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The latent structure of post-traumatic stress disorder: tests of invariance by gender and trauma type

Published online by Cambridge University Press:  07 March 2008

H. Chung  and
N. Breslau
H. Chung*
Affiliation:
Department of Epidemiology, Michigan State University, East Lansing, MI, USA
N. Breslau
Affiliation:
Department of Epidemiology, Michigan State University, East Lansing, MI, USA
*
*Address for correspondence: H. Chung, Ph.D., Department of Epidemiology, Michigan State University, B 601 West Fee Hall, East Lansing, MI 48823, USA. (Email: hchung@epi.msu.edu)
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Abstract

Background

Measurement invariance of Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) post-traumatic stress disorder (PTSD) criterion symptoms was tested by gender and trauma type, assaultive and non-assaultive.

Method

Analysis was conducted using latent class analysis (LCA), based on findings that the three-class LCA model from Breslau et al. (Archives of General Psychiatry 2005, 62, 1343–1351) fits the data across the four groups best. The classes represent three levels of PTSD-related disturbance: no disturbance, intermediate disturbance and pervasive disturbance, with the last one approximating the DSM-IV PTSD diagnosis.

Results

Analysis of measurement invariance showed that, with respect to gender, there was no evidence of differential symptom reporting within the same disturbance class. DSM-IV symptom indicators represent the latent structure of PTSD equally in males and females. We found that more female than male victims of assaultive violence experienced pervasive disturbance. In the absence of measurement variability associated with gender, the finding is likely to reflect a gender difference in susceptibility. The analysis of measurement invariance detected evidence of variability associated with trauma type. Victims of assaultive violence in the pervasive disturbance class report more severe distress (especially emotional numbing) than do victims of non-assaultive violence in the same class.

Conclusions

The finding of measurement bias associated with type of trauma raises questions about the applicability of a single definition for PTSD associated with assaultive violence and PTSD associated with traumatic events of lesser magnitude.

Keywords

Genderlatent structuremeasurement invariancepost-traumatic stress disordertrauma type
Type
Original Articles
Information
Psychological Medicine , Volume 38 , Issue 4 , April 2008 , pp. 563 - 573
Copyright
Copyright © Cambridge University Press 2008

