The hierarchical model of emotional disorders, as proposed by Norton and colleagues links negative affect (NA) to anxiety disorders through cognitive risk factors such as Anxiety Sensitivity (AS) and Intolerance of Uncertainty (IU). Even though AS and IU have been recognized as risk factors of PTSD, few studies have applied this model to posttraumatic stress disorder (PTSD). Furthermore, evidence about the relations of AS and IU with PTSD symptom clusters (Re-experiencing, Emotional Numbing, Avoidance, and Hyperarousal) has been inconsistent.
The goal of the current study was to examine the hierarchical model of emotional disorders in PTSD symptom clusters. In the current study, 201 people (M age = 37.13, SD = 15.88; 53% female) who experienced one or more traumatic events (33.8% receiving a PTSD diagnosis) were administered self-report measures to assess NA, AS, IU, and PTSD symptoms. The direct and then indirect relations between NA and PCL-5 subscales were examined using structural equation modeling. In the direct effects model, NA was significantly associated with Re-experiencing (β= .68, p < .001, R2 = .46), Avoidance (β= .57, p < .001, R2 = .33), Emotional Numbing (β= .70, p < .001, R2 = .48), and Hyperarousal (β= .81, p < .001, R2 = .64). In the indirect effects model, the relation between NA and Re-experiencing was both direct (β= .50, p < .001) and indirect, through AS (β= .22, 95% confidence interval [CI; .10, .33]). The relation between NA and Avoidance was both direct (β= .29, p < .01) and indirect, through AS (β= .23, 95% CI [.09, .36]). The relation between NA and Emotional Numbing was both direct (β= .45, p < .001) and indirect, through AS (β= .13, 95% CI [.01, .23]) as well as through IU (β= .12, 95% CI [.02, .21]). Finally, the relation between NA and Hyperarousal was both direct (β= .53, p < .001) and indirect, through AS (β= .17, 95% CI [.06, .28]) as well as through IU (β= .11, 95% CI [.01, .20]).
Kateryna Kolnogorova– Doctorate Student, Ohio University, Athens, Ohio
Amanda Raines– Post-Doctoral Fellow, Southeast Louisiana Veterans HealthCare System (SLVHCS)
Mary Oglesby– Student, Florida State University, Tallahassee, Florida
Norman Schmidt– Professor, Florida State University
Nicholas Allan– Assistant Professor, Ohio University
Southeast Louisiana Veterans HealthCare System (SLVHCS)