Elaboration on posttraumatic stress disorder diagnostic criteria: a factor analytic study of PTSD exposure to war or terror.
BACKGROUND
In societies facing prolonged exposure to war and terror, empirical research provides mixed support for the posttraumatic stress disorder (PTSD) symptom clusters groupings identified by the Diagnostic and Statistical Manual (DSM-IV-TR) as re-experiencing the event, avoidance and emotional numbing, and hyperarousal.


METHODS
This study examines the validity of the PTSD symptom clusters in elements of Israeli society exposed to man-made trauma. Survivors (N=2,198) of seven different war and terror-related traumas were assessed using a DSM-IV-TR based PTSD inventory. Four confirmatory factor analytic models were compared.


CONCLUSIONS
The most acceptable model was a correlated model consisting of four factors of re-experiencing, avoidance, emotional numbing, and hyperarousal. DSM-IV-TR avoidance empirically split into active avoidance and emotional numbing. These results corroborate knowledge and suggest that in Israel, where stressors are ongoing, the PTSD symptom clusters may be reformulated in DSM-5 to consist of re-experiencing, active avoidance, emotional numbing and hyperarousal.
The Department of Criminology, Bar-Ilan University, Ramat Gan, Israel.
Moshe
M
Bensimon
Stephen Zvi
SZ
Levine
Gadi
G
Zerach
Einat
E
Stein
Vlad
V
Svetlicky
Zahava
Z
Solomon
D000328:Adult; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005163:Factor Analysis, Statistical; D005260:Female; D006801:Humans; D007557:Israel / Q000208:ethnology; D008297:Male; D008875:Middle Aged; D013313:Stress Disorders, Post-Traumatic / Q000145:classification / Q000175:diagnosis* / Q000208:ethnology; D017741:Survivors / Q000523:psychology*; D023481:Terrorism / Q000208:ethnology*; D014728:Veterans / Q000523:psychology; D014857:Warfare; D055815:Young Adult