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An evaluation of competing models for the structure of PTSD symptoms using external measures of comorbidity

Authors

  • Mark W. Miller,

    Corresponding author
    1. National Center for PTSD, VA Boston Healthcare System and Boston University School of Medicine
    Current affiliation:
    1. National Center for PTSD, VA Boston Healthcare System & Department of Psychiatry, Boston University School of Medicine
    • National Center for PTSD (116B-2), VA Boston Healthcare System, 150 South Huntington Avenue, Boston, MA 02130
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  • Erika J. Wolf,

    1. National Center for PTSD, VA Boston Healthcare System and Boston University School of Medicine
    Current affiliation:
    1. National Center for PTSD, VA Boston Healthcare System & Department of Psychology, Boston University
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  • Kelly M. Harrington,

    1. National Center for PTSD, VA Boston Healthcare System and Boston University School of Medicine
    Current affiliation:
    1. National Center for PTSD, VA Boston Healthcare System & Department of Psychiatry, Boston University School of Medicine
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  • Timothy A. Brown,

    1. National Center for PTSD, VA Boston Healthcare System and Boston University School of Medicine
    Current affiliation:
    1. Department of Psychology, Boston University
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  • Danny G. Kaloupek,

    1. National Center for PTSD, VA Boston Healthcare System and Boston University School of Medicine
    Current affiliation:
    1. National Center for PTSD, VA Boston Healthcare System & Department of Psychiatry, Boston University School of Medicine
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  • Terence M. Keane

    1. National Center for PTSD, VA Boston Healthcare System and Boston University School of Medicine
    Current affiliation:
    1. National Center for PTSD, VA Boston Healthcare System & Department of Psychiatry, Boston University School of Medicine
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  • This research was supported, in part, by the VA Cooperative Studies Program of the Veterans Health Administration under designation CS-334, a VA Merit Review grant to Mark W. Miller, a National Institute of Mental Health grant to Mark W. Miller (5RO1MH079806), and a National Institute of Mental Health grant (5F31MH074267) to Erika J. Wolf.

Abstract

Research on the structure of posttraumatic stress disorder (PTSD) symptoms has yielded support for two 4-factor models: the King (King, Leskin, King, & Weathers, 1998) and Simms/Watson models (Simms, Watson, & Doebbeling, 2002). This study evaluated them using data drawn from 1,128 Vietnam veterans by comparing associations with a latent internalizing comorbidity variable and five scales from the MMPI-2 Restructured Clinical (RC) Scales (Tellegen et al., 2003). The Simms/Watson dysphoria factor failed to show evidence of superior convergent or discriminant validity in association with external measures relative to the numbing or hyperarousal factors of the King model. Findings raise questions about proposals to abandon the distinction between numbing and hyperarousal symptoms in favor of a dysphoria-based model.

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