This study attempted to extend research indicating that posttraumatic stress disorder (PTSD) factors of Re-experiencing, Avoidance and Hyperarousal are more related to Fear/phobic disorders, while PTSD Dysphoria is more related to Anxious-Misery disorders. Trauma exposure, PTSD and comorbidity data for 668 veteran patients were analysed using confirmatory factor analyses and relative strengths of the relationships between PTSD factors and the Fear and Anxious-Misery factors were assessed. Combining Simms, Watson, and Doebbeling's (2002) model of PTSD symptoms and Krueger's (1999) Fear/Anxious Misery model of mood and anxiety disorders fit the data well. Contrary to previous research, PTSD Re-experiencing, Avoidance and Hyperarousal did not correlate more with the Fear factor; nor did PTSD Dysphoria correlate more with Anxious-Misery. Hyperarousal was more closely related to Fear than was Re-experiencing; however, Avoidance was not. Dysphoria was more closely related to the Anxious-Misery factor than all other PTSD factors.
Posttraumatic stress disorder (PTSD) as currently defined has high rates of comorbidity with other mood and anxiety disorders (Creamer et al., 2001 and Kessler et al., 1995) and a heterogeneous clinical presentation (Blanchard, Hickling, Taylor, Loos, & Gerardi, 1994), features which are thought to pose a challenge to its diagnostic validity (Frueh et al., 2010, McNally, 2003, Rosen and Lilienfeld, 2008 and Spitzer et al., 2007). Research exploring the structural relationship between PTSD and other mood and anxiety disorders (e.g. Brown and McNiff, 2009, Elhai et al., 2011, Forbes et al., 2010, Frueh et al., 2000, Grant et al., 2008, Gros et al., 2010 and Simms et al., 2002) has begun to shed light on the nature and origins of this comorbidity and heterogeneity. Forbes et al. (2010) found that, in a sample of acute traumatic injury survivors, the PTSD symptoms more specific to the disorder (Re-experiencing, Avoidance and Hyperarousal) were more related to a Fear or phobic disorders factor underlying mood and anxiety disorders (Krueger, 1999), while the PTSD dysphoria symptoms (Simms et al., 2002) were more closely related to the Anxious-Misery factor (generalized anxiety disorder and major depression; Grant et al., 2008). This study aims to replicate Forbes et al.’s (2010) findings in a veterans’ general medical patient sample. It also seeks to extend these findings by clarifying differences between the PTSD factors in terms of their relationship to each of the Fear and Anxious-Misery factors. This will help improve diagnostic specificity as well as treatment selection for varying presentations of PTSD symptoms.
