title: The structure of PTSD in active-duty marines across the deployment cycle.
abstract: OBJECTIVE
  There has been significant debate about the optimal factor structure of posttraumatic stress disorder (PTSD). In military and veteran samples, most available studies have employed self-report measures, assessed PTSD cross-sectionally, used treatment-seeking samples, and assessed symptoms years after deployment. We extend previous studies by comparing the factor structure of clinician-assessed and self-report Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) PTSD in a nontreatment seeking sample at 4 time points spanning the deployment cycle.
  
  
  METHODS
  The data source for this study was the Marine Resiliency Study (MRS), a longitudinal study of 4 battalion cohorts of active-duty male Marines deployed to Iraq and Afghanistan between 2008 and 2012. We examined the fourth cohort (N = 892), which was evaluated 1 month predeployment, and 1, 5, and 8 months postdeployment.
  
  
  RESULTS
  Confirmatory factor analyses (CFA) revealed that the 5-factor solution best fit the data across all time points, and across both interview and self-report assessments.
  
  
  CONCLUSIONS
  The temporal consistency and convergence demonstrated by our analyses underscores the validity of the 5-factor model among service members exposed to warzone stressors. In particular, the findings suggest that diagnostic criteria for PTSD may benefit from disaggregating hyperarousal symptoms in military samples.
authors.affiliation: VA Boston Healthcare System, Massachusetts Veterans Epidemiology Research and Information Center.
authors.forename: Alyssa M
authors.initials: AM
authors.lastname: Boasso
authors.affiliation: New York University School of Medicine.
authors.forename: Maria M
authors.initials: MM
authors.lastname: Steenkamp
authors.affiliation: Women's Health Sciences Division, National Center for PTSD, VA Boston Healthcare System.
authors.forename: Annie B
authors.initials: AB
authors.lastname: Fox
authors.affiliation: Boston VA Research Institute, Inc.
authors.forename: William P
authors.initials: WP
authors.lastname: Nash
authors.affiliation: VA Boston Healthcare System, Massachusetts Veterans Epidemiology Research and Information Center.
authors.forename: Jonathan L
authors.initials: JL
authors.lastname: Larson
authors.affiliation: VA Boston Healthcare System, Massachusetts Veterans Epidemiology Research and Information Center, Boston University School of Medicine.
authors.forename: Brett T
authors.initials: BT
authors.lastname: Litz
mesh_terms: D000293:Adolescent; D000328:Adult; D055826:Afghan Campaign 2001-; D005163:Factor Analysis, Statistical; D006801:Humans; D007406:Interview, Psychological; D054542:Iraq War, 2003-2011; D008137:Longitudinal Studies; D008297:Male; D008889:Military Personnel / Q000523:psychology*; D008960:Models, Psychological; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology / Q000209:etiology / Q000523:psychology*; D013997:Time Factors; D000067453:War Exposure / Q000009:adverse effects*; D055815:Young Adult