title: Latent structure of the proposed ICD-11 post-traumatic stress disorder symptoms: implications for the diagnostic algorithm.
abstract: BACKGROUND
  The latent structure of the proposed ICD-11 post-traumatic stress disorder (PTSD) symptoms has not been explored.
  
  
  OBJECTIVE
  To investigate the latent structure of the proposed ICD-11 PTSD symptoms.
  
  
  METHODS
  Confirmatory factor analyses using data from structured clinical interviews administered to injury patients (n = 613) 6 years post-trauma. Measures of disability and psychological quality of life (QoL) were also administered.
  
  
  RESULTS
  Although the three-factor model implied by the ICD-11 diagnostic criteria fit the data well, a two-factor model provided equivalent, if not superior, fit. Whereas diagnostic criteria based on this two-factor model resulted in an increase in PTSD point prevalence (5.1% v. 3.4%; z = 2.32, P<0.05), they identified individuals with similar levels of disability (P = 0.933) and QoL (P = 0.591) to those identified by the ICD-11 criteria.
  
  
  CONCLUSIONS
  Consistent with theorised reciprocal relationships between re-experiencing and avoidance in PTSD, these findings support an alternative diagnostic algorithm requiring at least two of any of the four re-experiencing/avoidance symptoms and at least one of the two hyperarousal symptoms.
authors.affiliation: David Forbes, PhD, Emma Lockwood, PGDipPsych, Mark Creamer, PhD, Australian Centre For Posttraumatic Mental Health and Department of Psychiatry, University of Melbourne, Victoria; Richard A. Bryant, PhD, School of Psychology, University of New South Wales, New South Wales; Alexander C. McFarlane, MD, Centre for Traumatic Stress Studies, University of Adelaide, South Australia; Derrick Silove, MD, School of Psychiatry, University of New South Wales, New South Wales; Angela Nickerson, PhD, School of Psychology, University of New South Wales, New South Wales; Meaghan O'Donnell, PhD, Australian Centre for Posttraumatic Mental Health and Department of Psychiatry, University of Melbourne, Victoria, Australia.
authors.forename: David
authors.initials: D
authors.lastname: Forbes
authors.affiliation: David Forbes, PhD, Emma Lockwood, PGDipPsych, Mark Creamer, PhD, Australian Centre For Posttraumatic Mental Health and Department of Psychiatry, University of Melbourne, Victoria; Richard A. Bryant, PhD, School of Psychology, University of New South Wales, New South Wales; Alexander C. McFarlane, MD, Centre for Traumatic Stress Studies, University of Adelaide, South Australia; Derrick Silove, MD, School of Psychiatry, University of New South Wales, New South Wales; Angela Nickerson, PhD, School of Psychology, University of New South Wales, New South Wales; Meaghan O'Donnell, PhD, Australian Centre for Posttraumatic Mental Health and Department of Psychiatry, University of Melbourne, Victoria, Australia.
authors.forename: Emma
authors.initials: E
authors.lastname: Lockwood
authors.affiliation: David Forbes, PhD, Emma Lockwood, PGDipPsych, Mark Creamer, PhD, Australian Centre For Posttraumatic Mental Health and Department of Psychiatry, University of Melbourne, Victoria; Richard A. Bryant, PhD, School of Psychology, University of New South Wales, New South Wales; Alexander C. McFarlane, MD, Centre for Traumatic Stress Studies, University of Adelaide, South Australia; Derrick Silove, MD, School of Psychiatry, University of New South Wales, New South Wales; Angela Nickerson, PhD, School of Psychology, University of New South Wales, New South Wales; Meaghan O'Donnell, PhD, Australian Centre for Posttraumatic Mental Health and Department of Psychiatry, University of Melbourne, Victoria, Australia.
authors.forename: Mark
authors.initials: M
authors.lastname: Creamer
authors.affiliation: David Forbes, PhD, Emma Lockwood, PGDipPsych, Mark Creamer, PhD, Australian Centre For Posttraumatic Mental Health and Department of Psychiatry, University of Melbourne, Victoria; Richard A. Bryant, PhD, School of Psychology, University of New South Wales, New South Wales; Alexander C. McFarlane, MD, Centre for Traumatic Stress Studies, University of Adelaide, South Australia; Derrick Silove, MD, School of Psychiatry, University of New South Wales, New South Wales; Angela Nickerson, PhD, School of Psychology, University of New South Wales, New South Wales; Meaghan O'Donnell, PhD, Australian Centre for Posttraumatic Mental Health and Department of Psychiatry, University of Melbourne, Victoria, Australia.
