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

10 Citations (Scopus)

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 victims with 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 highly symptomatic 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 and suggest 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
Early online date11 May 2016
DOIs
Publication statusE-pub ahead of print - 11 May 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{0040cc9e529847d084ea1d0452d741da,
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 victims with 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 highly symptomatic 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 and suggest 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: References 1. Janet P (1907) The major symptoms of hysteria. McMillan: New York. 2. Cardena E, Carlson E (2011) Acute stress disorder revised. Annu Rev Clin Psycho, 7:245-267. doi: 10.1146/annurev-clinpsy-032210-104502 3. Breh DC, Seidler GH (2007) Is peritraumatic dissociation a risk factor of PTSD? Journal of Traum and Dissociation, 8:53-69. doi: 10.1300/J229v08n01_04 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 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 6. American Psychiatric Association (1994) Diagnostic and Statistical Manual of Mental Disorders, 4thed. Washington DC: American Psychiatric Association. 7. American Psychiatric Association (2013) Diagnostic and Statistical Manual of Mental Disorders, 5thed. Washington DC: American Psychiatric Association. 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 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 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 11. Frewen PA, Brown MFD, Steuwe C, Lanius RA (2015) Latent profile analysis and principal axis factoring of the DSM-5 dissociative subtype. European Journal of Psychotraumatology, 6:26406. doi: 10.3402/ejpt.v6.26406 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 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 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 Psychiat, 69:698–705. 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. Retrieved May 25 2015 from http://www.ptsd.va.gov 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. European Journal of Psychotraumatology, 3. doi:10.3402/ejpt.v3i0.18201 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. http://dx.doi.org/10.1016/j.janxdis.2012.01.008 18. Bovin MJ, Marx BP, Schnurr PP (2015) Evolving DSM diagnostic criteria for PTD: Relevance for assessment and treatment. Current Treatment Options in Psychiatry, 2:86-98. doi: 10.1007/s40501-015-0032-y 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 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 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 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: http://dx.doi.org/10.1037/0002-9432.71.3.374 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 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, Hauppauge New York: Nova Science Publishers Inc. 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 Psychiat, 66:231-237. doi: 10.4088/JCP.v66n0212 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 27. Elklit A, Shevlin M (2007). The structure of PTSD symptoms: A test of alternative models using confirmatory factor analysis. British Journal of Clinical Psychology, 46: 299-313. doi: 10.1348/014466506X171540 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. Journal of Child Sexual Abuse, 23:918-934. doi: 10.1080/10538712.2014.964440 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. European Journal of Psychotraumatology, 6:28766. doi: 10.3402/ejpt.v6.28766 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. 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 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. 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 35. Elklit A, Pedersen SS, Jind L (2001) The crisis support scale: Psychometric qualities and further validation. Pers Individual Differ, 31:1291-1302. doi: 10.1016/S0191-8869(00)00220-8 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 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 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 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 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 Modeling, 14:535-569. 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. 42. Yang C (2006) Evaluating latent class analysis models in qualitative phenotype identification. Computational Statistics and Data Analysis, 50:1090-1104. doi: 10.1016/j.csda.2004.11.004 43. Raftery AE (1995) Bayesian model selection in social research. Sociol Methodol, 25:111-163. 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). Retrieved from www.statmodel.com 45. Muth{\'e}n LK, Muth{\'e}n BO (1998-2013) 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, M J (2013). The prevalence and latent structure of proposed DSM–5 posttraumatic stress disorder symptoms in U.S. national and veteran samples. Psychological Trauma: Theory, Research, Practice, and Policy, 5: 501–512. doi: 10.1037/a0029730 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. Journal of Anxiety Disorders, 28: 345-351. doi: 10.1016/j.janxdis.2014.03.008 48. Hansen M, Andersen TE, Armour C, Elklit A, Palic S, Mackrill T, (2010) PTSD-8: A Short PTSD Inventory. Clinical Practice and Epidemiology in Mental Health, 6:101-108. doi: 10.2174{\%}2F1745017901006010101 49. Christiansen D, Elklit A (2012) Sex differences in PTSD. In E Ovuga (Ed.). Posttraumatic stress disorder in a global context (pp.113-142). In Tech: open access book. 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. Journal of Consulting and Clinical Psychology, 84: 95-100. doi: 10.1037/ccp0000036 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 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. European Journal of Psychotraumatology 5.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. European Journal of Psychotraumatology, 4. 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. European Journal of Psychotraumatology, 5. doi: 10.3402/ejpt.v5.25097",
