Center for Injury Research and Prevention

The latent structure of Acute Stress Disorder symptoms in trauma-exposed children and adolescents.

TitleThe latent structure of Acute Stress Disorder symptoms in trauma-exposed children and adolescents.
Publication TypeJournal Article
Year of Publication2016
AuthorsMcKinnon A, Meiser-Stedman R, Watson P, Dixon C, Kassam-Adams N, Ehlers A, Winston FK, Smith P, Yule W, Dalgleish T
JournalJ Child Psychol Psychiatry
Volume57
Issue11
Pagination1308-1316
Date Published07/2016
ISSN1469-7610
Abstract

BACKGROUND: The revision of Acute Stress Disorder (ASD) in the DSM-5 (DSM-5, 2013) proposes a cluster-free model of ASD symptoms in both adults and youth. Published evaluations of competing models of ASD clustering in youth have rarely been examined.

METHODS: We used Confirmatory Factor Analysis (combined with multigroup invariance tests) to explore the latent structure of ASD symptoms in a trauma-exposed sample of children and young people (N = 594). The DSM-5 structure was compared with the previous DSM-IV conceptualization (4-factor), and two alternative models proposed in the literature (3-factor; 5-factor). Model fit was examined using goodness-of-fit indices. We also established DSM-5 ASD prevalence rates relative to DSM-IV ASD, and the ability of these models to classify children impaired by their symptoms.

RESULTS: Based on both the Bayesian Information Criterion, the interfactor correlations and invariance testing, the 3-factor model best accounted for the profile of ASD symptoms. DSM-5 ASD led to slightly higher prevalence rates than DSM-IV ASD and performed similarly to DSM-IV with respect to categorising children impaired by their symptoms. Modifying the DSM-5 ASD algorithm to a 3+ or 4+ symptom requirement was the strongest predictor of impairment.

CONCLUSIONS: These findings suggest that a uni-factorial general-distress model is not the optimal model of capturing the latent structure of ASD symptom profiles in youth and that modifying the current DSM-5 9+ symptom algorithm could potentially lead to a more developmentally sensitive conceptualization.

DOI10.1111/jcpp.12597
Alternate JournalJ Child Psychol Psychiatry
PubMed ID27472990
PubMed Central IDPMC5091623
Grant ListMRC_MC_EX_G0802821 / / Medical Research Council / United Kingdom
MRC_MC_U105579212 / / Medical Research Council / United Kingdom