Journal of Abnormal Child Psychology

, Volume 45, Issue 4, pp 803–814 | Cite as

DSM-5 Posttraumatic Stress Disorder Symptom Structure in Disaster-Exposed Adolescents: Stability across Gender and Relation to Behavioral Problems

  • Xing Cao
  • Li WangEmail author
  • Chengqi Cao
  • Jianxin Zhang
  • Jon D. Elhai


Given the significant modifications to posttraumatic stress disorder (PTSD) symptom criteria from DSM-IV to DSM-5, a better understanding of the dimensionality underlying DSM-5 PTSD symptoms among adolescents is needed. However, to date, whether gender moderates the latent structure of DSM-5 PTSD symptoms in youth remains unclear. Meanwhile, little is known about how distinct PTSD dimensions relate to adolescent behavioral problems. The aim of this study was to fill these gaps. A sample of 1184 disaster-exposed Chinese adolescents (53.8 % girls) with age ranging from 13 to 17 years (M = 14.3, SD = 0.8) completed the PTSD Checklist for DSM-5, and the Withdrawn, Aggressive Behavior, and Delinquent Behavior subscales of the Youth Self-Report. Confirmatory factor analyses revealed that the seven-factor hybrid PTSD model provided the best fit to the data for both girls and boys. Measurement equivalence of this model held across gender, although girls had higher mean scores than boys on some factors. Differential patterns of associations emerged between PTSD dimensions and behavioral problems, with anhedonia symptoms most strongly relating to social withdrawal, and externalizing behavior symptoms most strongly relating to aggression and delinquency. These findings further support the gender invariance and external criterion validity of the newly refined hybrid model that best represents DSM-5 PTSD symptom structure in youth, and carry implications for accurate assessment, diagnosis, and gender comparison of DSM-5 PTSD symptomatology, and potential symptom targets for PTSD intervention among adolescent disaster survivors.


Posttraumatic stress disorder DSM-5 Measurement invariance Behavioral problems Adolescents 


Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.


This study was funded by the National Key Technology Research and Development Program of China (No.2013BAI08B02), the Key Research Program of the Chinese Academy of Sciences (No. KJZD-EW-L04), the National Natural Science Foundation of China (No.31271099 and No.31471004), the Chinese Academy of Sciences President’s International Fellowship Initiative (No.2016VEA019), and the Outstanding Young Investigator Foundation of the Institute of Psychology, Chinese Academy of Sciences.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  1. 1.Laboratory for Traumatic Stress Studies, Key Laboratory of Mental Health, Institute of PsychologyChinese Academy of SciencesBeijingChina
  2. 2.University of Chinese Academy of SciencesBeijingChina
  3. 3.Department of Psychology, and Department of PsychiatryUniversity of ToledoToledoUSA

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