Relations between PTSD and depression symptom clusters in samples differentiated by PTSD diagnostic status

Contractor, Ateka A.; Greene, Talya; Dolan, Megan; Elhai, Jon D.

doi:10.1016/j.janxdis.2018.08.004

Cited by 44 publications

(27 citation statements)

References 83 publications

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“…The DSM‐IV DA and DSM‐5 hybrid model factors demonstrated invariance at most levels compared to their respective counterparts and clinically used models (i.e., the DSM‐IV three‐factor and DSM‐5 four‐factor models). Consistent with existing empirical support (Armour, Mullerova, & Elhai, ; Contractor, Greene, Dolan, & Elhai, ), both models demonstrated a stable and comparable representation of the PTSD symptom structure (i.e., the structural aspect of construct validity). In addition, our findings support further investigation of the recently proposed and debated hybrid model and its clinical utility (Silverstein, Dieujuste, Kramer, Lee, & Weathers, ).…”

Section: Discussionsupporting

confidence: 79%

“…Such findings concur with existing literature that has questioned their significance within PTSD symptomatology (Armour, Contractor, Shea, Elhai, & Pietrzak, ; Friedman et al., ), which possibly contributed to modification of the foreshortened future item in the DSM‐5 (APA, ). Notably, our results showing that most numbing/dysphoria (e.g., anhedonia) items contributed to PTSD construct nonequivalence add to the existing debate on their specificity to the PTSD construct (Contractor, Greene et al., ). Removing or modifying these items may increase the validity of PTSD assessment instruments for certain subgroups (Sass, ).…”

Section: Discussionsupporting

confidence: 66%

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Invariance of the Construct of Posttraumatic Stress Disorder: A Systematic Review

Contractor

Caldas

Dolan

et al. 2019

Journal of Traumatic Stress

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We conducted a systematic review of studies that have evaluated invariance of the construct of posttraumatic stress disorder (PTSD) to summarize their conclusions related to invariance/noninvariance and sources of noninvariance. In November 2017, we searched Pubmed, PSYCINFO, PILOTS Web of Science, CINAHL, Medline, and Psychological and Behavioral Science Collection for abstracts and articles with these inclusionary criteria: peer-reviewed, including DSM-IV or DSM-5 PTSD invariance as a main study aim, use of multigroup confirmatory factor analyses, and use of an independent PTSD instrument or module. In total, 45 articles out of 1,169 initially identified abstracts met inclusion criteria. Research assistants then followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to complete a secondary search and independently extract data. Results indicated that DSM-IV dysphoric arousal and DSM-5 hybrid model factors demonstrated the most stability; sources of instability were some intrusion (distress to trauma cues), dysphoria/numbing (traumatic amnesia, foreshortened future, emotional numbness, detachment), and arousal (hypervigilance) items. The PTSD Checklist and PTSD Reaction Index were most often used to assess PTSD in studies investigating its invariance; however, these measures demonstrated partial conceptual equivalence of PTSD across subgroups. Instead, clinician-administered measures demonstrated more conceptual equivalence across subgroups. Age, gender, cultural/linguistic factors, and sample diversity had the least moderating effect on PTSD's symptom structure. Our review demonstrates the need to examine invariance of the PTSD construct following recommended guidelines for each empirical and clinical trial study to draw meaningful multigroup comparative conclusions.Clinicians and researchers use diverse instruments to measure the psychological construct of posttraumatic stress disorder (PTSD). Scores obtained from these instruments are compared across subgroups, using statistical tests that depend on-yet assume-empirically established conceptual equivalence of the construct of PTSD. From a latent variable model perspective, participants with the same true PTSD factor (latent) score interpret and/or respond to PTSD-related items in a conceptually similar manner (i.e., same probability of observed scores), and PTSD items similarly capture the latent symptomology of PTSD across subgroups (Bauer, 2017;Dimitrov, 2010;

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Section: Discussionsupporting

confidence: 79%

Section: Discussionsupporting

confidence: 66%

Invariance of the Construct of Posttraumatic Stress Disorder: A Systematic Review