authors.forename: Richard A
authors.initials: RA
authors.lastname: Bryant
authors.affiliation: David Forbes, PhD, Emma Lockwood, PGDipPsych, Mark Creamer, PhD, Australian Centre For Posttraumatic Mental Health and Department of Psychiatry, University of Melbourne, Victoria; Richard A. Bryant, PhD, School of Psychology, University of New South Wales, New South Wales; Alexander C. McFarlane, MD, Centre for Traumatic Stress Studies, University of Adelaide, South Australia; Derrick Silove, MD, School of Psychiatry, University of New South Wales, New South Wales; Angela Nickerson, PhD, School of Psychology, University of New South Wales, New South Wales; Meaghan O'Donnell, PhD, Australian Centre for Posttraumatic Mental Health and Department of Psychiatry, University of Melbourne, Victoria, Australia.
authors.forename: Alexander C
authors.initials: AC
authors.lastname: McFarlane
authors.affiliation: David Forbes, PhD, Emma Lockwood, PGDipPsych, Mark Creamer, PhD, Australian Centre For Posttraumatic Mental Health and Department of Psychiatry, University of Melbourne, Victoria; Richard A. Bryant, PhD, School of Psychology, University of New South Wales, New South Wales; Alexander C. McFarlane, MD, Centre for Traumatic Stress Studies, University of Adelaide, South Australia; Derrick Silove, MD, School of Psychiatry, University of New South Wales, New South Wales; Angela Nickerson, PhD, School of Psychology, University of New South Wales, New South Wales; Meaghan O'Donnell, PhD, Australian Centre for Posttraumatic Mental Health and Department of Psychiatry, University of Melbourne, Victoria, Australia.
authors.forename: Derrick
authors.initials: D
authors.lastname: Silove
authors.affiliation: David Forbes, PhD, Emma Lockwood, PGDipPsych, Mark Creamer, PhD, Australian Centre For Posttraumatic Mental Health and Department of Psychiatry, University of Melbourne, Victoria; Richard A. Bryant, PhD, School of Psychology, University of New South Wales, New South Wales; Alexander C. McFarlane, MD, Centre for Traumatic Stress Studies, University of Adelaide, South Australia; Derrick Silove, MD, School of Psychiatry, University of New South Wales, New South Wales; Angela Nickerson, PhD, School of Psychology, University of New South Wales, New South Wales; Meaghan O'Donnell, PhD, Australian Centre for Posttraumatic Mental Health and Department of Psychiatry, University of Melbourne, Victoria, Australia.
authors.forename: Angela
authors.initials: A
authors.lastname: Nickerson
authors.affiliation: David Forbes, PhD, Emma Lockwood, PGDipPsych, Mark Creamer, PhD, Australian Centre For Posttraumatic Mental Health and Department of Psychiatry, University of Melbourne, Victoria; Richard A. Bryant, PhD, School of Psychology, University of New South Wales, New South Wales; Alexander C. McFarlane, MD, Centre for Traumatic Stress Studies, University of Adelaide, South Australia; Derrick Silove, MD, School of Psychiatry, University of New South Wales, New South Wales; Angela Nickerson, PhD, School of Psychology, University of New South Wales, New South Wales; Meaghan O'Donnell, PhD, Australian Centre for Posttraumatic Mental Health and Department of Psychiatry, University of Melbourne, Victoria, Australia.
authors.forename: Meaghan
authors.initials: M
authors.lastname: O'Donnell
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000465:Algorithms; D001315:Australia / Q000453:epidemiology; D015897:Comorbidity; D039721:Diagnostic and Statistical Manual of Mental Disorders; D004185:Disability Evaluation; D005163:Factor Analysis, Statistical; D006801:Humans; D038801:International Classification of Diseases; D001523:Mental Disorders / Q000453:epidemiology*; D008875:Middle Aged; D008960:Models, Psychological; D011788:Quality of Life; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis* / Q000453:epidemiology*; D055815:Young Adult