PTSD’s Underlying Dimensions in Typhoon Haiyan Survivors: Assessing DSM-5 Symptomatology-Based PTSD Models and Their Relation to Posttraumatic Cognition
Abstract
The recent changes in posttraumatic stress disorder (PTSD) symptomatology in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) call for a re-examination of PTSD's latent factor structure. The present study assessed six competing models of PTSD based on DSM-5 symptomatology using confirmatory factor analysis in a sample of young adult Filipino survivors of typhoon Haiyan, one of the strongest typhoons in the world ever recorded at the time of its landfall (N = 632). Furthermore, the differential relationships of the factors of the best-fitting model with posttraumatic cognitions were also investigated. Results showed the 7-factor hybrid model of PTSD comprised of intrusion, avoidance, negative affect, anhedonia, externalizing behaviors, anxious arousal, and dysphoric arousal, to be the best fitting model. In addition, the varying degrees of relationship with posttraumatic cognitions support the distinctiveness of each factor. These findings are pertinent in light of the changes in DSM-5 PTSD symptomatology, as well as in understanding the underlying dimensions of PTSD among Asian, particularly Filipino, survivors of a natural disaster.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Active avoidance symptoms were found to be related to negative cognitions of the world, whereas reexperiencing was related to negative cognitions of the self.
“Indeed, active avoidance symptoms were found to be related to negative cognitions of the world, whereas reexperiencing was related to negative cognitions of the self (Mordeno et al., 2017).”
From Childhood Physical Abuse and Antisocial Traits: Mediating Role of Posttraumatic Stress Symptom Clusters (2022) · cites this paper as Mordeno et al., 2017
Cites
Diagnostic and Statistical Manual of Mental Disorders
American Psychiatric Association (2013) · doi:10.1176/appi.books.9780890425596 · Cited by 116,369 · see citing works
Diagnostic and Statistical Manual of Mental Disorders
Williams, J. B. W., & First, M. B. (2013) · Oxford University Press eBooks · doi:10.1093/acrefore/9780199975839.013.104 · Cited by 109,841 · see citing works
Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR)
American Psychiatric Association (2000) · doi:10.1176/appi.books.9780890423349 · Cited by 11,069 · see citing works
EQS : structural equations program manual
Bentler, P. M. (1989) · Medical Entomology and Zoology · Cited by 9,669 · see citing works
Bayesian model selection in social research
Raftery, A. E. (1995) · Sociological Methodology · doi:10.2307/271063 · Cited by 6,823 · see citing works
A cognitive model of posttraumatic stress disorder
Ehlers, A., & Clark, D. M. (2000) · Behaviour Research and Therapy · doi:10.1016/s0005-7967(99)00123-0 · Cited by 6,147 · see citing works
Structural Equation Modeling With AMOS: Basic Concepts, Applications, and Programming, Third Edition
Byrne, B. M. (2016) · doi:10.4324/9781315757421 · Cited by 4,653 · see citing works
Fears, phobias, and preparedness: toward an evolved module of fear and fear learning
Öhman, A., & Mineka, S. (2001) · Psychological Review · doi:10.1037/0033-295x.108.3.483 · Cited by 3,147 · cited 1× · see citing works
“On the other hand, fear, a core feature of anxious arousal, is strongly dependent on trauma survivors’ negative perception of the world due to the experience of the traumatic event [40], particularly when these events are perceived to be uncontrollable and unpredictable [63, 64].”
BackgroundEnsuring Positiveness of the Scaled Difference Chi-square Test Statistic
Satorra, A., & Bentler, P. M. (2009) · Psychometrika · doi:10.1007/s11336-009-9135-y · Cited by 2,725 · see citing works
The Posttraumatic Cognitions Inventory (PTCI): development and validation
Foa, E. B., Ehlers, A., Clark, D. M., Tolin, D. F., & Orsillo, S. M. (1999) · Psychological Assessment · doi:10.1037/1040-3590.11.3.303 · Cited by 1,727 · see citing works
Rethinking the mood and anxiety disorders: A quantitative hierarchical model for DSM-V.
