The underlying dimensionality of PTSD in the diagnostic and statistical manual of mental disorders: where are we going?

Abstract

There has been a substantial body of literature devoted to answering one question: Which latent model of posttraumatic stress disorder (PTSD) best represents PTSD's underlying dimensionality? This research summary will, therefore, focus on the literature pertaining to PTSD's latent structure as represented in the fourth (DSM-IV, 1994) to the fifth (DSM-5, 2013) edition of the DSM. This article will begin by providing a clear rationale as to why this is a pertinent research area, then the body of literature pertaining to the DSM-IV and DSM-IV-TR will be summarised, and this will be followed by a summary of the literature pertaining to the recently published DSM-5. To conclude, there will be a discussion with recommendations for future research directions, namely that researchers must investigate the applicability of the new DSM-5 criteria and the newly created DSM-5 symptom sets to trauma survivors. In addition, researchers must continue to endeavour to identify the “correct” constellations of symptoms within symptom sets to ensure that diagnostic algorithms are appropriate and aid in the development of targeted treatment approaches and interventions. In particular, the newly proposed DSM-5 anhedonia model, externalising behaviours model, and hybrid models must be further investigated. It is also important that researchers follow up on the idea that a more parsimonious latent structure of PTSD may exist.

• PTSD
• CFA
• DSM-IV
• DSM-5

This paper is part of the Special Issue: Trauma and PTSD: setting the research agenda. More papers from this issue can be found at www.ejpt.net

For the abstract or full text in other languages, please see Supplementary files under ‘Article Tools’

This paper is part of the Special Issue: Trauma and PTSD: setting the research agenda. More papers from this issue can be found at www.ejpt.net

For the abstract or full text in other languages, please see Supplementary files under ‘Article Tools’

Notes

This paper is part of the Special Issue: Trauma and PTSD: setting the research agenda. More papers from this issue can be found at www.ejpt.net

For the abstract or full text in other languages, please see Supplementary files under ‘Article Tools’

¹Note the 17 symptoms of the DSM-IV were consistent in the DSM-IV-TR and so will be referred to as DSM-IV symptoms.

²Note there were a number of additional changes such as changes to the definition of the traumatic stressor and the addition of a dissociative subtype; however, these will not be discussed in the present review.