Can the dissociative PTSD subtype be identified across two distinct trauma samples meeting caseness for PTSD?

Maj Hansen, Jana Mullerova, Ask Elklit, Cherie Armour

Research output: Contribution to journalArticle

Abstract

For over a century, the occurrence of dissociative symptoms in connection to traumatic exposure has been acknowledged in the scientific literature. Recently, the importance of dissociation has also been recognized in the long-term traumatic response within the DSM-5 nomenclature. Several studies have confirmed the existence of the dissociative posttraumatic stress disorder (PTSD) subtype. However, there is a lack of studies investigating latent profiles of PTSD solely in victimswith PTSD. Purpose and method. The current study investigates the possible presence of PTSD subtypes using latent class analysis (LCA) across two distinct trauma samples meeting caseness for DSM-5 PTSD based on self-reports (N = 787). Moreover, we assessed if a number of risk factors resulted in an increased probability of membership in a dissociative compared to a non-dissociative PTSD class. Results. The results of LCA revealed a two-class solution with two highlysymptomatic classes: a dissociative and a non-dissociative class across both samples. Increased emotion-focused coping increased the probability of individuals being grouped into the dissociative class across both samples. Social support reduced the probability of individuals being grouped into the dissociative class but only in the victims of motor vehicle accidents (MVA) suffering from whiplash. Conclusions. The results are discussed in light of their clinical implications andsuggest that the dissociative subtype can be identified in victims of incest and victims of MVA suffering from whiplash meeting caseness for DSM-5 PTSD.
LanguageEnglish
Pages1159-1169
JournalSocial Psychiatry and Psychiatric Epidemiology
Volume51
Issue number8
DOIs
Publication statusPublished - 31 Aug 2016

Fingerprint

posttraumatic stress disorder
Post-Traumatic Stress Disorders
trauma
Wounds and Injuries
Motor Vehicles
Accidents
motor vehicle
accident
Dissociative Disorders
Incest
Literature
incest
technical literature
Terminology
Social Support
Self Report
social support
Emotions
coping
emotion

