title: An examination of the construct validity of posttraumatic stress disorder with veterans using a revised criterion set.
abstract: Ongoing concerns exist in the literature regarding the construct of posttraumatic stress disorder (PTSD) and how to best conceptualize and measure this disorder. We compared the traditional DSM-IV PTSD symptom criteria (i.e., symptoms from clusters B, C, and D) to a revised criterion set that omits overlapping mood and other anxiety symptoms on PTSD prevalence, PTSD diagnostic caseness, associated psychiatric comorbidity, functional status, and structural validity using a cross-sectional, multi-site primary care sample of 747 veterans. After removing items theorized to overlap with mood and other anxiety disorders, PTSD prevalence was identical using both criterion sets (i.e., 12%). Overall, there were few statistically significant differences in PTSD caseness, associated psychiatric comorbidity, functional status, and structural validity across the two diagnostic criterion sets. These data provide further support that removing items that overlap with other psychiatric disorders does not significantly impact the prevalence of PTSD, its associated comorbidity and functional impairment, or its structural validity. Although the revised criterion set represents a more parsimonious model, the current study findings generally support the strong construct validity of PTSD. The implications of these study findings for research and clinical practice are discussed.
authors.affiliation: Ralph H. Johnson Veterans Affairs Medical Center, SC, USA. grubaugh@musc.edu
authors.forename: Anouk L
authors.initials: AL
authors.lastname: Grubaugh
authors.forename: Mary E
authors.initials: ME
authors.lastname: Long
authors.forename: Jon D
authors.initials: JD
authors.lastname: Elhai
authors.forename: B Christopher
authors.initials: BC
authors.lastname: Frueh
authors.forename: Kathryn M
authors.initials: KM
authors.lastname: Magruder
mesh_terms: D000368:Aged; D001008:Anxiety Disorders / Q000175:diagnosis* / Q000523:psychology; D003430:Cross-Sectional Studies; D003937:Diagnosis, Differential; D039721:Diagnostic and Statistical Manual of Mental Disorders; D004185:Disability Evaluation; D005163:Factor Analysis, Statistical; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008960:Models, Psychological; D019964:Mood Disorders / Q000175:diagnosis* / Q000523:psychology; D011569:Psychiatric Status Rating Scales / Q000592:standards*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis* / Q000523:psychology; D014728:Veterans / Q000523:psychology*