The Posttraumatic Stress Disorder Factorial Structure: Findings from a Multicultural Sample

ABSTRACT

Although several studies exploring Posttraumatic Stress Disorder (PTSD) factorial structure have been conducted, few of them have tested the ICD-11 and the DSM-5-based models in samples from low-income countries. Yet, most PTSD factorial structure research does not use external variables to confirm the model’s validity. The present study aims to investigate the PTSD factorial structure according to the ICD-11, DSM-5 and Anhedonia models in a multicultural sample of migrants and refugees. We also verified the associations between trauma type (interpersonal vs. non-interpersonal) and PTSD factorial structures. Factorial validity was assessed using Confirmatory Factor Analysis (CFA). A Multiple Indicators Multiple Causes (MIMIC) model was performed in order to verify associations between trauma type and the PTSD factorial structures. The final sample comprised 150 participants originally from 32 different countries. ICD-11 was the best fitting model, but all three models presented adequate fit. High cross-factor correlations were found in DSM-5 and Anhedonia models. The MIMIC model indicated that little of ICD-11 factors’ variation was explained by trauma-type. Trauma type’s influence on PTSD manifestation was mostly present on factors containing symptoms that are not considered PTSD core symptoms (e.g., dysphoric symptoms).

KEYWORDS:

• Posttraumatic stress disorder
• trauma
• confirmatory factor analysis
• multicultural

Disclosure of interest

The authors declare no conflict of interest.

Ethical standards and informed consent

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation and with the Helsinki Declaration of 1975, as revised in 2000. Informed consent was obtained from all participants for being included in the study.

Additional information

Funding

This work was supported by the Conselho Nacional de Desenvolvimento Científico e Tecnológico [Universal 01/2016]; to Christian H. Kristensen and by a grant from the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior [48/2017] to Alice E. Brunnet.