Keywords

  • PTSD
  • dissociation
  • subtype
  • latent class analysis

Cite this

Hansen, Maj ; Mullerova, Jana ; Elklit, Ask ; Armour, Cherie. / Can the dissociative PTSD subtype be identified across two distinct trauma samples meeting caseness for PTSD?. 2016 ; Vol. 51, No. 8. pp. 1159-1169.
@article{17582e4dddb34c7aa1de03f67c28b900,
title = "Can the dissociative PTSD subtype be identified across two distinct trauma samples meeting caseness for PTSD?",
abstract = "For over a century, the occurrence of dissociative symptoms in connection to traumatic exposure has been acknowledged in the scientific literature. Recently, the importance of dissociation has also been recognized in the long-term traumatic response within the DSM-5 nomenclature. Several studies have confirmed the existence of the dissociative posttraumatic stress disorder (PTSD) subtype. However, there is a lack of studies investigating latent profiles of PTSD solely in victimswith PTSD. Purpose and method. The current study investigates the possible presence of PTSD subtypes using latent class analysis (LCA) across two distinct trauma samples meeting caseness for DSM-5 PTSD based on self-reports (N = 787). Moreover, we assessed if a number of risk factors resulted in an increased probability of membership in a dissociative compared to a non-dissociative PTSD class. Results. The results of LCA revealed a two-class solution with two highlysymptomatic classes: a dissociative and a non-dissociative class across both samples. Increased emotion-focused coping increased the probability of individuals being grouped into the dissociative class across both samples. Social support reduced the probability of individuals being grouped into the dissociative class but only in the victims of motor vehicle accidents (MVA) suffering from whiplash. Conclusions. The results are discussed in light of their clinical implications andsuggest that the dissociative subtype can be identified in victims of incest and victims of MVA suffering from whiplash meeting caseness for DSM-5 PTSD.",
keywords = "PTSD, dissociation, subtype, latent class analysis",
author = "Maj Hansen and Jana Mullerova and Ask Elklit and Cherie Armour",
note = "Reference text: 1. Janet P (1907) The major symptoms of hysteria. McMillan, New York CrossRef 2. Cardena E, Carlson E (2011) Acute stress disorder revised. Annu Rev Clin Psycho 7:245–267. doi:10.1146/annurev-clinpsy-032210-104502 CrossRef 3. Breh DC, Seidler GH (2007) Is peritraumatic dissociation a risk factor of PTSD? J Traum Dissoc 8:53–69. doi:10.1300/J229v08n01_04 CrossRef 4. Dalenberg CJ, Brand BL, Gleaves DH et al (2012) Evaluation of the evidence for the trauma and fantasy models of dissociation. Psychol Bull 138:550–558. doi:10.1037/a0027447 CrossRefPubMed 5. Ozer EJ, Best SR, Lipsey TL, Weiss DS (2003) Predictors of posttraumatic stress disorder and symptoms in adults: a meta-analysis. Psychol Bull 129:52–73. doi:10.1037/0033-2909.129.1.52 CrossRefPubMed 6. American Psychiatric Association (1994) Diagnostic and statistical manual of mental disorder, 4th edn. American Psychiatric Association, Washington DC 7. American Psychiatric Association (2013) Diagnostic and statistical manual of mental disorders, 5th edn. American Psychiatric Association, Washington DC 8. Armour C, Elklit A, Lauterbach D, Elhai JD (2014) The DSM-5 dissociative-PTSD subtype: can levels of depression, anxiety, hostility, and sleeping difficulties differentiate between dissociative-PTSD and PTSD in rape and sexual assault victims? J Anxiety Disord 28:418–426. doi:10.1016/j.janxdis.2013.12.008 CrossRefPubMed 9. Armour C, Karstoft K, Richardson D (2014) The co-occurrence of PTSD and dissociation: differentiating severe PTSD from dissociative-PTSD. Soc Psych Psych Epid 49:1297–1306. doi:10.1007/s00127-014-0819-y CrossRef 10. Blevins CA, Weathers FW, Witte TK (2014) Dissociation and posttraumatic stress disorder: a latent profile analysis. J Trauma Stress 27:388–396. doi:10.1002/jts.21933 CrossRefPubMed 11. Frewen PA, Brown MFD, Steuwe C, Lanius RA (2015) Latent profile analysis and principal axis factoring of the DSM-5 dissociative subtype. Eur J Psychotraumatol 6:26406. doi:10.3402/ejpt.v6.26406 PubMed 12. Steuwe C, Lanius RA, Frewen PA (2012) Evidence for a dissociative subtype of PTSD by latent profile and confirmatory factor analyses in a civilian sample. Depress Anxiety 29:689–700. doi:10.1002/da.21944 CrossRefPubMed 13. Wolf EJ, Lunney A, Miller MW, Resick