Watson, D. (2005) · Journal of Abnormal Psychology · doi:10.1037/0021-843x.114.4.522 · Cited by 1,332 · cited 2× · see citing works
“, reduced positive affect) was based on the theoretical position of Watson and colleagues [28–30] asserting the difference between negative- and positive-valenced affect.”
BackgroundMethod(1997) · Medical Entomology and Zoology · Cited by 1,043 · see citing works
Mineka, S., & Zinbarg, R. (2006) · American Psychologist · doi:10.1037/0003-066x.61.1.10 · Cited by 929 · see citing works
King, D. W., Leskin, G. A., King, L. A., & Weathers, F. W. (1998) · Psychological Assessment · doi:10.1037/1040-3590.10.2.90 · Cited by 784 · see citing works
Simms, L. J., Watson, D., & Doebbeling, B. N. (2002) · Journal of Abnormal Psychology · doi:10.1037//0021-843x.111.4.637 · Cited by 699 · see citing works
(1993) · Medical Entomology and Zoology · Cited by 611 · see citing works
Emotion regulation and aggression
Roberton, T., Daffern, M., & Bucks, R. S. (2011) · Aggression and Violent Behavior · doi:10.1016/j.avb.2011.09.006 · Cited by 599 · see citing works
Simms, L. J., Watson, D., & Doebbelling, B. N. (2002) · Journal of Abnormal Psychology · doi:10.1037/0021-843x.111.4.637 · Cited by 528 · see citing works
Differentiating the mood and anxiety disorders: A quadripartite model
Watson, D. (2009) · Annual Review of Clinical Psychology · doi:10.1146/annurev.clinpsy.032408.153510 · Cited by 498 · see citing works
Finalizing PTSD in DSM-5 : Getting Here From There and Where to Go Next
Friedman, M. J. (2013) · Journal of Traumatic Stress · doi:10.1002/jts.21840 · Cited by 415 · see citing works
Armour, C., Tsai, J., Durham, T. A., Charak, R., Biehn, T. L., Elhai, J. D., & Pietrzak, R. H. (2015) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2014.10.012 · Cited by 384 · see citing works
Cognitive processing therapy for rape victims: A treatment manual
Chrestman, K. R. (1994) · Journal of Anxiety Disorders · doi:10.1016/0887-6185(94)90017-5 · Cited by 374 · see citing works
SMITH, P., YULE, W., PERRIN, S., TRANAH, T., DALGLEISH, T., & CLARK, D. M. (2007) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/chi.0b013e318067e288 · Cited by 355 · cited 1× · see citing works
“notion that the evolution and persistence of PTSD symptoms are significantly affected by having negative trauma-related cognitions [35, 38, 43, 44].”
BackgroundLongitudinal Study of Earthquake-Related PTSD in a Randomly Selected Community Sample in North China
Wang, X., Gao, L., Shinfuku, N., Zhang, H., Zhao, C., & Shen, Y. (2000) · American Journal of Psychiatry · doi:10.1176/appi.ajp.157.8.1260 · Cited by 339 · see citing works
Philippine Journal of Psychology
(2018) · Philippine Journal of Psychology · doi:10.31710/pjp/ · Cited by 335 · see citing works
A meta-analytic investigation of the structure of posttraumatic stress disorder symptoms.
Yufik, T., & Simms, L. J. (2010) · Journal of Abnormal Psychology · doi:10.1037/a0020981 · Cited by 323 · see citing works
Are avoidance and numbing distinct PTSD symptom clusters?
