DSM-5 PTSD's symptom dimensions and relations with major depression's symptom dimensions in a primary care sample

Ateka A Contractor; Tory A Durham; Julie A Brennan; Cherie Armour; Hanna R Wutrick; B Christopher Frueh; Jon D Elhai

doi:10.1016/j.psychres.2013.10.015

DSM-5 PTSD's symptom dimensions and relations with major depression's symptom dimensions in a primary care sample

Psychiatry Res. 2014 Jan 30;215(1):146-53. doi: 10.1016/j.psychres.2013.10.015. Epub 2013 Oct 23.

Authors

Ateka A Contractor¹, Tory A Durham¹, Julie A Brennan², Cherie Armour³, Hanna R Wutrick¹, B Christopher Frueh⁴, Jon D Elhai⁵

Affiliations

¹ Department of Psychology, University of Toledo, Toledo, OH, USA.
² St. Luke's Family Medicine Center, St. Luke's Hospital, Maumee, OH, USA; Department of Family Medicine, University of Toledo, Toledo, OH, USA.
³ School of Psychology, University of Ulster at Coleraine Campus, Northern Ireland, UK; The National Centre for Psychotraumatology, University of Southern Denmark, Odense, Denmark.
⁴ Department of Psychology, University of Hawaii at Hilo, HI, USA; The Menninger Clinic, Houston, TX, USA.
⁵ Department of Psychology, University of Toledo, Toledo, OH, USA; Department of Psychiatry, University of Toledo, Toledo, OH, USA. Electronic address: jonelhai@gmail.com.

PMID: 24230994
DOI: 10.1016/j.psychres.2013.10.015

Abstract

Existing literature indicates significant comorbidity between posttraumatic stress disorder (PTSD) and major depression. We examined whether PTSD's dysphoria and mood/cognitions factors, conceptualized by the empirically supported four-factor DSM-5 PTSD models, account for PTSD's inherent relationship with depression. We hypothesized that depression's somatic and non-somatic factors would be more related to PTSD's dysphoria and mood/cognitions factors than other PTSD model factors. Further, we hypothesized that PTSD's arousal would significantly mediate relations between PTSD's dysphoria and somatic/non-somatic depression. Using 181 trauma-exposed primary care patients, confirmatory factor analyses (CFA) indicated a well-fitting DSM-5 PTSD dysphoria model, DSM-5 numbing model and two-factor depression model. Both somatic and non-somatic depression factors were more related to PTSD's dysphoria and mood/cognitions factors than to re-experiencing and avoidance factors; non-somatic depression was more related to PTSD's dysphoria than PTSD's arousal factor. PTSD's arousal did not mediate the relationship between PTSD's dysphoria and somatic/non-somatic depression. Implications are discussed.

Keywords: Confirmatory factor analyses; DSM-5; Depression; Mediation; PTSD; Primary care sample; Structural equation modeling.

MeSH terms

Adolescent
Adult
Aged
Arousal
Depressive Disorder, Major / complications
Depressive Disorder, Major / diagnosis*
Diagnostic and Statistical Manual of Mental Disorders*
Factor Analysis, Statistical
Female
Humans
Male
Middle Aged
Primary Health Care
Stress Disorders, Post-Traumatic / complications
Stress Disorders, Post-Traumatic / diagnosis*
Young Adult