PA, Friedman MJ, Schnurr PP (2012) The dissociative subtype of PTSD: a replication and extension. Depress Anxiety 29:679–688. doi:10.1002/da.21946 CrossRefPubMed 14. Wolf EJ, Miller MW, Reardon AF, Ryabchenko KA, Castillo D, Freund R (2012) A latent class analysis of dissociation and posttraumatic stress disorder evidence for a dissociative subtype. Arch Gen Psychiatr 69:698–705 CrossRefPubMedPubMedCentral 15. Weathers FW, Litz BT, Keane TM, Palmieri PA, Marx BP, Schnurr PP (2013) The PTSD checklist for DSM-5 (PCL-5). Scale available from the national center for PTSD. http://www.ptsd.va.gov. Accessed May 25 2015 16. Hansen M, Armour C, Elklit A (2012) Assessing a dysphoric arousal model of acute stress disorder symptoms in a clinical sample of rape and bank robbery victims. Eur J Psychotraumatol. doi:10.3402/ejpt.v3i0.18201 PubMedPubMedCentral 17. Biehn T, Elhai JD, Fine TH, Seligman LD, Richardson JD (2012) PTSD factor structure differences between veterans with or without a PTSD diagnosis. J Anxiety Disord 26:480–485. doi:10.1016/j.janxdis.2012.01.008 CrossRefPubMed 18. Bovin MJ, Marx BP, Schnurr PP (2015) Evolving DSM diagnostic criteria for PTD: relevance for assessment and treatment. Curr Treat Options Psychiatry 2:86–98. doi:10.1007/s40501-015-0032-y CrossRef 19. Armour C, Elhai JD, Layne CM, Shevlin M, Duraković-Belko E, Djapo N, Pynoos RS (2011) Gender differences in the factor structure of posttraumatic stress disorder symptoms in war-exposed adolescents. J Anxiety Disord 25:604–611. doi:10.1016/j.janxdis.2011.01.010 CrossRefPubMed 20. Brewin CR, Andrews B, Valentine JD (2000) Meta-analysis of risk factors for posttraumatic stress disorder in trauma-exposed adults. J Consult Clin Psych 68:748–766. doi:10.1037//0022-006x.68.5.748 CrossRef 21. Christiansen DM, Elklit A, Olff M (2013) Parent bereaved by infant death: PTSD symptoms up to 18 years after the loss. Gen Hosp Psychiat 35:605–611. doi:10.1016/j.genhosppsych.2013.06.006 CrossRef 22. Dieperink M, Leskela J, Thuras P, Engdahl B (2001) Attachment style classification and posttraumatic stress disorder in former prisoners of war. Am J Orthopsychiat 71:374–378. doi:10.1037/0002-9432.71.3.374 CrossRefPubMed 23. Fraley RC, Fazzari DA, Bonanno GA, Dekel S (2006) Attachment and psychological adaptation in high exposure survivors of the September 11th attack on the World Trade Center. Pers Soc Psychol B 32:538–551. doi:10.1177/0146167205282741 CrossRef 24. Hansen M, Elklit A (2014) Who develops posttraumatic stress symptoms following bank robbery? In: Simmons JP (ed) Banking: performance, challenges and prospects for development. Nova Science Publishers Inc, Hauppauge 25. Simeon D, Greenberg J, Nelson D, Schmeidler J, Hollander E (2005) Dissociation and posttraumatic stress 1 year after the world trade center disaster: follow-up of a longitudinal survey. J Clin Psychiatr 66:231–237. doi:10.4088/JCP.v66n0212 CrossRef 26. Tolin DF, Foa E (2006) Sex differences in trauma and posttraumatic stress disorder: a quantitative review of 25 years of research. Psychol Bull 132:959–992. doi:10.1037/0033-2909.132.6.959 CrossRefPubMed 27. Elklit A, Shevlin M (2007) The structure of PTSD symptoms: a test of alternative models using confirmatory factor analysis. Br J Clin Psychol 46:299–313. doi:10.1348/014466506X171540 CrossRefPubMed 28. Elklit A, Christiansen DM, Palic S, Karsberg S, Eriksen SB (2014) Impact of traumatic events on posttraumatic stress disorder among Danish survivors of sexual abuse in childhood. J Child Sex Abuse 23:918–934. doi:10.1080/10538712.2014.964440 CrossRef 29. Hansen M, Hyland P, Armour C, Shevlin M, Elklit A (2015) Less is more? Assessing the validity of the ICD-11 model of PTSD across multiple trauma samples. Eur J Psychotraumatol 6:28766. doi:10.3402/ejpt.v6.28766 CrossRefPubMed 30. Mollica RF, Caspi-Yavin Y, Bollini P, Truong T, Tor S, Lavelle J (1992) Harvard Trauma Questionnaire. J Nerv Ment Dis 180:111–116 CrossRefPubMed 31. Briere J, Runtz M (1989) The Trauma Symptom Checklist (TSC-33): early data on a new scale. J Interpers Violence 4:151–163. doi:10.1177/088626089004002002 CrossRef 32. Elklit A (1990) M{\aa}ling af belastninger efter voldeligt overfald med TSC-33 traume symptom checkliste [Measuring distress after violent assault with TSC-33]. Nordisk Psykologi 42:281–289 CrossRef 33. Bach M (2003) En empirisk belysning og analyse af “Emotionel Numbing” som eventuel selvst{\ae}ndig faktor i PTSD [An empirical illumination and analysis of