Functional significance of a novel 7-factor model of DSM-5 PTSD symptoms: Results from the National Health and Resilience in Veterans Study

Pietrzak, Robert H.; Tsai, Jack; Armour, Chérie; Mota, Natalie; Harpaz‐Rotem, Ilan; Southwick, Steven M.

doi:10.1016/j.jad.2014.12.007

Cited by 144 publications

(89 citation statements)

References 10 publications

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“…Anhedonia and emotional numbing are often are clustered together (Pietrzak et al, 2015) but, as suggested by our findings, they may play entirely different roles in responses to traumatic stress. For instance, a reduction in reward responsiveness in the consummatory phase may be accompanied by an increase in reward-anticipating behaviour (Pickett, Bardeen, & Orcutt, 2011).…”

Section: Discussionsupporting

confidence: 69%

“…The PCL-C has been found to have high reliability (α = 0.94; Weathers et al, 1993), which was also the case in our study (α = 0.93). Anhedonia was indicated in PCL with the factor Anhedonia (PTSD-anhedonia) as defined by Pietrzak and colleagues (2015) and consisted of the symptoms loss of interest, detachment and restricted range of affect . Reliability of these three items combined as an anhedonia score was acceptable (α = 0.74).…”

Section: Methodsmentioning

confidence: 99%

“…In recent factor analytic studies of PTSD, anhedonia has been found to constitute an independent symptom cluster of PTSD (Armour et al, 2015; Pietrzak et al, 2015). Specifically, in a 7-factor model of PTSD, anhedonia consists of three symptoms, namely loss of interest, detachment and restricted range of affect (Armour et al, 2015).…”

Section: Introductionmentioning

confidence: 99%

“…Specifically, in a 7-factor model of PTSD, anhedonia consists of three symptoms, namely loss of interest, detachment and restricted range of affect (Armour et al, 2015). This anhedonia symptom cluster has been shown to be strongly associated with current depression, reduced mental functioning and quality of life as well as increased suicidal ideation (Pietrzak et al, 2015). As such, anhedonia might not only suggest severe PTSD, but constitute a comorbidity link between PTSD and depression and be a useful predictor of mental dysfunction and reduced quality of life in trauma survivors.…”

Section: Introductionmentioning

confidence: 99%

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Anhedonia and emotional numbing in treatment-seeking veterans: behavioural and electrophysiological responses to reward

Eskelund¹,

Karstoft

Andersen

2018

European Journal of Psychotraumatology

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Background: Anhedonia is a common symptom following exposure to traumatic stress and a feature of the PTSD diagnosis. In depression research, anhedonia has been linked to deficits in reward functioning, reflected in behavioural and neural responses. Such deficits following exposure to trauma, however, are not well understood.Objective: The current study aims to estimate the associations between anhedonia, PTSD symptom-clusters and behavioural and electrophysiological responses to reward.Methods: Participants (N = 61) were recruited among Danish treatment-seeking veterans at the Department of Military Psychology in the Danish Defence. Before entering treatment, participants were screened with symptom measurement instruments and participated in a joint behavioural-electrophysiological experiment. The experimental paradigm consisted of a signal-detection task aimed at assessing reward-driven learning. Simultaneous electrophysiological-recordings were analysed to evaluate neural responses upon receiving reward, as indicated by the Feedback-Related Negativity (FRN) component.Result: Anhedonia as conceptualized in depression correlated with behavioural learning (r = -0.28, p = .032). Neither anhedonia nor behavioural learning correlated with FRN. However, the anhedonia symptom cluster of PTSD did correlate with FRN (r = 0.29, p = .023). Extending upon this in an exploratory analysis, the specific PTSD-symptom emotional numbing was found to correlate moderately with FRN (r = 0.38, p = .003).Conclusion: The present data suggest that anhedonia in trauma-exposed individuals is related to the anticipatory aspect of reward, whereas the neural consummatory reward response seems unlinked. Interestingly, emotional numbing in the same population is related to the consummatory phase of reward, correlating with the FRN response. This suggests that anhedonia and emotional numbing in response to trauma might pertain to different phases of reward processing.