Asmundson, G. J. G., Stapleton, J. A., & Taylor, S. J. (2004) · Journal of Traumatic Stress · doi:10.1007/s10960-004-5795-7 · Cited by 300 · see citing works
Dobson, K. S., & Dozois, D. J. A. (2008) · Elsevier eBooks · doi:10.1016/b978-0-08-045078-0.x0001-9 · Cited by 299 · see citing works
Evidence for a unique PTSD construct represented by PTSD's D1–D3 symptoms
Elhai, J. D., Biehn, T. L., Armour, C., Klopper, J. J., Frueh, B. C., & Palmieri, P. A. (2010) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2010.10.007 · Cited by 288 · see citing works
Liu, P., Wang, L., Cao, C., Wang, R., Zhang, J., Zhang, B., Wu, Q., Zhang, H., Zhao, Z., Fan, G., et al. (2014) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2014.03.008 · Cited by 277 · see citing works
Cognitive Schemas, Beliefs and Assumptions
Dozois, D. J. A., & Beck, A. T. (2008) · Risk Factors in Depression · doi:10.1016/b978-0-08-045078-0.00006-x · Cited by 265 · see citing works
Cognitive change predicts symptom reduction with cognitive therapy for posttraumatic stress disorder
Kleim, B., Grey, N., Wild, J., Nussbeck, F. W., Stott, R., Hackmann, A., Clark, D. M., & Ehlers, A. (2013) · Journal of Consulting and Clinical Psychology · doi:10.1037/a0031290 · Cited by 235 · see citing works
Elhai, J. D., Miller, M. E., Ford, J. D., Biehn, T. L., Palmieri, P. A., & Frueh, B. C. (2011) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2011.08.013 · Cited by 230 · see citing works
Change in negative cognitions associated with PTSD predicts symptom reduction in prolonged exposure.
Zalta, A. K., Gillihan, S. J., Fisher, A. J., Mintz, J., McLean, C. P., Yehuda, R., & Foa, E. B. (2013) · Journal of Consulting and Clinical Psychology · doi:10.1037/a0034735 · Cited by 219 · see citing works
Miller, M. W., Wolf, E. J., Kilpatrick, D. G., Resnick, H. S., Marx, B. P., Holowka, D. W., Keane, T. M., Rosen, R. C., & Friedman, M. J. (2012) · Psychological Trauma Theory Research Practice and Policy · doi:10.1037/a0029730 · Cited by 210 · see citing works
Symptom overlap in posttraumatic stress disorder and major depression
Grös, D. F., Price, M., Magruder, K. M., & Frueh, B. C. (2012) · Psychiatry Research · doi:10.1016/j.psychres.2011.10.022 · Cited by 195 · see citing works
Dimensional Structure of DSM-5 Posttraumatic Stress Disorder Symptoms
Tsai, J., Harpaz‐Rotem, I., Armour, C., Southwick, S. M., Krystal, J. H., & Pietrzak, R. H. (2014) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.14m09091 · Cited by 194 · see citing works
Beck, J. G., Coffey, S. F., Palyo, S. A., Guðmundsdóttir, B., Miller, L. M., & Colder, C. R. (2004) · Psychological Assessment · doi:10.1037/1040-3590.16.3.289 · Cited by 190 · see citing works
Treating the Trauma of Rape: Cognitive-Behavioral Therapy for PTSD
Witterholt, S. T. (1999) · Psychiatric Services · doi:10.1176/ps.50.5.707 · Cited by 186 · see citing works
Pietrzak, R. H., Tsai, J., Armour, C., Mota, N., Harpaz-Rotem, I., & Southwick, S. M. (2015) · Journal of Affective Disorders · doi:10.1016/j.jad.2014.12.007 · Cited by 173 · cited 1× · see citing works
“Interestingly, a growing number of studies found this model to be best fitted in comparison to other models [17, 24, 34] (Table 1).”