emotional numbing as an independent factor in PTSD]. Psykologisk studieskriftserie 6:1–199 34. Joseph S, Andrews B, Williams R, Yule W (1992) Crisis support and psychiatric symptomatology in adult survivors of the Jupiter cruise ship disaster. Brit J Clin Psychol 31:63–73. doi:10.1111/j.2044-8260.1992.tb00968.x CrossRef 35. Elklit A, Pedersen SS, Jind L (2001) The crisis support scale: psychometric qualities and further validation. Pers Individ Differ 31:1291–1302. doi:10.1016/S0191-8869(00)00220-8 CrossRef 36. Roger D, Jarvis G, Narajian B (1993) Detachment and coping: the construction of a new scale for measuring coping strategies. Pers Indiv Differ 15:619–626. doi:10.1016/0191-8869(93)90003-L CrossRef 37. Elklit A (1996) Coping styles questionnaire: a contribution to the validation of a scale for measuring coping strategies. Pers Indiv Differ 21:809–812. doi:10.1016/0191-8869(96)00123-7 CrossRef 38. Collins NL (1996) Working models of attachment: implications for explanation, emotion, and behaviour. J Pers Soc Psychol 58:810–832. doi:10.1037/0022-3514.71.4.810 CrossRef 39. Collins NL, Read SJ (1990) Adult attachment, working models, and the relationship quality in dating couples. J Pers Soc Psychol 58:644–663. doi:10.1037/0022-3514.58.4.644 CrossRefPubMed 40. Nylund K, Asparouhov T, Muth{\'e}n BO (2007) Deciding on the number of classes in latent class analysis and growth mixture modeling: a monte-carlo simulation study. Struct Equ Model 14:535–569 CrossRef 41. Nylund K, Bellmore A, Nishina A, Graham S (2007) Subtypes, severity, and structural stability of peer victimization: what does latent class analysis say? Child Dev 78:1706–1722 CrossRefPubMed 42. Yang C (2006) Evaluating latent class analysis models in qualitative phenotype identification. Comput Stat Data Anal 50:1090–1104. doi:10.1016/j.csda.2004.11.004 CrossRef 43. Raftery AE (1995) Bayesian model selection in social research. Sociol Methodol 25:111–163 CrossRef 44. Asparouhov T, Muth{\'e}n BO (2014) Auxiliary variables in mixture modeling: a 3-step approach using Mplus. Mplus Web Notes (No. 15, Version 8). http://www.statmodel.com 45. Muth{\'e}n LK, Muth{\'e}n BO (2013) Mplus user’s guide, 7th ed. Muth{\'e}n & Muth{\'e}n, Los Angeles 46. Miller MW, Wolf EJ, Kilpatrick D, Resnick H, Marx B, Friedman MJ (2013) The prevalence and latent structure of proposed DSM–5 posttraumatic stress disorder symptoms in US national and veteran samples. Psychol Trauma Theory Res Pract and Policy 5:501–512. doi:10.1037/a0029730 CrossRef 47. Liu P, Wang L, Cao CR et al (2014) The underlying dimensions of DSM-5 posttraumatic stress disorder symptoms in an epidemiological sample of Chinese earthquake survivors. J Anxiety Disord 28:345–351. doi:10.1016/j.janxdis.2014.03.008 CrossRefPubMed 48. Hansen M, Andersen TE, Armour C, Elklit A, Palic S, Mackrill T (2010) PTSD-8: a Short PTSD Inventory. Clin Pract Epidemiol Ment Health 6:101–108. doi:10.2174/1745017901006010101 CrossRefPubMedPubMedCentral 49. Christiansen D, Elklit A (2012) Sex differences in PTSD. In: Ovuga E (ed) Posttraumatic stress disorder in a global context. In Tech: open access book, pp 113–142 50. Wolf EJ, Lunney C, Schnurr PP (2016) The influence of the dissociative subtype of posttraumatic stress disorder on treatment efficacy in female veterans and active duty service members. J Consult Clin Psychol 84:95–100. doi:10.1037/ccp0000036 CrossRefPubMed 51. Maercker A, Brewin CR, Bryant RA et al (2013) Proposals for mental disorders specifically associated with stress in the ICD-11. Lancet 381:1683–1685. doi:10.1016/S0140-6736 CrossRefPubMed 52. Elklit A, Hyland P, Shevlin M (2014) Evidence of symptom profiles consistent with posttraumatic stress disorder and complex posttraumatic stress disorder in different trauma samples. Eur J Psychotraumatol. doi:10.3402/ejpt.v5.24221 53. Cloitre M, Garvert DW, Brewin CR, Bryant RA, Maercker A (2013) Evidence for proposed ICD-11 PTSD and complex PTSD: a latent profile analysis. Eur J Psychotraumatol. doi:10.3402/ejpt.v4i0.20706 54. Cloitre M, Garvert DW, Weiss B, Carlson EB, Bryant RA (2014) Distinguishing PTSD, complex PTSD, and borderline personality disorder: a latent class analysis. Eur J Psychotraumatol. doi:10.3402/ejpt.v5.25097 PubMedPubMedCentral",
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Can the dissociative PTSD subtype be identified across two distinct trauma samples meeting caseness for PTSD? / Hansen, Maj; Mullerova, Jana; Elklit, Ask; Armour, Cherie.

