Posttraumatic Symptom Structure Across Age Groups

The applicability of diagnostic criteria of Posttraumatic Stress Disorder to the pediatric population has been a focus of much debate (e.g., Carrion, Weems, Ray, & Reiss, 2002), informing changes in the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5). The current study examined the factor structure of posttraumatic distress among adult versus pediatric samples using confirmatory factor analysis. The analysis was performed on the DSM-IV-adherent Posttraumatic Diagnostic Scale (Foa, Cashman, Jaycox, & Perry, 1997) and Child Posttraumatic Symptom Scale (Foa, Johnson, Feeny, & Treadwell, 2001). The sample included 378 adult and 204 child and adolescent victims of diverse single-event traumas. A series of models based on previous findings and DSM-IV specification were evaluated. A 4-factor model (Intrusions, Avoidance, Dysphoria, and Hyperarousal), similar to the DSM-5 model, best fit the data among adults, and a different 4-factor model (Intrusion, Avodiance, Numbing, and Hyperarousal) best fit the data among children and adolescents. Despite some similarity, the posttraumatic symptom profiles of pediatric and adult samples may differ. These differences are not fully incorporated into the DSM-5, and warrant further examination.