Confirmatory factor analysis of posttraumatic stress symptoms in Brazilian primary care patients: An examination of seven alternative models

The DSM-IV-TR postulates that PTSD symptoms are organized into 3 clusters. This assumption has been challenged by growing number of factor analytical studies, which tend to favor 4-factor, first-order models. Our objective was to investigate whether the clusters of PTSD symptoms identified in North American and European studies could be replicated in a Brazilian sample composed of 805 primary care patients living in hillside slums. Volunteers were asked to fill out the Brazilian version of the Posttraumatic Stress Disorder Checklist—Civilian Version and a confirmatory factor analysis of this scale was conducted with the software LISREL 8.80. Seven models were tested and a 4-factor, first-order solution including an emotional numbing cluster was found to provide the best fit. Although PTSD has been characterized by some critics as a Western culture-specific disorder lacking universal validity, our results seem to uphold the cross-cultural validity of the 4-factor, first-order model.

► The DSM-IV-TR postulates that PTSD symptoms are organized into 3 clusters.
► However, recent factor analytical studies tend to favor 4-factor, first-order models.
► 805 Brazilian primary care patients filled out the PCL-C and a CFA was conducted.
► A 4-factor, first-order solution including a numbing cluster provided the best fit.
► The results uphold the cross-cultural validity of the 4-factor, first-order model.