Vol. 51, No. 8, 31.08.2016, p. 1159-1169.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Can the dissociative PTSD subtype be identified across two distinct trauma samples meeting caseness for PTSD?

AU - Hansen, Maj

AU - Mullerova, Jana

AU - Elklit, Ask

AU - Armour, Cherie

N1 - Reference text: 1. Janet P (1907) The major symptoms of hysteria. McMillan, New York CrossRef 2. Cardena E, Carlson E (2011) Acute stress disorder revised. Annu Rev Clin Psycho 7:245–267. doi:10.1146/annurev-clinpsy-032210-104502 CrossRef 3. Breh DC, Seidler GH (2007) Is peritraumatic dissociation a risk factor of PTSD? J Traum Dissoc 8:53–69. doi:10.1300/J229v08n01_04 CrossRef 4. Dalenberg CJ, Brand BL, Gleaves DH et al (2012) Evaluation of the evidence for the trauma and fantasy models of dissociation. Psychol Bull 138:550–558. doi:10.1037/a0027447 CrossRefPubMed 5. Ozer EJ, Best SR, Lipsey TL, Weiss DS (2003) Predictors of posttraumatic stress disorder and symptoms in adults: a meta-analysis. Psychol Bull 129:52–73. doi:10.1037/0033-2909.129.1.52 CrossRefPubMed 6. American Psychiatric Association (1994) Diagnostic and statistical manual of mental disorder, 4th edn. American Psychiatric Association, Washington DC 7. American Psychiatric Association (2013) Diagnostic and statistical manual of mental disorders, 5th edn. American Psychiatric Association, Washington DC 8. Armour C, Elklit A, Lauterbach D, Elhai JD (2014) The DSM-5 dissociative-PTSD subtype: can levels of depression, anxiety, hostility, and sleeping difficulties differentiate between dissociative-PTSD and PTSD in rape and sexual assault victims? J Anxiety Disord 28:418–426. doi:10.1016/j.janxdis.2013.12.008 CrossRefPubMed 9. Armour C, Karstoft K, Richardson D (2014) The co-occurrence of PTSD and dissociation: differentiating severe PTSD from dissociative-PTSD. Soc Psych Psych Epid 49:1297–1306. doi:10.1007/s00127-014-0819-y CrossRef 10. Blevins CA, Weathers FW, Witte TK (2014) Dissociation and posttraumatic stress disorder: a latent profile analysis. J Trauma Stress 27:388–396. doi:10.1002/jts.21933 CrossRefPubMed 11. Frewen PA, Brown MFD, Steuwe C, Lanius RA (2015) Latent profile analysis and principal axis factoring of the DSM-5 dissociative subtype. Eur J Psychotraumatol 6:26406. doi:10.3402/ejpt.v6.26406 PubMed 12. Steuwe C, Lanius RA, Frewen PA (2012) Evidence for a dissociative subtype of PTSD by latent profile and confirmatory factor analyses in a civilian sample. Depress Anxiety 29:689–700. doi:10.1002/da.21944 CrossRefPubMed 13. Wolf EJ, Lunney A, Miller MW, Resick PA, Friedman MJ, Schnurr PP (2012) The dissociative subtype of PTSD: a replication and extension. Depress Anxiety 29:679–688. doi:10.1002/da.21946 CrossRefPubMed 14. Wolf EJ, Miller MW, Reardon AF, Ryabchenko KA, Castillo D, Freund R (2012) A latent class analysis of dissociation and posttraumatic stress disorder evidence for a dissociative subtype. Arch Gen Psychiatr 69:698–705 CrossRefPubMedPubMedCentral 15. Weathers FW, Litz BT, Keane TM, Palmieri PA, Marx BP, Schnurr PP (2013) The PTSD checklist for DSM-5 (PCL-5). Scale available from the national center for PTSD. http://www.ptsd.va.gov. Accessed May 25 2015 16. Hansen M, Armour C, Elklit A (2012) Assessing a dysphoric arousal model of acute stress disorder symptoms in a clinical sample of rape and bank robbery victims. Eur J Psychotraumatol. doi:10.3402/ejpt.v3i0.18201 PubMedPubMedCentral 17. Biehn T, Elhai JD, Fine TH, Seligman LD, Richardson JD (2012) PTSD factor structure differences between veterans with or without a PTSD diagnosis. J Anxiety Disord 26:480–485. doi:10.1016/j.janxdis.2012.01.008 CrossRefPubMed 18. Bovin MJ, Marx BP, Schnurr PP (2015) Evolving DSM diagnostic criteria for PTD: relevance for assessment and