The structure of acute posttraumatic stress symptoms: 'reexperiencing', 'active avoidance', 'dysphoria', and 'hyperarousal'

J Anxiety Disord. 2009 Jun;23(5):656-9. doi: 10.1016/j.janxdis.2009.02.003. Epub 2009 Feb 11.

Abstract

Empirical data have challenged chronic posttraumatic stress disorder (PTSD) consisting of three dimensions. In the present study we aimed to determine the factor structure of acute posttraumatic symptoms in two recently traumatized samples. In sample 1, 203 civilian trauma survivors were administered the Davidson Trauma Scale (DTS) approximately 1 week posttrauma. In sample 2, 182 civilian treatment seeking trauma survivors completed the DTS at an average of 41.4 days posttrauma. Our confirmatory factor analyses indicated that a 4-factor intercorrelated model provided the best representation of the data in both samples. The four factors are best described as reexperiencing, active avoidance, dysphoria, and hyperarousal. For acute posttraumatic symptoms, the empirical data suggest to split the avoidance cluster into 'Active avoidance' and 'Dysphoria'-confirming findings in studies on chronic PTSD. In future revisions of the DSM, the diagnostic criteria for PTSD may need to be adapted to fit the research findings.

MeSH terms

  • Acute Disease
  • Adult
  • Arousal*
  • Diagnostic and Statistical Manual of Mental Disorders
  • Escape Reaction*
  • Factor Analysis, Statistical
  • Female
  • Humans
  • Male
  • Mood Disorders / diagnosis
  • Mood Disorders / psychology*
  • Severity of Illness Index
  • Stress Disorders, Post-Traumatic / diagnosis
  • Stress Disorders, Post-Traumatic / psychology*