An examination of the structure of posttraumatic stress disorder in relation to the anxiety and depressive disorders

J Affect Disord. 2011 Jul;132(1-2):165-72. doi: 10.1016/j.jad.2011.02.011. Epub 2011 Apr 14.


The nature and structure of posttraumatic stress disorder (PTSD) has been the subject of much interest in recent times. This research has been represented by two streams, the first representing a substantive body of work which focuses specifically on the factor structure of PTSD and the second exploring PTSD's relationship with other mood and anxiety disorders. The present study attempted to bring these two streams together by examining structural models of PTSD and their relationship with dimensions underlying other mood and anxiety disorders. PTSD, anxiety and mood disorder data from 989 injury survivors interviewed 3-months following their injury were analyzed using a series of confirmatory factor analyses (CFA) to identify the optimal structural model. CFA analyses indicated that the best fitting model included PTSD's re-experiencing (B1-5), active avoidance (C1-2), and hypervigilance and startle (D4-5) loading onto a Fear factor (represented by panic disorder, agoraphobia and social phobia) and the PTSD dysphoria symptoms (numbing symptoms C3-7 and hyperarousal symptoms D1-3) loading onto an Anxious Misery/Distress factor (represented by depression, generalized anxiety disorder and obsessive compulsive disorder). The findings have implications for informing potential revisions to the structure of the diagnosis of PTSD and the diagnostic algorithm to be applied, with the aim of enhancing diagnostic specificity.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Agoraphobia / classification
  • Agoraphobia / diagnosis
  • Agoraphobia / psychology
  • Algorithms
  • Anxiety Disorders / classification
  • Anxiety Disorders / diagnosis*
  • Anxiety Disorders / psychology*
  • Arousal
  • Depressive Disorder, Major / classification
  • Depressive Disorder, Major / diagnosis*
  • Depressive Disorder, Major / psychology*
  • Diagnostic and Statistical Manual of Mental Disorders
  • Female
  • Humans
  • Interview, Psychological
  • Male
  • Mass Screening
  • Middle Aged
  • Obsessive-Compulsive Disorder / classification
  • Obsessive-Compulsive Disorder / diagnosis
  • Obsessive-Compulsive Disorder / psychology
  • Panic Disorder / classification
  • Panic Disorder / diagnosis
  • Panic Disorder / psychology
  • Phobic Disorders / classification
  • Phobic Disorders / diagnosis
  • Phobic Disorders / psychology
  • Stress Disorders, Post-Traumatic / classification
  • Stress Disorders, Post-Traumatic / diagnosis*
  • Stress Disorders, Post-Traumatic / psychology*
  • Wounds and Injuries / psychology*