Existing literature indicates significant comorbidity between posttraumatic stress disorder (PTSD) and major depression. We examined whether PTSD's dysphoria and mood/cognitions factors, conceptualized by the empirically supported four-factor DSM-5 PTSD models, account for PTSD's inherent relationship with depression. We hypothesized that depression's somatic and non-somatic factors would be more related to PTSD's dysphoria and mood/cognitions factors than other PTSD model factors. Further, we hypothesized that PTSD's arousal would significantly mediate relations between PTSD's dysphoria and somatic/non-somatic depression. Using 181 trauma-exposed primary care patients, confirmatory factor analyses (CFA) indicated a well-fitting DSM-5 PTSD dysphoria model, DSM-5 numbing model and two-factor depression model. Both somatic and non-somatic depression factors were more related to PTSD's dysphoria and mood/cognitions factors than to re-experiencing and avoidance factors; non-somatic depression was more related to PTSD's dysphoria than PTSD's arousal factor. PTSD's arousal did not mediate the relationship between PTSD's dysphoria and somatic/non-somatic depression. Implications are discussed. (C) 2013 Elsevier Ireland Ltd. All rights reserved.
Psychiatry Research, 2014, Vol 215, Issue 1, p. 146-153
PTSD Depression DSM-5 Primary care sample Structural equation modeling Mediation Confirmatory factor analyses POSTTRAUMATIC-STRESS-DISORDER CONFIRMATORY FACTOR-ANALYSIS NATIONAL COMORBIDITY SURVEY PATIENT HEALTH QUESTIONNAIRE-9 PSYCHOLOGICAL DISTRESS UNDERLYING DIMENSIONS SURVEY REPLICATION ANXIETY DISORDERS COMPETING MODELS PHYSICAL HEALTH