Relations Between PTSD and Distress Dimensions in an Indian Child/Adolescent Sample Following the 2008 Mumbai Terrorist Attacks

Posttraumatic stress disorder’s (PTSD) four-factor dysphoria model has substantial empirical support (reviewed in Elhai & Palmieri, Journal of Anxiety Disorders, 25, 849–854, 2011; Yufik & Simms, Journal of Abnormal Psychology, 119, 764–776, 2010). However, debatable is whether the model’s dysphoria factor adequately captures all of PTSD’s emotional distress (e.g., Marshall et al., Journal of Abnormal Psychology, 119(1), 126–135, 2010), which is relevant to understanding the assessment and psychopathology of PTSD. Thus, the present study assessed the factor-level relationship between PTSD and emotional distress in 818 children/adolescents attending school in the vicinity of the 2008 Mumbai terrorist attacks. The effective sample had a mean age of 12.85 years (SD = 1.33), with the majority being male (n = 435, 53.8 %). PTSD and emotional distress were measured by the UCLA PTSD Reaction Index (PTSD-RI) and Brief Symptom Inventory-18 (BSI-18) respectively. Confirmatory factor analyses (CFA) assessed the PTSD and BSI-18 model fit; Wald tests assessed hypothesized PTSD-distress latent-level relations; and invariance testing examined PTSD-distress parameter differences using age, gender and direct exposure as moderators. There were no moderating effects for the PTSD-distress structural parameters. BSI-18’s depression and somatization factors related more to PTSD’s dysphoria than PTSD’s avoidance factor. The results emphasize assessing for specificity and distress variance of PTSD factors on a continuum, rather than assuming dysphoria factor’s complete accountability for PTSD’s inherent distress. Additionally, PTSD’s dysphoria factor related more to BSI-18’s depression than BSI-18’s anxiety/somatization factors; this may explain PTSD’s comorbidity mechanism with depressive disorders