Examining posttraumatic stress disorder's latent structure between treatment-seeking and non-treatment-seeking Filipinos

Abstract

Background The discourse of latent structure of posttraumatic stress disorder (PTSD) has been extensive in trauma literature. Although findings have been consistent in rejecting DSM-IV-TR's three-factor model, alternative models are still fervently argued. This study contributes to the discussion by examining and comparing PTSD factor structure of the three most validated models—numbing model ( King et al., 1998 ), dysphoria model ( Simms et al., 2002 ), and dysphoric arousal model ( Elhai et al., 2011b )—and determining if these are generalizable across treatment-seeking and non-treatment-seeking Filipinos with exposure to trauma events.

Methods Filipino-Tagalog version of Harvard Trauma Questionnaire (HTQ; Mollica et al., 1992 ) was administered to a sample of 737 treatment-seeking (n = 526) and non-treatment-seeking (n = 211) Filipinos who experienced and witnessed varied trauma events. Confirmatory factor analysis (CFA) was conducted involving the three models in order to determine the best-fitting model and generalizability across samples.

Results Results showed that all three models achieved excellent fit, with dysphoric arousal model slightly fitting better than numbing and dysphoria models in both treatment-seeking and non-treatment-seeking samples. Series of invariance testing, however, indicated that although dysphoric arousal model fits significantly better than dysphoria model, it did not significantly differ from numbing model. Results revealed that aside from the factor loadings, the two groups are noninvariant in all parameters. Treatment-seeking sample had larger intercepts, factor variances and covariances and factor means than non-treatment-seeking group.

Discussion The findings strongly contribute to the literature by showing how the type of groupings (treatment-seeking vs. non-treatment-seeking) moderates PTSD latent structure. It affirms the suggestion of Biehn et al. (2012) to be cautious in concluding the generalizability of PTSD models in the context that type of participants moderates PTSD's factor structure.