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Factor analysis of posttraumatic stress disorder symptoms using data pooled from two venlafaxine extended-release clinical trials

Factor analysis of posttraumatic stress disorder symptoms using data pooled from two venlafaxine extended-release clinical trials
Factor analysis of posttraumatic stress disorder symptoms using data pooled from two venlafaxine extended-release clinical trials
BACKGROUND: Confirmatory factor analysis (CFA) of Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) (DSM-IV) three-factor posttraumatic stress disorder (PTSD) diagnostic criteria was conducted to determine fit for this patient population. An exploratory factor analysis (EFA) of alternate symptom structures was planned to identify symptoms that cluster in this population. The response of symptom factors to treatment with venlafaxine extended release (ER) was explored.

METHODS: Baseline 17-item Clinician-Administered PTSD Scale (CAPS-SX17) data were pooled from patients enrolled in two double-blind, randomized, placebo-controlled trials. The CFA was conducted using maximum likelihood and weighted, least-squares factor extraction methods. The EFA was performed using a polychoric correlation covariance matrix and Pearson correlation matrix.

RESULTS: Data from a pooled population of 685 patients (venlafaxine ER: n = 339; placebo: n = 346) were analyzed. CFA rejected the DSM-IV three-factor structure. The EFA identified a different three-factor structure as the best fit: factor 1 included reexperiencing symptoms, factor 2 included symptoms of altered mood and cognition, whereas factor 3 comprised avoidance and arousal symptoms. All DSM-IV symptom factors and all factors in the identified three-factor model responded positively to venlafaxine ER treatment.

CONCLUSIONS: Data are consistent with literature failing to confirm the three-factor structure of DSM-IV PTSD, and they support the DSM-5 inclusion of a symptom cluster addressing altered mood and cognition in PTSD. The efficacy of venlafaxine ER in reducing a range of symptom clusters in PTSD is consistent with its multiple mechanisms of action.

738-746
Stein, D.J.
908f8238-f5e4-4ea1-9f19-9be45feea5b6
Rothbaum, B.O.
6899f274-4948-49e3-8377-6be800f7cde3
Baldwin, D.S.
1beaa192-0ef1-4914-897a-3a49fc2ed15e
Szumski, A.
9dfb8768-7bbf-4c6a-893d-b2b094af89ef
Pedersen, R.
5da51cec-d52d-471e-abf8-b00a1a700376
Davidson, J.R.T.
16d30295-c5f9-403c-b9db-702d0f25b2b2
Stein, D.J.
908f8238-f5e4-4ea1-9f19-9be45feea5b6
Rothbaum, B.O.
6899f274-4948-49e3-8377-6be800f7cde3
Baldwin, D.S.
1beaa192-0ef1-4914-897a-3a49fc2ed15e
Szumski, A.
9dfb8768-7bbf-4c6a-893d-b2b094af89ef
Pedersen, R.
5da51cec-d52d-471e-abf8-b00a1a700376
Davidson, J.R.T.
16d30295-c5f9-403c-b9db-702d0f25b2b2

Stein, D.J., Rothbaum, B.O., Baldwin, D.S., Szumski, A., Pedersen, R. and Davidson, J.R.T. (2013) Factor analysis of posttraumatic stress disorder symptoms using data pooled from two venlafaxine extended-release clinical trials. Brain and Behavior, 3 (6), 738-746. (doi:10.1002/brb3.183).

Record type: Article

Abstract

BACKGROUND: Confirmatory factor analysis (CFA) of Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) (DSM-IV) three-factor posttraumatic stress disorder (PTSD) diagnostic criteria was conducted to determine fit for this patient population. An exploratory factor analysis (EFA) of alternate symptom structures was planned to identify symptoms that cluster in this population. The response of symptom factors to treatment with venlafaxine extended release (ER) was explored.

METHODS: Baseline 17-item Clinician-Administered PTSD Scale (CAPS-SX17) data were pooled from patients enrolled in two double-blind, randomized, placebo-controlled trials. The CFA was conducted using maximum likelihood and weighted, least-squares factor extraction methods. The EFA was performed using a polychoric correlation covariance matrix and Pearson correlation matrix.

RESULTS: Data from a pooled population of 685 patients (venlafaxine ER: n = 339; placebo: n = 346) were analyzed. CFA rejected the DSM-IV three-factor structure. The EFA identified a different three-factor structure as the best fit: factor 1 included reexperiencing symptoms, factor 2 included symptoms of altered mood and cognition, whereas factor 3 comprised avoidance and arousal symptoms. All DSM-IV symptom factors and all factors in the identified three-factor model responded positively to venlafaxine ER treatment.

CONCLUSIONS: Data are consistent with literature failing to confirm the three-factor structure of DSM-IV PTSD, and they support the DSM-5 inclusion of a symptom cluster addressing altered mood and cognition in PTSD. The efficacy of venlafaxine ER in reducing a range of symptom clusters in PTSD is consistent with its multiple mechanisms of action.

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Published date: 16 October 2013
Organisations: Faculty of Medicine

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Local EPrints ID: 367939
URI: http://eprints.soton.ac.uk/id/eprint/367939
PURE UUID: 572092c2-7455-46fe-a03d-9f478ef7f3b4
ORCID for D.S. Baldwin: ORCID iD orcid.org/0000-0003-3343-0907

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Date deposited: 20 Aug 2014 16:07
Last modified: 18 Feb 2021 16:44

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Contributors

Author: D.J. Stein
Author: B.O. Rothbaum
Author: D.S. Baldwin ORCID iD
Author: A. Szumski
Author: R. Pedersen
Author: J.R.T. Davidson

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