title: Confirmatory factor analysis of the PTSD Checklist and the Clinician-Administered PTSD Scale in disaster workers exposed to the World Trade Center Ground Zero.
abstract: Although posttraumatic stress disorder (PTSD) factor analytic research has yielded little support for the DSM-IV 3-factor model of reexperiencing, avoidance, and hyperarousal symptoms, no clear consensus regarding alternative models has emerged. One possible explanation is differential instrumentation across studies. In the present study, the authors used confirmatory factor analysis to compare a self-report measure, the PTSD Checklist (PCL), and a structured clinical interview, the Clinician-Administered PTSD Scale (CAPS), in 2,960 utility workers exposed to the World Trade Center Ground Zero site. Although two 4-factor models fit adequately for each measure, the latent structure of the PCL was slightly better represented by correlated reexperiencing, avoidance, dysphoria, and hyperarousal factors, whereas that of the CAPS was slightly better represented by correlated reexperiencing, avoidance, emotional numbing, and hyperarousal factors. After accounting for method variance, the model specifying dysphoria as a distinct factor achieved slightly better fit. Patterns of correlations with external variables provided additional support for the dysphoria model. Implications regarding the underlying structure of PTSD are discussed.
authors.affiliation: Center for the Treatment and Study of Traumatic Stress and Department of Psychiatry, St. Thomas Hospital, Summa Health System, Akron, OH 44310, USA. palmierp@summa-health.org
authors.forename: Patrick A
authors.initials: PA
authors.lastname: Palmieri
authors.forename: Frank W
authors.initials: FW
authors.lastname: Weathers
authors.forename: JoAnn
authors.initials: J
authors.lastname: Difede
authors.forename: Dainel W
authors.initials: DW
authors.lastname: King
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005163:Factor Analysis, Statistical; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D009519:New York City; D009784:Occupational Diseases / Q000175:diagnosis* / Q000523:psychology; D010552:Personality Assessment / Q000706:statistics & numerical data*; D010555:Personality Inventory / Q000706:statistics & numerical data*; D011594:Psychometrics / Q000706:statistics & numerical data; D012066:Relief Work; D047851:September 11 Terrorist Attacks / Q000523:psychology*; D013223:Statistics as Topic; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis* / Q000523:psychology