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

McKinnon, Anna, Meiser-Stedman, Richard ORCID:, Watson, Peter, Dixon, Clare, Kassam-Adams, Nancy, Ehlers, Anke, Winston, Flaura, Smith, Patrick, Yule, William and Dalgleish, Tim (2016) The latent structure of Acute Stress Disorder symptoms in trauma-exposed children and adolescents. Journal of Child Psychology and Psychiatry, 57 (11). 1308–1316. ISSN 0021-9630

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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.

Item Type: Article
Uncontrolled Keywords: acute stress disorder,dsm-5,factor analysis,children,post-traumatic stress disorder
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
Depositing User: Pure Connector
Date Deposited: 14 Jun 2016 16:00
Last Modified: 22 Oct 2022 01:15
DOI: 10.1111/jcpp.12597

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