Article

The internalizing and externalizing structure of psychiatric comorbidity in combat veterans

National Center for PTSD, VA Boston Healthcare System, Boston, MA 02130, USA.
Journal of Traumatic Stress (Impact Factor: 2.72). 02/2008; 21(1):58-65. DOI: 10.1002/jts.20303
Source: PubMed

ABSTRACT This study examined the latent structure of psychiatric disorders in a sample with a high prevalence of PTSD. A series of confirmatory factor analyses tested competing models for the covariation between Structured Clinical Interview for DSM-III-R diagnoses among 1,325 Vietnam veterans. The best-fitting solution was a 3-factor model that included two correlated internalizing factors: anxious-misery, defined by PTSD and major depression, and fear, defined by panic disorder/agoraphobia and obsessive-compulsive disorder. The third factor, externalizing, was defined by antisocial personality disorder, alcohol abuse/dependence, and drug abuse/dependence. Both substance-related disorders also showed significant, albeit smaller, cross-loadings on the anxious-misery factor. These findings shed new light on the structure of psychiatric comorbidity in a treatment-seeking sample characterized by high rates of PTSD.

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