Reappraising the dimensional structure of the PTSD Checklist: lessons from the DSM-IV-based PCL-C

Area of Science:

• Psychiatry
• Psychometrics
• Mental Health Research

Background:

• The dimensional structure of posttraumatic stress disorder (PTSD) remains debated, with existing literature showing inconsistencies.
• Methodological issues in evaluating PTSD diagnostic models require further investigation.

Purpose of the Study:

• To re-evaluate the configural and metric structures of key models for the DSM-IV-based civilian version of the PTSD Checklist (PCL-C).
• To address gaps and methodological issues in understanding PTSD's dimensional structure.

Main Methods:

• Confirmatory factor analysis (CFA) and exploratory structural equation models (ESEM) were employed.
• The study analyzed data from 456 women 6-8 weeks postpartum in Rio de Janeiro, Brazil.

Main Results:

• The original three-factor solution and widely supported four-factor models (PTSD-dysphoria, PTSD-numbing) were rejected.
• A two-factor model, encompassing re-experience/avoidance and numbing/hyperarousal, was supported.

Conclusions:

• The findings challenge the dimensional structures proposed in both DSM-IV and DSM-5.
• This necessitates a revised understanding of PTSD's latent structure and PCL-C operationalization.