摘要：Arthur R. Rademaker ae* , Agnes van Minnen b , Freek Ebberink a , Mirjam van Zuiden ad , Muriel A. Hagenaars c & Elbert Geuze aea Research Centre, Military Mental Healthcare , Utrecht , the Netherlands b Overwaal Centre for Anxiety Disorders, Radboud University Nijmegen , Nijmegen , the Netherlands c Department of ClinicalHealth, and Neuropsychology, Leiden University , Leiden , the Netherlands d Centre for Psychological Trauma, Academic Medical Center , Amsterdam , the Netherlands e Department of PsychiatryRudolf Magnus Institute of Neuroscience , Utrecht University Medical Centre , Utrecht , the Netherlands * Arthur R. Rademaker , Research Centre Military Mental Healthcare, PO Box 90.000, NL-3509 AA Utrecht, the Netherlands. Tel: +31 (0)30 250 2587, Fax: +31 (0)30 250 2683. Email: ar.rademaker@mindef.nl Background As of yet, no collective agreement has been reached regarding the precise factor structure of posttraumatic stress disorder (PTSD). Several alternative factor-models have been proposed in the last decades. Objective The current study examined the fit of a hierarchical adaptation of the Simms et al. ( 2002 ) dysphoria model and compared it to the fit of the PTSD model as depicted in the Diagnostic and Statistical Manual for Mental Disorders, Fourth Edition (DSM-IV), a correlated four-factor emotional numbing, and a correlated four-factor dysphoria model. Methods Data were collected using the Clinician-Administered PTSD Scale in a mixed-trauma sample of treatment-seeking PTSD patients (N=276). Results All examined models provided superior fit to the three-factor model of DSM-IV. The hierarchical four-factor solution provided a better fit than competing models. Conclusion The present study provides empirical support for a conceptualization of PTSD that includes a higher-order PTSD factor that encompasses re-experiencing, arousal, and effortful avoidance sub-factors and a dysphoria factor.
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