The structure of post-traumatic stress symptoms in young survivors of war

Research on the dimensionality of post-traumatic stress disorder (PTSD) has generally failed to provide support for the three clusters of PTSD suggested in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). However, much research has been restricted to samples in North America and Western European countries. The aim of the current study was to test four alternative factor models among a relatively understudied population–young civilian survivors of war who had experienced war-related events as adolescents–in order to establish whether the factor structure of PTSD is consistent among various traumatized populations and age groups. Using the Posttraumatic Stress Diagnostic Scale, the results indicated that the four-factor model including intrusion, avoidance, hyperarousal, and numbing factors provided a better fit than the three-factor model suggested by the DSM-IV. The current study offers additional support from another population for a four-factor model of PTSD that implies a separation of avoidance and numbing items. Case conceptualization and treatment implications are discussed.