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Section: Discussionsupporting

confidence: 69%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Anhedonia and emotional numbing in treatment-seeking veterans: behavioural and electrophysiological responses to reward

Eskelund¹,

Karstoft

Andersen

2018

European Journal of Psychotraumatology

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“…The anxious arousal factor consists of hypervigilance (E3) and exaggerated startle (E4), while the dysphoric arousal factor consists of difficulty concentrating (E5) and sleep disturbance (E6). As indicated by Pietrzak et al (2015), the seven-factor model may provide greater specificity in understanding associations between DSM-5 PTSD and quality of life. There are no current studies that evaluate how the seven dimensions of DSM-5 PTSD symptoms related to different aspects of HRQoL.…”

Section: Introductionmentioning

confidence: 97%

DSM-5 posttraumatic stress symptom dimensions and health-related quality of life among Chinese earthquake survivors

Wang

Cao

et al. 2018

European Journal of Psychotraumatology

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It has been well-documented that posttraumatic stress symptoms cause impairments in health-related quality of life (HRQoL). Until now we have little data on how DSM-5 PTSD symptom dimensions relate to different aspects of HRQoL. Clarifying this question would be informative to improve the quality of life of PTSD patients. This study aimed to investigate the effects of dimensions of a well-supported seven-factor model of DSM-5 PTSD symptoms on physical and psychosocial HRQoL. A total of 1063 adult survivors of the 2008 Wenchuan earthquake took part in this study nine years after the disaster. PTSD symptoms were measured by the PTSD Checklist for DSM-5 (PCL-5). HRQoL was measured by the Medical Outcomes Survey Short Form-36 (SF-36). The associations between PTSD symptom dimensions and HRQoL were examined using structural equation models. Dysphoric arousal symptoms were found to significantly relate to physical HRQoL. Other symptom dimensions were not associated with HRQoL. Our findings contribute to the relationship between DSM-5 PTSD and HRQoL, and carry implications for further clinical practice and research on trauma-exposed individuals.

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The short‐term dynamics of posttraumatic stress disorder symptoms during the acute posttrauma period

Price

Legrand

Brier

et al. 2019

Depression and Anxiety

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Background The manner in which posttraumatic stress disorder (PTSD) develops remains largely unknown. PTSD is comprised of 20 symptoms across 4 clusters. These clusters were hypothesized to reflect a failure of recovery model in which intrusive symptoms appear first. Intrusive symptoms led to avoidance of trauma‐related stimuli, which resulted in sustained arousal. The sustained arousal ultimately led to dysphoria. Methods This hypothesized symptom progression was evaluated during the acute posttrauma period (the first 30 days postevent). Participants (N = 80) reported their PTSD symptoms for 30 days via mobile devices. Using a short‐term dynamic modeling framework, a temporal and contemporaneous model of PTSD symptoms was obtained. Results In the temporal network, a fear‐conditioning component was identified that supported the hypothesized set of relations among symptom clusters. The contemporaneous network was classified by two subnetworks. The first corresponded to a fear‐conditioning model that included symptoms of intrusions and avoidance. The second included symptoms of dysphoria and arousal. Conclusions These findings suggest that, after a trauma, there may be a fear‐conditioning process that involves intrusions, avoidance, and arousal symptoms. Dysphoric symptoms were also present but developed as a partially distinct component.

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Functional significance of a novel 7-factor model of DSM-5 PTSD symptoms: Results from the National Health and Resilience in Veterans Study

Cited by 144 publications

References 10 publications

Anhedonia and emotional numbing in treatment-seeking veterans: behavioural and electrophysiological responses to reward

Anhedonia and emotional numbing in treatment-seeking veterans: behavioural and electrophysiological responses to reward

DSM-5 posttraumatic stress symptom dimensions and health-related quality of life among Chinese earthquake survivors

The short‐term dynamics of posttraumatic stress disorder symptoms during the acute posttrauma period

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