A Bayesian Structural Equation Modeling Factor Analysis of the UCLA Posttraumatic Stress Disorder Reaction Index for DSM-5 in a Polyvictimized Sample of Adolescents

The revised criteria for posttraumatic stress disorder (PTSD) in the fifth edition of the Diagnostic and Statistical Manual necessitated the development of new screening tools for youth, one of the most widely used of which is the UCLA Posttraumatic Stress Disorder Reaction Index for DSM-5 (RI-5). Thus far, the few studies that have investigated the RI-5's factor structure have supported a four-factor model. However, to date this research has been limited to youth with histories of exposure to single-event traumatic stressors, a significant limitation as evidence suggests many trauma-exposed youth report exposure to multiple types of traumatic stressors, or polyvictimization. It is imperative to determine the generalizability of previous factor models to specific populations which they are purported to represent. We investigated whether the RI-5's four-factor model replicated in a sample of 455 polyvictimized justice-involved adolescents. Initial confirmatory factor analysis demonstrated that the four-factor model did not converge. Therefore, we utilized Bayesian Structural Equations Modeling (BSEM) to determine why the previously proposed factor structure did not converge. The BSEM model suggested that the global factor structure was acceptable and did not require addition or subtraction of any factor or cross-factor loadings. However, small and moderate residual covariances resulted in model misspecification, suggesting there may be additional associations not captured by the current DSM-5 model for polyvictimized youth. Future work should continue examining the RI-5's factor structure in order to better understand whether the current results are unique and how measurements assessing DSM-5 PTSD symptom criteria perform in diverse trauma-exposed youth populations.