treatment. Curr Treat Options Psychiatry 2:86–98. doi:10.1007/s40501-015-0032-y CrossRef 19. Armour C, Elhai JD, Layne CM, Shevlin M, Duraković-Belko E, Djapo N, Pynoos RS (2011) Gender differences in the factor structure of posttraumatic stress disorder symptoms in war-exposed adolescents. J Anxiety Disord 25:604–611. doi:10.1016/j.janxdis.2011.01.010 CrossRefPubMed 20. Brewin CR, Andrews B, Valentine JD (2000) Meta-analysis of risk factors for posttraumatic stress disorder in trauma-exposed adults. J Consult Clin Psych 68:748–766. doi:10.1037//0022-006x.68.5.748 CrossRef 21. Christiansen DM, Elklit A, Olff M (2013) Parent bereaved by infant death: PTSD symptoms up to 18 years after the loss. Gen Hosp Psychiat 35:605–611. doi:10.1016/j.genhosppsych.2013.06.006 CrossRef 22. Dieperink M, Leskela J, Thuras P, Engdahl B (2001) Attachment style classification and posttraumatic stress disorder in former prisoners of war. Am J Orthopsychiat 71:374–378. doi:10.1037/0002-9432.71.3.374 CrossRefPubMed 23. Fraley RC, Fazzari DA, Bonanno GA, Dekel S (2006) Attachment and psychological adaptation in high exposure survivors of the September 11th attack on the World Trade Center. Pers Soc Psychol B 32:538–551. doi:10.1177/0146167205282741 CrossRef 24. Hansen M, Elklit A (2014) Who develops posttraumatic stress symptoms following bank robbery? In: Simmons JP (ed) Banking: performance, challenges and prospects for development. Nova Science Publishers Inc, Hauppauge 25. Simeon D, Greenberg J, Nelson D, Schmeidler J, Hollander E (2005) Dissociation and posttraumatic stress 1 year after the world trade center disaster: follow-up of a longitudinal survey. J Clin Psychiatr 66:231–237. doi:10.4088/JCP.v66n0212 CrossRef 26. Tolin DF, Foa E (2006) Sex differences in trauma and posttraumatic stress disorder: a quantitative review of 25 years of research. Psychol Bull 132:959–992. doi:10.1037/0033-2909.132.6.959 CrossRefPubMed 27. Elklit A, Shevlin M (2007) The structure of PTSD symptoms: a test of alternative models using confirmatory factor analysis. Br J Clin Psychol 46:299–313. doi:10.1348/014466506X171540 CrossRefPubMed 28. Elklit A, Christiansen DM, Palic S, Karsberg S, Eriksen SB (2014) Impact of traumatic events on posttraumatic stress disorder among Danish survivors of sexual abuse in childhood. J Child Sex Abuse 23:918–934. doi:10.1080/10538712.2014.964440 CrossRef 29. Hansen M, Hyland P, Armour C, Shevlin M, Elklit A (2015) Less is more? Assessing the validity of the ICD-11 model of PTSD across multiple trauma samples. Eur J Psychotraumatol 6:28766. doi:10.3402/ejpt.v6.28766 CrossRefPubMed 30. Mollica RF, Caspi-Yavin Y, Bollini P, Truong T, Tor S, Lavelle J (1992) Harvard Trauma Questionnaire. J Nerv Ment Dis 180:111–116 CrossRefPubMed 31. Briere J, Runtz M (1989) The Trauma Symptom Checklist (TSC-33): early data on a new scale. J Interpers Violence 4:151–163. doi:10.1177/088626089004002002 CrossRef 32. Elklit A (1990) Måling af belastninger efter voldeligt overfald med TSC-33 traume symptom checkliste [Measuring distress after violent assault with TSC-33]. Nordisk Psykologi 42:281–289 CrossRef 33. Bach M (2003) En empirisk belysning og analyse af “Emotionel Numbing” som eventuel selvstændig faktor i PTSD [An empirical illumination and analysis of emotional numbing as an independent factor in PTSD]. Psykologisk studieskriftserie 6:1–199 34. Joseph S, Andrews B, Williams R, Yule W (1992) Crisis support and psychiatric symptomatology in adult survivors of the Jupiter cruise ship disaster. Brit J Clin Psychol 31:63–73. doi:10.1111/j.2044-8260.1992.tb00968.x CrossRef 35. Elklit A, Pedersen SS, Jind L (2001) The crisis support scale: psychometric qualities and further validation. Pers Individ Differ 31:1291–1302. doi:10.1016/S0191-8869(00)00220-8 