Chengqi Cao

The underlying dimensions of DSM-5 posttraumatic stress disorder symptoms in an epidemiological sample of Chinese earthquake survivors

The current study investigated the underlying dimensions of DSM-5 PTSD symptoms in an epidemiological sample of Chinese earthquake survivors. The sample consisted of 810 females and 386 males, with a mean age of 47.9 years (SD=10.0, range: 16-73). PTSD symptoms were assessed using the PTSD Checklist for DSM-5, and alternative models were evaluated with confirmatory factor analysis. Results indicated that a six-factor model comprised of intrusion, avoidance, negative affect, anhedonia, dysphoric arousal, and anxious arousal factors emerged as the best fitting model. The current findings add to limited literature on the latent structure of PTSD symptoms described in the recently released DSM-5, and carry implications for further trauma-related research and clinical practice.

Assessing the underlying dimensionality of DSM-5 PTSD symptoms in Chinese adolescents surviving the 2008 Wenchuan earthquake

By analyzing data yielded from a sample of Chinese adolescents surviving a high-intensity earthquake, this study investigated the underlying dimensionality of DSM-5 PTSD symptoms. The sample included 743 traumatized middle school students (396 females and 332 males) aged 11-17 years (mean=13.6, SD=1.0). Results of confirmatory factor analysis showed that an intercorrelated seven-factor model comprised of intrusion, avoidance, negative affect, anhedonia, externalizing behaviors, anxious arousal, and dysphoric arousal factors provided a significant better representation of DSM-5 PTSD symptoms than other alternative models. Further analyses indicated that external measures of major depression disorder and panic disorder symptoms displayed unique associations with four PTSD factors. The findings provide further support for the newly proposed seven-factor model of DSM-5 PTSD symptoms, add to very limited empirical knowledge on the latent structure of DSM-5 PTSD symptoms among adolescents, and carry implications for further refinement of the current classifications of PTSD symptoms and further clinical practice and research on posttraumatic stress symptomatology.

Stathmin genotype is associated with reexperiencing symptoms of posttraumatic stress disorder in Chinese earthquake survivors

Stathmin (STMN1) has been demonstrated as a regulator of fear processing across species, which implicates that it may be important in the etiopathogenesis of fear-related psychiatric disorders such as posttraumatic stress disorder (PTSD). This study examined the association between STMN1 rs182455 genotype, a single nucleotide polymorphism (SNP) located within or close to the putative transcriptional control region of STMN1 gene, and PTSD symptoms. A total of 326 Chinese adults who suffered from a deadly 2008 Wenchuan earthquake and unexpectedly lost their children during the disaster participated in this study. PTSD symptoms were measured with the PTSD Checklist (PCL). The Sequenom iPlex chemistries and the MassARRAY system were used to genotype the STMN1 rs182455 SNP. Our results indicated that the STMN1rs182455 genotype was not associated with severity of total PTSD symptoms in either females or males; however, it could significantly predict severity of PTSDs reexperiencing symptoms in females. The findings provide preliminary evidence supporting the important role of STMN1 in the development of PTSD, and expand extant knowledge on the genetic underpinnings of PTSD and the sex-specific expression of PTSDs symptoms.

The dimensionality of PTSD symptoms and their relationship to health-related quality of life in Chinese earthquake survivors

The current study investigated the latent structure of PTSD symptoms with a sample of 326 Chinese survivors who lost their children during a deadly earthquake. The results of confirmatory factor analysis indicated that a five-factor intercorrelated model comprised of intrusion, avoidance, emotional numbing, dysphoric arousal, and anxiety arousal provided significant better fit than both the four-factor numbing model of King, Leskin, King, and Weathers (1998) and the four-factor dysphoria model of Simms, Watson, and Doebbeling (2002). Further analyses with structural equation modeling showed that the PTSD factors were differentially associated with external measures of psychosocial and physical health-related quality of life. The findings provide further empirical support for the novel five-factor PTSD model, and carry implications for conceptualizing and assessing PTSD for the upcoming DSM-5.

The Underlying Dimensions of DSM-5 PTSD Symptoms and Their Relations with Anxiety and Depression in a Sample of Adolescents Exposed to an Explosion Accident

ABSTRACT Background: A large number of empirical studies pertaining to the latent dimensions of DSM-5 PTSD symptoms have accumulated. However, there is still a lack of studies specific to youths. Objective: This study sought to investigate the latent dimensions of DSM-5 PTSD symptoms in a sample of adolescents exposed to an explosion accident. Method: Participants were 836 students (407 females and 428 males). Self-reported measures including the PTSD Checklist for DSM-5 and the anxiety and depression subscales of the 21-item Depression Anxiety Stress Scale were administered to participants. Confirmatory factor analysis (CFA) was implemented to test competing factor models. Results: A seven-factor model composed of intrusion, avoidance, negative affect, anhedonia, externalizing behaviours, anxious arousal and dysphoric arousal factors emerged as the best fitting model, and PTSD’s factors displayed distinguishable correlations with external measures of anxiety and depression. Conclusions: The findings provide and extend empirical evidence supporting the newly refined seven-factor hybrid model of DSM-5 PTSD symptoms, and have implications for further trauma-related clinical practice and research.

The factor structure of posttraumatic stress disorder symptoms in patients with traumatic spinal cord injuries.

