PTSD Symptoms Are Differentially Associated with General Distress and Physiological Arousal

Implications for the Conceptualization and Measurement of PTSD

Published in: Journal of Anxiety Disorders, Volume 62, pages 26-34 (March 2019). doi: 10.1016/j.janxdis.2018.10.003

Posted on on August 13, 2019

by Grant N. Marshall, Lisa H. Jaycox, Charles C. Engel, Andrea Richardson, Sunny J. Dutra, Terence M. Keane, Raymond C. Rosen, Brian P. Marx

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The primary purpose of this study was to examine the place of posttraumatic stress disorder (PTSD) vis-à-vis the external dimensions of general distress and physiological arousal.


Using data collected from veterans of the wars in Iraq and Afghanistan (N = 1350), latent variable covariance structure modeling was employed to compare correlations of PTSD symptom clusters and individual PTSD symptoms with general distress and physiological arousal.


Each PTSD symptom cluster, and 17 of 20 individual PTSD symptoms were more strongly associated with general distress than with physiological arousal. However, moderate to strong associations were also found between physiological arousal and both PTSD clusters and symptoms.


Findings are based on self-reported data elicited from a single sample of veterans with substantial PTSD symptoms. Replication, particularly by clinician interview, is necessary. Generalizability to other traumatized populations is unknown.


Results offer support, with caveats, for viewing PTSD as a distress disorder. Findings are not consistent with the position that PTSD is a hybrid disorder with some features reflecting hyperarousal and others indicative of general distress. Results have implications for the conceptualization and measurement of PTSD.

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