ResultMeiser‐Stedman, R., Dalgleish, T., Glucksman, E., Yule, W., & Smith, P. A. (2009) · Journal of Abnormal Psychology · doi:10.1037/a0016945 · Cited by 157 · see citing works
McLean, C. P., Yeh, R., Rosenfield, D., & Foa, E. B. (2015) · Behaviour Research and Therapy · doi:10.1016/j.brat.2015.03.008 · Cited by 147 · see citing works
Evidence for a unique PTSD construct represented by PTSD's D1-D3 symptoms
Armour, C., Elhai, J., Biehn, T. L., Klopper, J. N., Frueh, B. C., & Palmieri, P. A. (2011) · University of Southern Denmark Research Portal (University of Southern Denmark) · Cited by 145 · see citing works
Ehring, T. W., Ehlers, A., Cleare, A. J., & Glucksman, E. (2008) · Psychiatry Research · doi:10.1016/j.psychres.2007.08.014 · Cited by 126 · see citing works
Contractor, A. A., Durham, T. A., Brennan, J. A., Armour, C., Wutrick, H., Frueh, B. C., & Elhai, J. D. (2013) · Psychiatry Research · doi:10.1016/j.psychres.2013.10.015 · Cited by 121 · see citing works
Emotions and the emotional disorders: A quantitative hierarchical perspective
Watson, D., Clark, L. A., & Stasik, S. M. (2011) · DOAJ (DOAJ: Directory of Open Access Journals) · Cited by 117 · see citing works
Armour, C., Elhai, J. D., Richardson, J. D., Ractliffe, K. C., Wang, L., & Elklit, A. (2011) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2011.12.002 · Cited by 102 · see citing works
Palosaari, E. J., Punamäki, R., Qouta, S., & Diab, M. (2013) · Child Abuse & Neglect · doi:10.1016/j.chiabu.2013.04.006 · Cited by 96 · see citing works
Toward a Cognitive-Behavioral Classification System for Mental Disorders
Hofmann, S. G. (2014) · Behavior Therapy · doi:10.1016/j.beth.2014.03.001 · Cited by 93 · see citing works
Armour, C., Elklit, A., Lauterbach, D., & Elhai, J. D. (2014) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2013.12.008 · Cited by 77 · see citing works
Shahar, G., Noyman-Veksler, G., Schnidel-Allon, I., & Gilboa‐Schechtman, E. (2012) · Psychiatry Research · doi:10.1016/j.psychres.2012.07.053 · Cited by 77 · see citing works
The dimensional structure of posttraumatic stress symptomatology in 323,903 U.S. veterans
Harpaz‐Rotem, I., Tsai, J., Pietrzak, R. H., & Hoff, R. A. (2013) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2013.10.020 · Cited by 72 · see citing works
Prevalence and duration of PTSD in survivors 6 years after a natural disaster.
Arnberg, F., Bergh-Johannesson, K., & Michel, P. (2013) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2013.03.011 · Cited by 71 · see citing works
Factor structure of PTSD, and relation with gender in trauma survivors from India
Charak, R., Armour, C., Elklit, A., Angmo, D., Elhai, J., & Koot, H. (2014) · European Journal of Psychotraumatology · doi:10.3402/ejpt.v5.25547 · Cited by 69 · see citing works
Zelazny, K., & Simms, L. J. (2015) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2015.05.009 · Cited by 68 · see citing works
Wang, L., Long, D., Li, Z., & Armour, C. (2011) · Journal of Abnormal Child Psychology · doi:10.1007/s10802-011-9508-4 · Cited by 65 · see citing works
Shevlin, M., McBride, O., Armour, C., & Adamson, G. (2009) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2009.07.001 · Cited by 63 · see citing works
Forbes, D., Lockwood, E., Elhai, J. D., Creamer, M. C., Bryant, R. A., McFARLANE, A. C., Silove, D. M., Miller, M. W., Nickerson, A., & O'Donnell, M. L. (2014) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2014.11.004 · Cited by 56 · see citing works
Daie-Gabai, A., Aderka, I. M., Schindel-Allon, I., Foa, E. B., & Gilboa‐Schechtman, E. (2010) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2010.09.012 · Cited by 56 · see citing works
