating to pretraumatic, peritraumatic and posttraumatic characteristics that may increase or decrease the risk of developing posttraumatic stress disorder (PTSD) following spinal cord injury (SCI). STUDY DESIGN Systematic review. METHODS Seventeen studies were identified from the PubMed, PsycInfo, Embase, Scopus, CINAHL, Web of Science and PILOTS databases. Effect size estimates (r) with associated 95% confidence intervals (CIs), P-values and fail-safe Ns were calculated. RESULTS Individual studies reported medium-to-large associations between factors that occurred before (psychiatric history r=0.48 (95% CI, 0.23-0.79) P=0.01) or at the time of injury (tetraplegia r=-0.36 (95% CI, -0.50 to -0.19) P<0.01). Postinjury factors had the strongest pooled effects: depressed mood (rw=0.64, (95% CI, 0.54-0.72)), negative appraisals (rw=0.63 (95% CI, 0.52-0.72)), distress (rw=0.57 (95% CI, 0.50-0.62)), anxiety (rw=0.56 (95% CI, 0.49-0.61)) and pain severity (rw=0.35 (95% CI, 0.27-0.43)) were consistently related to worsening PTSD symptoms (P<0.01). Level of injury significantly correlated with current PTSD severity for veteran populations (QB (1)=18.25, P<0.001), although this was based on limited data. CONCLUSION Combinations of peri- and post-injury factors appear to be influential in the development of PTSD among persons with SCI. Further studies are needed to extrapolate these findings to the broader spinal cord-injured population. More longitudinal research, driven by multicausal models of causation such as the diathesis-stress model, is also needed to determine the temporality of PTSD risk factors.
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Affiliation(s)
- K Pollock
- School of Psychology, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia
| | - D Dorstyn
- School of Psychology, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia
| | - L Butt
- Craig Hospital, Englewood, CO, USA
| | - S Prentice
- School of Psychology, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia
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Mordeno IG, Nalipay MJN, Sy DJS, Luzano JGC. PTSD factor structure and relationship with self-construal among internally displaced persons. J Anxiety Disord 2016; 44:102-110. [PMID: 27842239 DOI: 10.1016/j.janxdis.2016.10.013] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2016] [Revised: 08/15/2016] [Accepted: 10/28/2016] [Indexed: 10/20/2022]
Abstract
The present study examined the factor structure of six competing posttraumatic stress disorder (PTSD) models based on the recent changes in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) in a sample that, while highly vulnerable to PTSD, very few studies have focused on-Asians, particularly Filipino internally displaced persons (IDPs). In recognition of the role of culture in PTSD factor structure, we also investigated the associations of the factors of the best-fitting model with self-construal. A sample of 460 IDPs in government resettlement communities participated in the study. Results of confirmatory factor analyses revealed the seven-factor hybrid model composed of intrusion, avoidance, negative affect, anhedonia, externalizing behaviors, anxious arousal, and dysphoric arousal as the best-fitting model. Furthermore, it was found that associations between independent self-construal and PTSD factors were higher than that of interdependent self-construal and PTSD factors.
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Affiliation(s)
- Imelu G Mordeno
- Mindanao State University, Iligan Institute of Technology, Philippines
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Vindbjerg E, Carlsson J, Mortensen EL, Elklit A, Makransky G. The latent structure of post-traumatic stress disorder among Arabic-speaking refugees receiving psychiatric treatment in Denmark. BMC Psychiatry 2016; 16:309. [PMID: 27596249 PMCID: PMC5011808 DOI: 10.1186/s12888-016-0936-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2015] [Accepted: 06/20/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Refugees are known to have high rates of post-traumatic stress disorder (PTSD). Although recent years have seen an increase in the number of refugees from Arabic speaking countries in the Middle East, no study so far has validated the construct of PTSD in an Arabic speaking sample of refugees. METHODS Responses to the Harvard Trauma Questionnaire (HTQ) were obtained from 409 Arabic-speaking refugees diagnosed with PTSD and undergoing treatment in Denmark. Confirmatory factor analysis was used to test and compare five alternative models. RESULTS All four- and five-factor models provided sufficient fit indices. However, a combination of excessively small clusters, and a case of mistranslation in the official Arabic translation of the HTQ, rendered results two of the models inadmissible. A post hoc analysis revealed that a simpler factor structure is supported, once local dependence is addressed. CONCLUSIONS Overall, the construct of PTSD is supported in this sample of Arabic-speaking refugees. Apart from pursuing maximum fit, future studies may wish to test simpler, potentially more stable models, which allow a more informative analysis of individual items.
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Affiliation(s)
- Erik Vindbjerg
- Competence Centre for Transcultural Psychiatry, Mental Health Centre Ballerup, Copenhagen, Denmark. .,Department of Psychology, University of Southern Denmark, Odense, Denmark.
