ArticlePsychiatry investigation2026
Confirmatory Factor Analysis of the PTSD Checklist for DSM-5 in Psychiatric Outpatients With PTSD.
Article in Psychiatry investigation, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveAccumulating evidence suggests that the latent structure of post-traumatic stress disorder (PTSD) symptoms may be more differentiated than the four-factor model proposed in Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). While expanded factor models have been supported in trauma-exposed and community samples, their applicability in clinically diagnosed psychiatric outpatient populations remains unexplored. This study aimed to evaluate and compare competing DSM-5-based PTSD factor models in a general adult psychiatric outpatient sample using the Korean version of the PTSD Checklist for DSM-5 (K-PCL-5).
methodsPsychological data were obtained from 229 adults who were first-visit psychiatric outpatients diagnosed with PTSD or probable PTSD at a university hospital in South Korea. PTSD symptoms were assessed using the K-PCL-5. Confirmatory factor analyses (CFA) were conducted to compare eight competing PTSD models, including one- and two-factor models, the DSM-5 four-factor model, and alternative multidimensional models (dysphoria, dysphoric arousal, externalizing behavior, anhedonia, and hybrid). Models were estimated using the weighted least squares mean- and variance-adjusted estimator for ordinal data. Model fit was evaluated using multiple fit indices.
resultsThe DSM-5 four-factor model demonstrated a borderline fit. All alternative multidimensional models showed improved fit relative to the DSM-5 model. Among them, the seven-factor hybrid model provided the best overall fit, followed by the six-factor anhedonia and externalizing behavior models. One- and two-factor models demonstrated poor fit.
conclusionPTSD symptoms in Korean adult psychiatric outpatients are better represented by expanded multidimensional factor models than by the DSM-5 four-factor model. These findings support the clinical applicability of post-DSM-5 expanded PTSD models and highlight the need for further validation across diverse clinical populations.
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