Posttraumatic stress disorder factor structure in hurricane-affected Puerto Ricans: A PTSD Checklist for DSM-5 comparison with non-Latiné White individuals.

Abstract

Due to Puerto Rico's location, there is heightened vulnerability to the consequences of natural disasters, contributing to an elevated risk of posttraumatic stress disorder (PTSD). Given PTSD's heterogeneous nature, this study examined whether PTSD factor structure, based on DSM-5 criteria and measured using the PTSD Checklist for DSM-5 (PCL-5), was equivalent across hurricane-exposed Puerto Ricans (n = 596) and non-Latiné White (NLW) individuals (n = 459). Confirmatory factor analysis (CFA) indicated the seven-factor hybrid model of PTSD was the best-fitting structure, χ²(N = 897, 298) = 685.59, CFI = .967, TLI = .958, RMSEA = .054, SRMR = .038. Latent factor correlations (range: .61-.93) supported the distinctiveness of PTSD symptom dimensions. PTSD prevalence estimates varied significantly (DSM-5: 47.8%, hybrid: 28.2%). Multigroup CFA results supported partial scalar invariance, with PCL-5 Item 8 (memory impairment) requiring varying intercepts, χ²(N = 897, 330) = 806.97, p < .001, CFI = .960, TLI = .954, RMSEA = .057, 90% CI [.052, .062], SRMR = .047, BIC = 49,586.9. NHWs reported higher avoidance (ΔM = 0.186), p = .011; negative affect (ΔM = 0.160), p = .028; anhedonia (ΔM = 0.217), p = .002; and dysphoric arousal symptoms (ΔM = 0.187), p = .015, relative to Puerto Ricans. Strong associations between PTSD factors and depression and psychological distress, βs = .57-.82, supported convergent validity. Findings highlight the relevance of the hybrid model for conceptualizing PTSD symptoms among hurricane-exposed populations, with important implications for culturally informed assessment and treatment in Puerto Rican communities.