Contractor

Caldas

Dolan

et al. 2019

Journal of Traumatic Stress

Self Cite

View full text Add to dashboard Cite

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“…To date, the most heterogeneous model of PTSD with good empirical support has been the seven‐factor hybrid model (Armour et al., 2015), which consists of intrusions, avoidance, negative affect, anhedonia, externalizing behaviors, anxious arousal, and dysphoric arousal symptom clusters (see Table 1). In several factor analytic studies, the hybrid model has outperformed other models, including the four‐factor DSM‐5 model (e.g., Contractor et al., 2018; Ito, Takebayashi, Suzuki, & Horikoshi, 2019), and several studies have shown the hybrid model's factors to have differential associations with external variables (e.g., Liu, Wang, Cao, Qing, & Armour, 2016; Zelazny & Simms, 2015) and substantial construct equivalence across compared subgroups (Contractor, Caldas, et al., 2019). Utilizing the seven‐factor hybrid model of PTSD rather than the 20 individual PTSD items reduces the number of parameters to be estimated in the network, which may increase the accuracy and stability of the estimated network when sample sizes are small (Epskamp, Borsboom, & Fried, 2018; Epskamp, Kruis, & Marsman, 2017).…”

Section: Symptom Clusters In the Dsm‐5 Seven‐factor Hybrid Model (Armmentioning

confidence: 99%

Posttraumatic Stress Disorder Symptoms and Reckless Behaviors: A Network Analysis Approach

Armour

Greene

Contractor

et al. 2020

Journal of Traumatic Stress

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Existing literature indicates a theoretical and empirical relation between engagement in reckless behaviors and posttraumatic stress disorder (PTSD). Thus, the DSM‐5 revision of the PTSD nosology added a new “reckless or self‐destructive behavior” (RSDB) symptom (Criterion E2). The current study applied a network analytic approach to examine the item‐level relations among a range of reckless behaviors and PTSD symptom clusters. Participants were recruited from Amazon's Mechanical Turk (N = 417), and network analysis was conducted with 20 variables: six PTSD symptom clusters, corresponding to the hybrid model of PTSD (Armour et al., 2015) and excluding the externalizing behavior cluster (Community 1), and 14 items related to reckless behavior (Community 2). The results showed that the network associations were strongest within each construct (i.e., within PTSD and within reckless behaviors), although several bridge connections (i.e., between PTSD clusters and reckless behaviors) were identified. Most reckless behavior items had direct associations with one or more PTSD symptom clusters. The present findings support the existence of close relations between a variety of reckless behaviors and PTSD symptom clusters beyond their relations with DSM Criterion E2. The results provide testable hypotheses about the associations between specific reckless behaviors and PTSD symptom clusters, which may inform future research.

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“…Post-traumatic stress disorder (PTSD) is often comorbid with depression in the aftermath of trauma. In a study of over 350 trauma-exposed adults, Contractor and colleagues (2018) found that the negative alterations in cognitions and mood present in PTSD accounted for significant variance between PTSD and non-somatic depression, though it is notable that other research (e.g., Byllesby et al, 2017) suggests that a general distress factor provides a better explanation for the comorbidity between these disorders. Gurak and colleagues (2016) describe the treatment of a young adult woman with comorbid PTSD and recurrent MDD, as well as a childhood trauma history.…”

Section: Theoretical and Research Basis For Treatmentmentioning

confidence: 98%

Schema Therapy for Chronic Depression Associated with Childhood Trauma: A Case Study

Herts

Evans

2020

Clinical Case Studies

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Chronic depression lasting longer than 2 years is often undertreated. Research suggests that maladaptive cognitive schemas mediate the association between childhood trauma and later depression. Schema Therapy (ST) is an integrative treatment approach that targets maladaptive cognitive schemas through cognitive, behavioral, interpersonal, and experiential interventions. ST has been studied in patients with chronic depression with good results. The purpose of this case study is to detail how an ST treatment was used to treat chronic depression in a woman, “Amy,” with a childhood trauma history. Amy presented with a persistent depressive disorder that had lasted over 40 years. An ST approach was chosen in light of the chronicity of Amy’s symptoms and her childhood trauma history. Standardized measures including the Beck Depression Inventory were used to assess progress throughout treatment. We provide a comprehensive summary of the 22-session ST case conceptualization and treatment, through which Amy’s depressive symptoms evidenced a 73 percent reduction. Amy qualitatively reported reduced depressive rumination and avoidance behaviors as well as increased frequency of positive mood.

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Relations between PTSD and depression symptom clusters in samples differentiated by PTSD diagnostic status

Cited by 44 publications

References 83 publications

Invariance of the Construct of Posttraumatic Stress Disorder: A Systematic Review

Invariance of the Construct of Posttraumatic Stress Disorder: A Systematic Review

Posttraumatic Stress Disorder Symptoms and Reckless Behaviors: A Network Analysis Approach

Schema Therapy for Chronic Depression Associated with Childhood Trauma: A Case Study

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