Testing competing factor models of the latent structure of post-traumatic stress disorder and complex post-traumatic stress disorder according to ICD-11

Figures & data

Figure 1. Alternative confirmatory factor analysis (CFA) models. Model 1: unidimensional complex post-traumatic stress disorder (CPTSD). Model 2: six-factor first-order model of CPTSD. Model 3: seven-factor first-order model of CPTSD. Model 4: single-factor second-order with six correlated factors. Model 5: single-factor second-order with seven correlated factors. Model 6: two-factor second-order model with six correlated factors. Model 7: two-factor second-order model with seven correlated factors. Re, re-experiencing; Av, avoidance; Th, sense of threat; Ad, AD, affect dysregulation; Ns, NSC, negative self-concept; Dr, DR, disturbed relationships; Hyper, hyper-activation; Hypo, hypo-activation; PTSD, post-traumatic stress disorder.

Figure 1. (Continued).

Table 1. Descriptive statistics of International Trauma Questionnaire (ITQ) subscales and gender.

ICD-11	Male (%)	Female (%)	Total (%)	χ^2 (df) p
Re-experiencing	46.7	53.3	73.5	1.84 (1) 0.175
Avoidance	50.7	49.3	66.3	0.85 (1) 0.357
Sense of threat	48.9	51.1	59.7	0.00 (1) 0.961
Hyper-activation	51.2	48.8	79.6	2.28 (1) 0.131
Hypo-activation	48.4	51.6	49.5	0.05 (1) 0.819
Negative self-concept	47.9	52.1	54.0	0.18 (1) 0.668
Disturbed relationships	50.5	49.5	33.3	0.16 (1) 0.689

Table 2. Fit statistics for the alternative models of the ICD-11 post-traumatic stress disorder (PTSD) and complex post-traumatic stress disorder (CPTSD) symptoms.

Model	Model	χ^2	df	CFI	TLI	RMSEA	WRMR
1	Unidimensional	1426.36	209	0.845	0.829	0.136	2.05
						(0.130–0.143)
2	Correlated six-factor first-order	1050.10	194	0.891	0.870	0.119	1.65
						(0.112–0.126)
3	Correlated seven-factor	737.92	188	0.930	0.914	0.097	1.35
	first-order					(0.089–0.104)
4	One-factor second-order, six first-order factors	1060.01	203	0.891	0.876	0.097	1.72
						(0.109–0.123)
5	One-factor second-order, seven first-order factors	778.33	202	0.927	0.916	0.095	1.46
						(0.088–0.103)
6	order, six first-order factors	1053.59	202	0.892	0.876	0.116	1.70
						(0.109–0.123)
7	Two-factor second-order, seven first-order factors	767.94	201	0.928	0.917	0.095	1.44
						(0.088–0.102)

df, degrees of freedom; CFI, comparative fit index; TLI, Tucker–Lewis Index; RMSEA, root mean square error of approximation; WRMR, weighted root mean square residual.

Table 3. Standardized factor loadings and factor correlations for the seven-factor first-order complex post-traumatic stress disorder (CPTSD) model.

	Re	Av	Th	Hyper	Hypo	NSC	DR
Re1	0.71
Re2	0.85
Av1		0.66
Av2		0.76
Th1			0.88
Th2			0.90
AD1				0.60
AD2				0.80
AD3				0.79
AD4				0.79
AD5				0.50
AD6					0.51
AD7					0.58
AD8					0.80
AD9					0.82
NSC1						0.89
NSC2						0.88
NSC3						0.71
NSC4						0.76
DR1							0.81
DR2							0.83
DR3							0.73
Factor correlations
Av	0.66	–
Th	0.76	0.35	–
Hyper	0.63	0.41	0.42	–
Hypo	0.81	0.64	0.76	0.66	–
NSC	0.69	0.35	0.67	0.64	0.85	–
DR	0.71	0.42	0.71	0.54	0.91	0.83	–

Re, re-experiencing; Av, avoidance; Th, sense of threat; AD, affect dysregulation; NSC, negative self-concept; DR, disturbed relationships; Hyper, hyper-activation; Hypo, hypo-activation.