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Distress Variance and Specificity of Symptom Dimensions in Posttraumatic Stress Disorder: a Quadripartite Perspective

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Abstract

The relation of posttraumatic stress disorder (PTSD) to other forms of psychopathology is complex as diagnostic criteria include symptoms of both mood- and anxiety-related conditions. Drawing from Watson’s (2009) quadripartite model of comorbidity, the current study examined (a) the association of PTSD symptom dimensions with indices of generalized distress, (b) the specificity of PTSD symptom dimensions for core aspects of anxiety and depression, and (c) the unique associations of symptom dimensions with markers of positive emotionality, somatic arousal, generalized distress, and cumulative trauma history. Confirmatory analyses were used to model symptom dimensions in help-seeking survivors of intimate partner violence (N = 238; 51.7% White/Non-Hispanic). Latent markers of positive emotionality, somatic arousal, and generalized distress were also estimated. A 3-factor version of the Simms et al. (2002) Dysphoria model was identified as a preferred solution, with Intrusion and Avoidance criteria collapsed on a common dimension. Analyses revealed moderate correlations of generalized distress with Intrusion-Avoidance, Dysphoria, and Hyperarousal dimensions (r = .30–.38). Intrusion-Avoidance and Hyperarousal factors evidenced specificity for the core aspects of anxiety while Dysphoria demonstrated an association with the characteristic features of depression when controlling for nonspecific distress. Hyperarousal was the only symptom dimension holding a unique association with cumulative trauma controlling for somatic arousal, positive emotionality, and generalized distress. Results offer preliminary support for the specificity of core dimensions of PTSD above and beyond the influence of nonspecific distress.

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Notes

  1. The number of items used to identify latent NA, PA, and SA factors was limited to manage the size of the joint measurement model. Efforts were taken to select indicators capturing various aspects of the target construct.

  2. We thank an anonymous reviewer for their assistance with identification of this scale.

  3. MPlus syntax for the final series of models are provided in a supplemental appendix.

  4. Estimates of specificity and general distress variance for the 3-factor Numbing model are available from the first author upon request.

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Funding

This work was supported by funds provided through the University of Memphis Lillian and Morrie Moss Chair of Excellence, held by Dr. Beck.

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Authors and Affiliations

  1. Department of Psychology, University of Wyoming, 1000 E. University Ave, Laramie, WY, 82071, USA

    Joshua D. Clapp

  2. Department of Psychiatry and Human Behavior, Bradley Hospital, Alpert Medical School of Brown University, 1011 Veterans Memorial Pkwy, Riverside, RI, 02915, USA

    Joshua J. Kemp

  3. Department of Psychological Sciences, Western Kentucky University, 1906 College Heights Blvd, Bowling Green, KY, 42101, USA

    Matthew J. Woodward

  4. Department of Psychology, University of Memphis, 202 Psychology Building, Memphis, TN, 38152, USA

    J. Gayle Beck

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Correspondence to Joshua D. Clapp.

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Joshua Clapp, Joshua Kemp, Matthew Woodward, and J. Gayle Beck declare that they have no conflict of interest.

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Clapp, J.D., Kemp, J.J., Woodward, M.J. et al. Distress Variance and Specificity of Symptom Dimensions in Posttraumatic Stress Disorder: a Quadripartite Perspective. J Psychopathol Behav Assess 42, 328–339 (2020). https://doi.org/10.1007/s10862-019-09772-9

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