CrossRef 36. Roger D, Jarvis G, Narajian B (1993) Detachment and coping: the construction of a new scale for measuring coping strategies. Pers Indiv Differ 15:619–626. doi:10.1016/0191-8869(93)90003-L CrossRef 37. Elklit A (1996) Coping styles questionnaire: a contribution to the validation of a scale for measuring coping strategies. Pers Indiv Differ 21:809–812. doi:10.1016/0191-8869(96)00123-7 CrossRef 38. Collins NL (1996) Working models of attachment: implications for explanation, emotion, and behaviour. J Pers Soc Psychol 58:810–832. doi:10.1037/0022-3514.71.4.810 CrossRef 39. Collins NL, Read SJ (1990) Adult attachment, working models, and the relationship quality in dating couples. J Pers Soc Psychol 58:644–663. doi:10.1037/0022-3514.58.4.644 CrossRefPubMed 40. Nylund K, Asparouhov T, Muthén BO (2007) Deciding on the number of classes in latent class analysis and growth mixture modeling: a monte-carlo simulation study. Struct Equ Model 14:535–569 CrossRef 41. Nylund K, Bellmore A, Nishina A, Graham S (2007) Subtypes, severity, and structural stability of peer victimization: what does latent class analysis say? Child Dev 78:1706–1722 CrossRefPubMed 42. Yang C (2006) Evaluating latent class analysis models in qualitative phenotype identification. Comput Stat Data Anal 50:1090–1104. doi:10.1016/j.csda.2004.11.004 CrossRef 43. Raftery AE (1995) Bayesian model selection in social research. Sociol Methodol 25:111–163 CrossRef 44. Asparouhov T, Muthén BO (2014) Auxiliary variables in mixture modeling: a 3-step approach using Mplus. Mplus Web Notes (No. 15, Version 8). http://www.statmodel.com 45. Muthén LK, Muthén BO (2013) Mplus user’s guide, 7th ed. Muthén & Muthén, Los Angeles 46. Miller MW, Wolf EJ, Kilpatrick D, Resnick H, Marx B, Friedman MJ (2013) The prevalence and latent structure of proposed DSM–5 posttraumatic stress disorder symptoms in US national and veteran samples. Psychol Trauma Theory Res Pract and Policy 5:501–512. doi:10.1037/a0029730 CrossRef 47. Liu P, Wang L, Cao CR et al (2014) The underlying dimensions of DSM-5 posttraumatic stress disorder symptoms in an epidemiological sample of Chinese earthquake survivors. J Anxiety Disord 28:345–351. doi:10.1016/j.janxdis.2014.03.008 CrossRefPubMed 48. Hansen M, Andersen TE, Armour C, Elklit A, Palic S, Mackrill T (2010) PTSD-8: a Short PTSD Inventory. Clin Pract Epidemiol Ment Health 6:101–108. doi:10.2174/1745017901006010101 CrossRefPubMedPubMedCentral 49. Christiansen D, Elklit A (2012) Sex differences in PTSD. In: Ovuga E (ed) Posttraumatic stress disorder in a global context. In Tech: open access book, pp 113–142 50. Wolf EJ, Lunney C, Schnurr PP (2016) The influence of the dissociative subtype of posttraumatic stress disorder on treatment efficacy in female veterans and active duty service members. J Consult Clin Psychol 84:95–100. doi:10.1037/ccp0000036 CrossRefPubMed 51. Maercker A, Brewin CR, Bryant RA et al (2013) Proposals for mental disorders specifically associated with stress in the ICD-11. Lancet 381:1683–1685. doi:10.1016/S0140-6736 CrossRefPubMed 52. Elklit A, Hyland P, Shevlin M (2014) Evidence of symptom profiles consistent with posttraumatic stress disorder and complex posttraumatic stress disorder in different trauma samples. Eur J Psychotraumatol. doi:10.3402/ejpt.v5.24221 53. Cloitre M, Garvert DW, Brewin CR, Bryant RA, Maercker A (2013) Evidence for proposed ICD-11 PTSD and complex PTSD: a latent profile analysis. Eur J Psychotraumatol. doi:10.3402/ejpt.v4i0.20706 54. Cloitre M, Garvert DW, Weiss B, Carlson EB, Bryant RA (2014) Distinguishing PTSD, complex PTSD, and borderline personality disorder: a latent class analysis. Eur J Psychotraumatol. doi:10.3402/ejpt.v5.25097 PubMedPubMedCentral

