A longitudinal analysis of posttraumatic stress disorder symptoms and their relationship with Fear and Anxious-Misery disorders: implications for DSM-V

J Affect Disord. 2010 Dec;127(1-3):147-52. doi: 10.1016/j.jad.2010.05.005. Epub 2010 Jun 3.


This paper examined the hypothesis that PTSD-unique symptom clusters of re-experiencing, active avoidance and hyperarousal were more related to the fear/phobic disorders, while shared PTSD symptoms of dysphoria were more closely related to Anxious-Misery disorders (MDD/GAD). Confirmatory factor and correlation analyses examining PTSD, anxiety and mood disorder data from 714 injury survivors interviewed 3, 12 and 24-months following their injury supported this hypothesis with these relationships remaining robust from 3-24 months posttrauma. Of the nine unique fear-oriented PTSD symptoms, only one is currently required for a DSM-IV diagnosis. Increasing emphasis on PTSD fear symptoms in DSM-V, such as proposed DSM-V changes to mandate active avoidance, is critical to improve specificity, ensure inclusion of dimensionally distinct features and facilitate tailoring of treatment.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Anxiety Disorders / diagnosis*
  • Anxiety Disorders / epidemiology
  • Anxiety Disorders / psychology
  • Australia
  • Comorbidity
  • Depressive Disorder, Major / diagnosis*
  • Depressive Disorder, Major / epidemiology
  • Depressive Disorder, Major / psychology
  • Diagnostic and Statistical Manual of Mental Disorders*
  • Fear*
  • Female
  • Follow-Up Studies
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Models, Psychological
  • Patient Admission
  • Phobic Disorders / diagnosis
  • Phobic Disorders / psychology
  • Stress Disorders, Post-Traumatic / diagnosis*
  • Stress Disorders, Post-Traumatic / epidemiology
  • Stress Disorders, Post-Traumatic / psychology
  • Survivors / psychology*
  • Wounds and Injuries / psychology*
  • Young Adult