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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, 11.05.2016, 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: References 1. Janet P (1907) The major symptoms of hysteria. McMillan: New York. 2. Cardena E, Carlson E (2011) Acute stress disorder revised. Annu Rev Clin Psycho, 7:245-267. doi: 10.1146/annurev-clinpsy-032210-104502 3. Breh DC, Seidler GH (2007) Is peritraumatic dissociation a risk factor of PTSD? Journal of Traum and Dissociation, 8:53-69. doi: 10.1300/J229v08n01_04 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 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 6. American Psychiatric Association (1994) Diagnostic and Statistical Manual of Mental Disorders, 4thed. Washington DC: American Psychiatric Association. 7. American Psychiatric Association (2013) Diagnostic and Statistical Manual of Mental Disorders, 5thed. Washington DC: American Psychiatric Association. 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 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 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 11. Frewen PA, Brown MFD, Steuwe C, Lanius RA (2015) Latent profile analysis and principal axis factoring of the DSM-5 dissociative subtype. European Journal of Psychotraumatology, 6:26406. doi: 10.3402/ejpt.v6.26406 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 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 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 Psychiat, 69:698–705. 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. Retrieved May 25 2015 from http://www.ptsd.va.gov 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. European Journal of Psychotraumatology, 3. doi:10.3402/ejpt.v3i0.18201 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. http://dx.doi.org/10.1016/j.janxdis.2012.01.008 18. Bovin MJ, Marx BP, Schnurr PP (2015) Evolving DSM diagnostic criteria for PTD: Relevance for assessment and treatment. Current Treatment Options in Psychiatry, 2:86-98. doi: 10.1007/s40501-015-0032-y 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 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 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 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: http://dx.doi.org/10.1037/0002-9432.71.3.374 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 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, Hauppauge New York: Nova Science Publishers Inc. 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 Psychiat, 66:231-237. doi: 10.4088/JCP.v66n0212 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 27. Elklit A, Shevlin M (2007). The structure of PTSD symptoms: A test of alternative models using confirmatory factor analysis. British Journal of Clinical Psychology, 46: 299-313. doi: 10.1348/014466506X171540 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. Journal of Child Sexual Abuse, 23:918-934. doi: 10.1080/10538712.2014.964440 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. European Journal of Psychotraumatology, 6:28766. doi: 10.3402/ejpt.v6.28766 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. 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 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. 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 35. Elklit A, Pedersen SS, Jind L (2001) The crisis support scale: Psychometric qualities and further validation. Pers Individual Differ, 31:1291-1302. doi: 10.1016/S0191-8869(00)00220-8 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 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 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 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 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 Modeling, 14:535-569. 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. 42. Yang C (2006) Evaluating latent class analysis models in qualitative phenotype identification. Computational Statistics and Data Analysis, 50:1090-1104. doi: 10.1016/j.csda.2004.11.004 43. Raftery AE (1995) Bayesian model selection in social research. Sociol Methodol, 25:111-163. 44. Asparouhov T, Muthén BO (2014) Auxiliary variables in mixture modeling: A 3-step approach using Mplus. Mplus Web Notes (No. 15, Version 8). Retrieved from www.statmodel.com 45. Muthén LK, Muthén BO (1998-2013) Mplus user’s guide (7th ed). Muthén & Muthén, Los Angeles. 46. Miller MW, Wolf EJ, Kilpatrick D, Resnick H, Marx B, & Friedman, M J (2013). The prevalence and latent structure of proposed DSM–5 posttraumatic stress disorder symptoms in U.S. national and veteran samples. Psychological Trauma: Theory, Research, Practice, and Policy, 5: 501–512. doi: 10.1037/a0029730 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. Journal of Anxiety Disorders, 28: 345-351. doi: 10.1016/j.janxdis.2014.03.008 48. Hansen M, Andersen TE, Armour C, Elklit A, Palic S, Mackrill T, (2010) PTSD-8: A Short PTSD Inventory. Clinical Practice and Epidemiology in Mental Health, 6:101-108. doi: 10.2174%2F1745017901006010101 49. Christiansen D, Elklit A (2012) Sex differences in PTSD. In E Ovuga (Ed.). Posttraumatic stress disorder in a global context (pp.113-142). In Tech: open access book. 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. Journal of Consulting and Clinical Psychology, 84: 95-100. doi: 10.1037/ccp0000036 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 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. European Journal of Psychotraumatology 5.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. European Journal of Psychotraumatology, 4. 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. European Journal of Psychotraumatology, 5. doi: 10.3402/ejpt.v5.25097

PY - 2016/5/11

Y1 - 2016/5/11

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 victims with 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 highly symptomatic 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 and suggest 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 victims with 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 highly symptomatic 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 and suggest 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 -