The latent structure of Acute Stress Disorder symptoms in trauma-exposed children and adolescents

Anna McKinnon, Richard Meiser-Stedman, Peter Watson, Clare Dixon, Nancy Kassam-Adams, Anke Ehlers, Flaura Winston, Patrick Smith, William Yule, Tim Dalgleish

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Background: The revision of Acute Stress Disorder (ASD) in the DSM-5 (DSM-5, 2013) proposes a cluster-free model of ASD symptoms in both adults and youth. Published evaluations of competing models of ASD clustering in youth have rarely been examined.

Methods: We used Confirmatory Factor Analysis (combined with multigroup invariance tests) to explore the latent structure of ASD symptoms in a trauma-exposed sample of children and young people (N = 594). The DSM-5 structure was compared with the previous DSM-IV conceptualization (4-factor), and two alternative models proposed in the literature (3-factor; 5-factor). Model fit was examined using goodness-of-fit indices. We also established DSM-5 ASD prevalence rates relative to DSM-IV ASD, and the ability of these models to classify children impaired by their symptoms.

Results: Based on both the Bayesian Information Criterion, the interfactor correlations and invariance testing, the 3-factor model best accounted for the profile of ASD symptoms. DSM-5 ASD led to slightly higher prevalence rates than DSM-IV ASD and performed similarly to DSM-IV with respect to categorising children impaired by their symptoms. Modifying the DSM-5 ASD algorithm to a 3+ or 4+ symptom requirement was the strongest predictor of impairment.

Conclusions: These findings suggest that a uni-factorial general-distress model is not the optimal model of capturing the latent structure of ASD symptom profiles in youth and that modifying the current DSM-5 9+ symptom algorithm could potentially lead to a more developmentally sensitive conceptualization.
Original languageEnglish
Pages (from-to)1308–1316
Number of pages9
JournalJournal of Child Psychology and Psychiatry
Issue number11
Early online date30 Jul 2016
Publication statusPublished - Nov 2016


  • Acute Stress Disorder
  • DSM-5
  • factor analysis
  • children
  • post-traumatic stress disorder

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