PY - 2016/8/31

Y1 - 2016/8/31

N2 - For over a century, the occurrence of dissociative symptoms in connection to traumatic exposure has been acknowledged in the scientific literature. Recently, the importance of dissociation has also been recognized in the long-term traumatic response within the DSM-5 nomenclature. Several studies have confirmed the existence of the dissociative posttraumatic stress disorder (PTSD) subtype. However, there is a lack of studies investigating latent profiles of PTSD solely in victimswith PTSD. Purpose and method. The current study investigates the possible presence of PTSD subtypes using latent class analysis (LCA) across two distinct trauma samples meeting caseness for DSM-5 PTSD based on self-reports (N = 787). Moreover, we assessed if a number of risk factors resulted in an increased probability of membership in a dissociative compared to a non-dissociative PTSD class. Results. The results of LCA revealed a two-class solution with two highlysymptomatic classes: a dissociative and a non-dissociative class across both samples. Increased emotion-focused coping increased the probability of individuals being grouped into the dissociative class across both samples. Social support reduced the probability of individuals being grouped into the dissociative class but only in the victims of motor vehicle accidents (MVA) suffering from whiplash. Conclusions. The results are discussed in light of their clinical implications andsuggest that the dissociative subtype can be identified in victims of incest and victims of MVA suffering from whiplash meeting caseness for DSM-5 PTSD.

AB - For over a century, the occurrence of dissociative symptoms in connection to traumatic exposure has been acknowledged in the scientific literature. Recently, the importance of dissociation has also been recognized in the long-term traumatic response within the DSM-5 nomenclature. Several studies have confirmed the existence of the dissociative posttraumatic stress disorder (PTSD) subtype. However, there is a lack of studies investigating latent profiles of PTSD solely in victimswith PTSD. Purpose and method. The current study investigates the possible presence of PTSD subtypes using latent class analysis (LCA) across two distinct trauma samples meeting caseness for DSM-5 PTSD based on self-reports (N = 787). Moreover, we assessed if a number of risk factors resulted in an increased probability of membership in a dissociative compared to a non-dissociative PTSD class. Results. The results of LCA revealed a two-class solution with two highlysymptomatic classes: a dissociative and a non-dissociative class across both samples. Increased emotion-focused coping increased the probability of individuals being grouped into the dissociative class across both samples. Social support reduced the probability of individuals being grouped into the dissociative class but only in the victims of motor vehicle accidents (MVA) suffering from whiplash. Conclusions. The results are discussed in light of their clinical implications andsuggest that the dissociative subtype can be identified in victims of incest and victims of MVA suffering from whiplash meeting caseness for DSM-5 PTSD.

KW - PTSD

KW - dissociation

KW - subtype

KW - latent class analysis

U2 - 10.1007/s00127-016-1235-2

DO - 10.1007/s00127-016-1235-2

M3 - Article

VL - 51

SP - 1159

EP - 1169

IS - 8

ER -