The current study investigated the factor structure of posttraumatic stress disorder (PTSD) symptoms in a sample of 256 patients with traumatic spinal cord injuries (SCI) in China. The confirmatory factor analysis results showed that a five-factor model composed of intrusion, avoidance, emotional numbing, dysphoric arousal, and anxious arousal fits the data significantly better than the tripartite DSM-IV model and the two well-supported four-factor models, and the C3 symptom (inability to recall important aspect of the trauma) loaded weakly on its corresponding factor. Implications and limitations for the results are discussed.

Patterns of DSM-5 posttraumatic stress disorder and depression symptoms in an epidemiological sample of Chinese earthquake survivors: A latent profile analysis

BACKGROUND Posttraumatic stress disorder (PTSD) and depression are highly comorbid in association with serious clinical consequences. Nevertheless, to date, no study using latent class or latent profile analysis (LCA/LPA) has examined patterns of co-occurring PTSD and depression symptoms among natural disaster survivors, nor has the distinctiveness of DSM-5 PTSD and depression symptoms been clarified in the aftermath of trauma. This study was primarily aimed at filling these gaps. METHODS LPA was used to examine self-reported PTSD and depression symptoms in an epidemiological sample of 1196 Chinese earthquake survivors. RESULTS A 4-class solution characterized by low symptoms (53.9%), predominantly depression (18.2%), predominantly PTSD (18.9%) and combined PTSD-depression (9.0%) patterns fit the data best. Demographic characteristics and earthquake-related exposures were specifically or consistently associated with the non-parallel profiles varying in physical health impairment. LIMITATIONS A sample exposed to specific traumatic events was assessed by self-report measures. CONCLUSIONS The distinctiveness of DSM-5 PTSD and depression symptoms following an earthquake suggests that PTSD and depression may be independent sequelae of psychological trauma rather than a manifestation of a single form of psychopathology. The current findings support the distinction between PTSD and depression constructs, and highlight the need for identifications of natural disaster survivors at high risk for PTSD and/or depression, and interventions individually tailored to ones symptom presentations.

Factor structure of DSM-5 PTSD symptoms in trauma-exposed adolescents: Examining stability across time

This study investigated the latent structure of DSM-5 PTSD symptoms using two-wave longitudinal data collected from a sample of adolescents exposed to an explosion accident. Two waves of surveys were conducted approximately 3 and 8 months after the accident, respectively. A total of 836 students completed the baseline survey, and 762 students completed the follow-up survey. The results of confirmatory factor analyses(CFA) indicated that a seven-factor hybrid model composed of intrusion, avoidance, negative affect, anhedonia, externalizing behaviors, anxious arousal and dysphoric arousal factors yielded significantly better data fit at both waves than the other models including the DSM-5 four-factor model, the six-factor anhedonia and externalizing behaviors models. Furthermore, the results of CFA invariance tests supported the longitudinal invariance of the model. Implications and limitations in terms of these results are discussed.

Oxytocin is associated with PTSD’s anxious arousal symptoms in Chinese male earthquake survivors

Background Posttraumatic stress disorder (PTSD) is a complex and severe mental disorder triggered by exposure to an extraordinarily traumatic event. Human and animal studies have implied the functional role of the oxytocin system in the development of PTSD (Cochran, Fallon, Hill, & Frazier, 2013; Koch et al., 2014; Olff, 2012). Specification of the role of the oxytocin system in the emergence and progression of PTSD symptomatology would provide evidence to inform both theory and clinical practice. Methods This study examined the association between oxytocin serum levels and PTSD symptoms. A total of 106 Chinese male adults who suffered from the deadly 2008 Wenchuan earthquake participated in this study. PTSD symptoms were measured with PTSD Checklist for DSM-5 (PCL-5), and serum oxytocin level was determined with ELISA oxytocin kits. Results The mean score on the PCL-5 was 19.30 (SD=14.50, range: 1–65) in this sample. The mean oxytocin level was 101.59 pg/ml (SD=55.89, range: 31.50–286.71). The results indicated that although the oxytocin was not associated with total PTSD symptoms, it was associated with PTSDs anxious arousal symptoms. Conclusion These findings support that the oxytocin may play an important functional role in the development of PTSD and contribute to the extant knowledge on the genetic basis of the PTSD symptoms.

TPH2 genotype is associated with PTSD's avoidance symptoms in Chinese female earthquake survivors

Genetic factors are important in the development of post-traumatic stress disorder (PTSD) following exposure to traumatic events. However, the molecular genetic underpinnings of this disorder have not been definitive. This study examined the association between tryptophan hydroxylase 2 (TPH2) rs11178997 genotype, a single-nucleotide polymorphism (SNP) located in the transcriptional control region, and PTSD symptoms. A total of 326 Chinese adults who suffered from the deadly 2008 Wenchuan earthquake and lost their children during the disaster participated in this study. PTSD symptoms were measured with PTSD checklist, and the SNP was successfully genotyped by the MassARRAY system. The results indicated that, although the rs11178997 genotype was not associated with total PTSD symptoms, it could significantly predict severity of PTSD’s avoidance symptoms in women. These findings support that TPH2 may play an important functional role in the development of PTSD and contribute to the limited literature regarding the genetic basis and the sex-specific expression of PTSD’s symptoms.