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References

APA (1994). Diagnostic and Statistical Manual of Mental Disorders: DSM-IV. American Psychiatric Association: Washington, DC.Google Scholar
Asmundson, GJ, Frombach, I, McQuaid, J, Pedrelli, P, Lenox, R, Stein, MB (2000). Dimensionality of posttraumatic stress symptoms: a confirmatory factor analysis of DSM-IV symptom clusters and other symptom models. Behavioral Research and Therapy 38, 203–214.CrossRefGoogle ScholarPubMed
Asmundson, GJ, Stapleton, JA, Taylor, S (2004). Are avoidance and numbing distinct PTSD symptom clusters? Journal of Trauma Stress 17, 467–475.CrossRefGoogle ScholarPubMed
Bandeen-Roche, K, Miglioretti, DL, Zeger, SL, Rathouz, PJ (1997). Latent variable regression for multiple discrete outcomes. Journal of the American Statistical Association 92, 1375–1386.CrossRefGoogle Scholar
Breslau, N, Chase, GA, Anthony, JC (2002). The uniqueness of the DSM definition of post-traumatic stress disorder: implications for research. Psychological Medicine 32, 573–576.CrossRefGoogle ScholarPubMed
Breslau, N, Chilcoat, HD, Kessler, RC, Peterson, EL, Lucia, VC (1999). Vulnerability to assaultive violence: further specification of the sex difference in post-traumatic stress disorder. Psychological Medicine 29, 813–821.CrossRefGoogle ScholarPubMed
Breslau, N, Kessler, RC, Chilcoat, HD, Schultz, LR, Davis, GC, Andreski, P (1998 a). Trauma and posttraumatic stress disorder in the community: the 1996 Detroit Area Survey of Trauma. Archives of General Psychiatry 55, 626–632.CrossRefGoogle ScholarPubMed
Breslau, N, Kessler, RC, Peterson, EL (1998 b). Post-traumatic stress disorder assessment with a structured interview: reliability and concordance with a standardized clinical interview. Journal of Methods in Psychiatric Research 7, 121–127.CrossRefGoogle Scholar
Breslau, N, Lucia, VC, Davis, GC (2004 a). Partial PTSD versus full PTSD: an empirical examination of associated impairment. Psychological Medicine 34, 1205–1214.CrossRefGoogle ScholarPubMed
Breslau, N, Reboussin, BA, Anthony, JC, Storr, CL (2005). The structure of posttraumatic stress disorder: latent class analysis in 2 community samples. Archives of General Psychiatry 62, 1343–1351.CrossRefGoogle ScholarPubMed
Breslau, N, Wilcox, HC, Storr, CL, Lucia, VC, Anthony, JC (2004 b). Trauma exposure and posttraumatic stress disorder: a study of youths in urban America. Journal of Urban Health 81, 530–544.CrossRefGoogle ScholarPubMed
Buckley, TC, Blanchard, EB, Hickling, EJ (1998). A confirmatory factor analysis of posttraumatic stress symptoms. Behavioral Research and Therapy 36, 1091–1099.CrossRefGoogle ScholarPubMed
Bulik, CM, Sullivan, PF, Kendler, KS (2000). An empirical study of the classification of eating disorders. American Journal of Psychiatry 157, 886–895.CrossRefGoogle ScholarPubMed
Chung, H, Flaherty, BP, Schultz, LR (2006). Latent class logistic regression: application to marijuana use and attitudes among high school seniors. Journal of the Royal Statistical Society Series A, 169, 723–743.CrossRefGoogle Scholar
Horowitz, MJ (1976). Stress Response Syndromes. Aronson: New York, NY.Google Scholar
Keel, PK, Fichter, M, Quadflieg, N, Bulik, CM, Baxter, MG, Thornton, L, Halmi, KA, Kaplan, AS, Strober, M, Woodside, DB, Crow, SJ, Mitchell, JE, Rotondo, A, Mauri, M, Cassano, G, Treasure, J, Goldman, D, Berrettini, WH, Kaye, WH (2004). Application of a latent class analysis to empirically define eating disorder phenotypes. Archives of General Psychiatry 61, 192–200.CrossRefGoogle ScholarPubMed
Kellam, SG, Anthony, JC (1998). Targeting early antecedents to prevent tobacco smoking: findings from an epidemiologically based randomized field trial. American Journal of Public Health 88, 1490–1495.CrossRefGoogle ScholarPubMed
Kellam, SG, Werthamer-Larsson, L, Dolan, LJ, Brown, CH, Mayer, LS, Rebok, GW, Anthony, JC, Laudolff, J, Edelsohn, G (1991). Developmental epidemiologically based preventive trials: baseline modeling of early target behaviors and depressive symptoms. American Journal of Community Psychology 19, 563–584.CrossRefGoogle ScholarPubMed
Kendler, KS, Karkowski, LM, Walsh, D (1998). The structure of psychosis: latent class analysis of probands from the Roscommon Family Study. Archives of General Psychiatry 55, 492–499.CrossRefGoogle ScholarPubMed
Kendler, KS, Karkowski-Shuman, L, O'Neill, FA, Straub, RE, MacLean, CJ, Walsh, D (1997). Resemblance of psychotic symptoms and syndromes in affected sibling pairs from the Irish Study of High-Density Schizophrenia Families: evidence for possible etiologic heterogeneity. American Journal of Psychiatry 154, 191–198.Google ScholarPubMed
Kessler, RC, Sonnega, A, Bromet, E, Hughes, M, Nelson, CB (1995). Posttraumatic stress disorder in the National Comorbidity Survey. Archives of General Psychiatry 52, 1048–1060.CrossRefGoogle ScholarPubMed
King, DW, Leskin, GA, King, LA, Weathers, FW (1998). Confirmatory factor analysis of the clinician-administered PTSD scale: evidence for the dimensionality of posttraumatic stress disorder. Psychological Assessment 10, 90–96.CrossRefGoogle Scholar
McNally, RJ (2003). Progress and controversy in the study of posttraumatic stress disorder. Annual Review of Psychology 54, 229–252.CrossRefGoogle Scholar
Simms, LJ, Watson, D, Doebbeling, BN (2002). Confirmatory factor analyses of posttraumatic stress symptoms in deployed and nondeployed veterans of the Gulf War. Journal of Abnormal Psychology 111, 637–647.CrossRefGoogle ScholarPubMed
Storr, CL, Reboussin, BA, Anthony, JC (2004). Early childhood misbehavior and the estimated risk of becoming tobacco-dependent. American Journal of Epidemiology 160, 126–130.CrossRefGoogle ScholarPubMed
Sullivan, PF, Kessler, RC, Kendler, KS (1998). Latent class analysis of lifetime depressive symptoms in the national comorbidity survey. American Journal of Psychiatry 155, 1398–1406.CrossRefGoogle ScholarPubMed
Taylor, S, Kuch, K, Koch, WJ, Crockett, DJ, Passey, G (1998). The structure of posttraumatic stress symptoms. Journal of Abnormal Psychology 107, 154–160.CrossRefGoogle ScholarPubMed
Tolin, DF, Foa, EB (2006). Sex differences in trauma and posttraumatic stress disorder: a quantitative review of 25 years of research. Psychological Bulletin 132, 959–992.CrossRefGoogle ScholarPubMed
Wilcox, HC, Anthony, JC (2004). The development of suicide ideation and attempts: an epidemiologic study of first graders followed into young adulthood. Drug and Alcohol Dependence 76 (Suppl.), S53–S67.CrossRefGoogle ScholarPubMed
WHO (1997). Composite International Diagnostic Interview. World Health Organization: Geneva, Switzerland.Google Scholar
Young, A (1995). The Harmony of Illusions: Inventing Post-Traumatic Stress Disorder. Princeton University Press: Princeton, NJ.Google Scholar