Bennett, S. A., Beck, J. G., & Clapp, J. D. (2009) · Behaviour Research and Therapy · doi:10.1016/j.brat.2009.07.015 · Cited by 48 · see citing works
Belsher, B. E., Tiêt, Q. Q., Garvert, D. W., & Rosen, C. S. (2012) · Journal of Traumatic Stress · doi:10.1002/jts.21747 · Cited by 34 · see citing works
Armour, C., Ghazali, S. R., & Elklit, A. (2012) · Psychiatry Research · doi:10.1016/j.psychres.2012.09.012 · Cited by 29 · see citing works
Blain, L. M., Galovski, T. E., Elwood, L. S., & Meriac, J. P. (2012) · Psychological Trauma Theory Research Practice and Policy · doi:10.1037/a0030251 · Cited by 21 · see citing works
Demoralization and the longitudinal course of PTSD following Hurricane Mitch
Kohn, R. (2013) · The European Journal of Psychiatry · doi:10.4321/s0213-61632013000100003 · Cited by 19 · see citing works
Mordeno, I. G., Nalipay, M. J. N., Untalan, J. H. C., & Decatoria, J. B. (2014) · Asian Journal of Psychiatry · doi:10.1016/j.ajp.2014.05.003 · Cited by 18 · see citing works
Self-citationRole of prior negative cognitions on the development of intrusive thoughts
Wilksch, S. R., & Nixon, R. D. V. (2009) · Australian Journal of Psychology · doi:10.1080/00049530903089513 · Cited by 18 · see citing works
Mordeno, I. G. (2012) · Philippine Journal of Psychology · Cited by 11 · see citing works
Self-citationSsenyonga, J., Owens, V., & Olema, D. K. (2013) · Procedia - Social and Behavioral Sciences · doi:10.1016/j.sbspro.2013.06.256 · Cited by 11 · see citing works
Hiskey, S., Ayres, R., Andrews, L., & Troop, N. (2014) · Personality and Individual Differences · doi:10.1016/j.paid.2014.10.021 · Cited by 8 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Forkus, S. R., Raudales, A. M., Rafiuddin, H. S., Weiss, N. H., Messman, B. A., & Contractor, A. A. (2023) · Clinical Psychology: Science and Practice · doi:10.1037/cps0000111 · Cited by 262 · see citing works
Harris, C. E., Allbaugh, L. J., & Kaslow, N. J. (2022) · Journal of Child & Adolescent Trauma · doi:10.1007/s40653-021-00364-y · Cited by 2 · see citing works
- Authors
- Mordeno, I. G., Carpio, J. G. E., Nalipay, M. J. N., & Saavedra, R. L. J.
- Affiliations
- Mindanao State University – Iligan Institute of Technology (PH)
- De La Salle University (PH)
- Leyte Normal University (PH)
- Corresponding author
- Nalipay, Ma. Jenina N.
- Venue
- Psychiatric Quarterly
- Published
- 2016-02-26
- Volume
- 88
- Issue
- 1
- Pages
- 9-23
- ISSN
- 0033-2720 (ISSN-L)
- 1573-6709
- OpenAlex
- W2337985392
- Cited by
- 46
- References
- 69
- Citations by year
- 2025: 3 · 2024: 5 · 2023: 3 · 2022: 5 · 2021: 7 · 2020: 5 · 2019: 5 · 2018: 3 · 2017: 6 · 2016: 4
- FWCI
- 8.02
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Psychiatric Quarterly (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Social Sciences › Psychology › Clinical Psychology › Migration, Health and Trauma
- Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
- Keywords
- post-traumatic stress disorder, Typhoon Haiyan, natural disaster survivors, latent factor structure, intrusion, avoidance, negative affect, anhedonia, externalizing problems, anxious arousal, dysphoric arousal
- MeSH terms
- Adolescent, Affect, Anxiety, Arousal, Avoidance Learning, Cognition, Disasters, Dreams, Factor Analysis, Statistical, Female, Humans, Male, Models, Psychological, Philippines, Stress Disorders, Post-Traumatic, Survivors, Diagnostic and Statistical Manual of Mental Disorders, Young Adult, Cyclonic Storms, Anhedonia
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review