| | - Jessica Carlsson
- Competence Centre for Transcultural Psychiatry, Mental Health Centre Ballerup, Copenhagen, Denmark
| | - Erik Lykke Mortensen
- Department of Public Health and Center for Healthy Aging, University of Copenhagen, Copenhagen, Denmark
| | - Ask Elklit
- Department of Psychology, University of Southern Denmark, Odense, Denmark
| | - Guido Makransky
- Department of Psychology, University of Southern Denmark, Odense, Denmark
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Armour C, Műllerová J, Elhai JD. A systematic literature review of PTSD's latent structure in the Diagnostic and Statistical Manual of Mental Disorders: DSM-IV to DSM-5. Clin Psychol Rev 2015; 44:60-74. [PMID: 26761151 DOI: 10.1016/j.cpr.2015.12.003] [Citation(s) in RCA: 169] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Revised: 11/20/2015] [Accepted: 12/17/2015] [Indexed: 10/22/2022]
Abstract
The factor structure of posttraumatic stress disorder (PTSD) has been widely researched, but consensus regarding the exact number and nature of factors is yet to be reached. The aim of the current study was to systematically review the extant literature on PTSD's latent structure in the Diagnostic and Statistical Manual of Mental Disorders (DSM) in order to identify the best-fitting model. One hundred and twelve research papers published after 1994 using confirmatory factor analysis and DSM-based measures of PTSD were included in the review. In the DSM-IV literature, four-factor models received substantial support, but the five-factor Dysphoric arousal model demonstrated the best fit, regardless of gender, measurement instrument or trauma type. The recently proposed DSM-5 PTSD model was found to be a good representation of PTSD's latent structure, but studies analysing the six- and seven-factor models suggest that the DSM-5 PTSD factor structure may need further alterations.
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Affiliation(s)
- Cherie Armour
- School of Psychology, Ulster University, Coleraine, Northern Ireland, UK.
| | - Jana Műllerová
- School of Psychology, Ulster University, Coleraine, Northern Ireland, UK
| | - Jon D Elhai
- Department of Psychology, University of Toledo, Toledo, OH, USA; Department of Psychiatry, University of Toledo, Toledo, OH, USA
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Hair cortisone level is associated with PTSD׳s dysphoric arousal symptoms in highly traumatized Chinese females. J Affect Disord 2015; 182:18-22. [PMID: 25958219 DOI: 10.1016/j.jad.2015.04.036] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2014] [Revised: 04/20/2015] [Accepted: 04/21/2015] [Indexed: 01/31/2023]
Abstract
BACKGROUND Cortisone has been proposed as a useful additional biomarker for stress research. However, only very limited studies has investigated alterations of cortisone levels in stress-related mental disorder such as PTSD. The present study investigated the associations between PTSD symptomatology and hair cortisone levels which can reflect cumulative cortisone secretion over prolonged periods of time and is more robust to the influence of situational confounding. METHODS Participants included 201 females who experienced 2008 Wenchuan earthquake and lost their children during the disaster. PTSD symptoms were assessed with the PTSD Checklist (PCL), and depression symptoms with the Center for epidemiological studies depression scale (CES-D). Hair cortisone levels were quantified by liquid chromatography tandem mass spectrometer. RESULTS The results indicated that although hair cortisone secretion could not distinguish traumatized individuals with and without PTSD, it was uniquely linked to dysphoric arousal symptoms, a key aspect of the complex PTSD phenotype LIMITATIONS A sample of females exposed to specific traumatic events was used, and PTSD was assessed using a self-reported measure. CONCLUSIONS The findings provide preliminary evidence supporting the critical role of long-term cortisone changes in the development and maintenance of PTSD symptoms, and add to extant knowledge on the neuroendocrinological underpinnings of posttraumatic psychopathology.
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11
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Wang L, Zhang L, Armour C, Cao C, Qing Y, Zhang J, Liu P, Zhang B, Wu Q, Zhao Z, Fan G. Assessing the underlying dimensionality of DSM-5 PTSD symptoms in Chinese adolescents surviving the 2008 Wenchuan earthquake. J Anxiety Disord 2015; 31:90-7. [PMID: 25768398 DOI: 10.1016/j.janxdis.2015.02.006] [Citation(s) in RCA: 94] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2015] [Revised: 02/14/2015] [Accepted: 02/20/2015] [Indexed: 11/25/2022]
Abstract
By analyzing data yielded from a sample of Chinese adolescents surviving a high-intensity earthquake, this study investigated the underlying dimensionality of DSM-5 PTSD symptoms. The sample included 743 traumatized middle school students (396 females and 332 males) aged 11-17 years (mean=13.6, SD=1.0). Results of confirmatory factor analysis showed that an intercorrelated seven-factor model comprised of intrusion, avoidance, negative affect, anhedonia, externalizing behaviors, anxious arousal, and dysphoric arousal factors provided a significant better representation of DSM-5 PTSD symptoms than other alternative models. Further analyses indicated that external measures of major depression disorder and panic disorder symptoms displayed unique associations with four PTSD factors. The findings provide further support for the newly proposed seven-factor model of DSM-5 PTSD symptoms, add to very limited empirical knowledge on the latent structure of DSM-5 PTSD symptoms among adolescents, and carry implications for further refinement of the current classifications of PTSD symptoms and further clinical practice and research on posttraumatic stress symptomatology.
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Affiliation(s)
- Li Wang
- Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China.
| | - Lingmin Zhang
- Department of Psychology, Hebei Normal University, Shijiazhuang, Hebei, China
| | - Cherie Armour
- Psychology Research Institute, University of Ulster, Coleraine, Northern Ireland, UK
| | - Chengqi Cao
- Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Graduate University of Chinese Academy of Sciences, Beijing, China
| | - Yulan Qing
- Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Graduate University of Chinese Academy of Sciences, Beijing, China
| | - Jianxin Zhang
- Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Ping Liu
- Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Graduate University of Chinese Academy of Sciences, Beijing, China; People's Hospital of Deyang City, Deyang, Sichuan, China
| | - Biao Zhang
- People's Hospital of Deyang City, Deyang, Sichuan, China
| | - Qi Wu
- People's Hospital of Deyang City, Deyang, Sichuan, China
| | - Zhihong Zhao
- Hanwang People's Hospital, Deyang, Sichuan, China
| | - Gaolin Fan
- Hanwang People's Hospital, Deyang, Sichuan, China
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