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The internalizing and externalizing structure of psychiatric comorbidity in combat veterans
Author(s) -
Miller Mark W.,
Fogler Jason M.,
Wolf Erika J.,
Kaloupek Danny G.,
Keane Terence M.
Publication year - 2008
Publication title -
journal of traumatic stress
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.259
H-Index - 134
eISSN - 1573-6598
pISSN - 0894-9867
DOI - 10.1002/jts.20303
Subject(s) - agoraphobia , comorbidity , psychology , panic disorder , psychiatry , clinical psychology , panic , substance abuse , confirmatory factor analysis , alcohol dependence , depression (economics) , anxiety disorder , antisocial personality disorder , anxiety , structural equation modeling , poison control , injury prevention , medicine , alcohol , statistics , chemistry , mathematics , environmental health , economics , macroeconomics , biochemistry
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.