Confirmatory factor analyses of posttraumatic stress symptoms in deployed and nondeployed veterans of the Gulf War

Confirmatory factor analysis was used to compare 6 models of posttraumatic stress disorder (PTSD) symptoms, ranging from 1 to 4 factors, in a sample of 3,695 deployed Gulf War veterans (N 1,896) and nondeployed controls (N 1,799). The 4 correlated factors—intrusions, avoidance, hyperarousal, and dysphoria—provided the best fit. The dysphoria factor combined traditional markers of numbing and hyperarousal. Model superiority was cross-validated in multiple subsamples, including a subset of deployed participants who were exposed to traumatic combat stressors. Moreover, convergent and discriminant validity correlations suggested that intrusions may be relatively specific to PTSD, whereas dysphoria may represent a nonspecific component of many disorders. Results are discussed in the context of hierarchical models of anxiety and depression. Posttraumatic stress disorder (PTSD) is an anxiety disorder characterized by three symptom clusters that may result from exposure to a severely traumatic event, according to criteria of the Diagnostic and Statistical Manual of Mental Disorders (4th edi-tion; DSM–IV; American Psychiatric Association, 1994), which require (a) that the event involved actual or threatened death o