title: The latent structure of Acute Stress Disorder symptoms in trauma-exposed children and adolescents.
abstract: The revision of Acute Stress Disorder (ASD) in the DSM-5 (DSM-5, 2013) proposes a cluster-free model of ASD symptoms in both adults and youth. Published evaluations of competing models of ASD clustering in youth have rarely been examined.
  
  
  
  We used Confirmatory Factor Analysis (combined with multigroup invariance tests) to explore the latent structure of ASD symptoms in a trauma-exposed sample of children and young people (N = 594). The DSM-5 structure was compared with the previous DSM-IV conceptualization (4-factor), and two alternative models proposed in the literature (3-factor; 5-factor). Model fit was examined using goodness-of-fit indices. We also established DSM-5 ASD prevalence rates relative to DSM-IV ASD, and the ability of these models to classify children impaired by their symptoms.
  
  
  
  Based on both the Bayesian Information Criterion, the interfactor correlations and invariance testing, the 3-factor model best accounted for the profile of ASD symptoms. DSM-5 ASD led to slightly higher prevalence rates than DSM-IV ASD and performed similarly to DSM-IV with respect to categorising children impaired by their symptoms. Modifying the DSM-5 ASD algorithm to a 3+ or 4+ symptom requirement was the strongest predictor of impairment.
  
  
  
  These findings suggest that a uni-factorial general-distress model is not the optimal model of capturing the latent structure of ASD symptom profiles in youth and that modifying the current DSM-5 9+ symptom algorithm could potentially lead to a more developmentally sensitive conceptualization.
authors.affiliation: Centre for Emotional Health, Macquarie University, Sydney, NSW, Australia. anna.mckinnon@mq.edu.au.
authors.forename: Anna
authors.initials: A
authors.lastname: McKinnon
authors.affiliation: Department of Clinical Psychology, Norwich Medical School, University of East Anglia, Norwich, UK.
authors.forename: Richard
authors.initials: R
authors.lastname: Meiser-Stedman
authors.affiliation: Medical Research Council Cognition and Brain Sciences Unit, Cambridge, UK.
authors.forename: Peter
authors.initials: P
authors.lastname: Watson
authors.affiliation: Department of Psychology, University of Bath, Somerset, UK.
authors.forename: Clare
authors.initials: C
authors.lastname: Dixon
authors.affiliation: Center for Injury Research and Prevention, The Children's Hospital of Philadelphia, Philadelphia, PA, USA.
authors.forename: Nancy
authors.initials: N
authors.lastname: Kassam-Adams
authors.affiliation: Department of Experimental Psychology, University of Oxford, Oxford, UK.
authors.forename: Anke
authors.initials: A
authors.lastname: Ehlers
authors.affiliation: Center for Injury Research and Prevention, The Children's Hospital of Philadelphia, Philadelphia, PA, USA.
authors.forename: Flaura
authors.initials: F
authors.lastname: Winston
authors.affiliation: Institute of Psychiatry, Psychology, and Neuroscience, Kings College London, London, UK.
authors.forename: Patrick
authors.initials: P
authors.lastname: Smith
authors.affiliation: Institute of Psychiatry, Psychology, and Neuroscience, Kings College London, London, UK.
authors.forename: William
authors.initials: W
authors.lastname: Yule
authors.affiliation: Medical Research Council Cognition and Brain Sciences Unit, Cambridge, UK.
authors.forename: Tim
authors.initials: T
authors.lastname: Dalgleish
mesh_terms: D000293:Adolescent; D002648:Child; D004739:England / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D015233:Models, Statistical; D015143:Philadelphia / Q000453:epidemiology; D015995:Prevalence; D040701:Stress Disorders, Traumatic, Acute / Q000145:classification / Q000175:diagnosis / Q000453:epidemiology
keywords: Acute Stress Disorder; DSM-5; children; factor analysis; post-traumatic stress disorder