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Sex differences in PTSD symptoms: A differential item functioning approach.

Siobhan Murphy1, Ask Elklit1, Yoke Yong Chen2

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Psychological Trauma : Theory, Research, Practice and Policy
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Sex differences in posttraumatic stress disorder (PTSD) symptoms were examined using differential item functioning (DIF). While minor sex-based differences were found in specific PTSD criteria, overall measurement invariance suggests comparable symptom expression across sexes.

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Area of Science:

  • Psychiatry
  • Psychology
  • Mental Health Research

Background:

  • Sex differences in posttraumatic stress disorder (PTSD) symptom expression are suggested by existing evidence.
  • Few studies have investigated whether these observed sex differences are attributable to measurement invariance.

Purpose of the Study:

  • To examine sex differences in PTSD symptoms based on the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5).
  • To utilize differential item functioning (DIF) analysis to assess measurement invariance of PTSD symptoms across sexes.

Main Methods:

  • Confirmatory factor analysis of the DSM-5 PTSD model.
  • Application of a multiple indicators multiple causes (MIMIC) model to detect DIF.
  • Analysis of data from a Malaysian adolescent sample (n=481).

Main Results:

  • Differential item functioning (DIF) was identified for 2 out of 20 PTSD criteria.
  • Females reported higher emotional cue reactivity (B4), while males reported higher rates of reckless/self-destructive behavior (E2).
  • The magnitude of these item-level sex differences was small.

Conclusions:

  • The presence of DIF for two DSM-5 PTSD symptoms does not strongly support measurement nonequivalence across sexes.
  • Findings suggest that overall PTSD symptom assessment may be comparable between males and females despite minor variations.