Confirmatory factor analyses of DSM-5 posttraumatic stress disorder symptoms in psychiatric samples differing in Criterion A status

•We compared several DSM-5 PTSD models in a large psychiatric sample.•Patients reported symptoms referencing a Criterion-A trauma or stressful life event.•A novel 6-factor dysphoria and 7-factor hybrid model outperformed other models.•Criterion-A qualification did not alter structural results.•The 6-factor dysphoria model emerged as the most parsimonious solution.

We examined the symptom structure of posttraumatic stress disorder (PTSD), as defined by American Psychiatric Association (2013. Diagnostic and statistical manual of mental disorders (DSM-5) (5th ed.). Washington, DC: Author). DSM-5 introduced notable changes to PTSD criteria, and the structural impact of these changes is unclear. We conducted confirmatory factor analyses comparing seven commonly investigated or recently proposed PTSD models in a large sample of interviewed psychiatric outpatients reporting a Criterion A trauma (n = 310) or a sub-threshold (non-Criterion A) stressful life event (n = 284). A novel six-factor dysphoria model and recently proposed seven-factor hybrid model outperformed other models and fit the data equally well in both groups. Our results suggest equal fit for both models, although the six-factor model is more parsimonious. These results have implications for research regarding the mechanisms underlying and the treatments targeting PTSD.