A Distinction Without a Difference? A Multi-Method Approach to Understanding PTSD and Depression Symptom Overlap Among Disaster-Exposed Adolescents

Springer Science and Business Media LLC - Tập 51 - Trang 1021-1035 - 2023
James Kyle Haws1, Lauren M. Laifer2, Laura M. Acosta2, Allura L. Ralston2, Kenneth J. Ruggiero3, Tatiana M. Davidson3, Arthur R. Andrews2
1Department of Family Medicine, and the Adult and Child Adult & Child Center for Outcomes Research & Delivery Science, University of Colorado School of Medicine, Aurora, USA
2Department of Psychology, University of Nebraska-Lincoln, Lincoln, USA
3College of Nursing, Medical University of South Carolina, Charleston, USA

Tóm tắt

Among adolescents exposed to trauma, posttraumatic stress disorder (PTSD) and major depressive disorder (MDD) commonly co-occur. Despite the prevalence of comorbidity, the question of how PTSD and MDD are related and appropriate conceptual models for understanding their linkage in adolescence remains unclear. This study applies a multi-methodological approach to advance conceptual and theoretical understanding of the overlap between PTSD and MDD diagnoses/symptoms. We tested three methodological approaches with three distinct theoretical underpinnings on the structure of each disorder proposed in the literature: confirmatory factor analysis (CFA) with dimensional constructs, latent class analysis (LCA) with person-based categorical constructs, and network analysis with symptom-to-symptom associations. Across the three different analytical approaches, there was a significant overlap between PTSD and MDD. Overall, there was no compelling evidence for distinct boundaries between disorders among trauma-exposed adolescents. Instead, we found considerable evidence that the typical latent-construct-based conceptualizations, whether categorical or dimensional, may need revision.

Tài liệu tham khảo

Achenbach, T. M. (2017). Future directions for clinical research, services, and training: Evidence-based assessment across informants, cultures, and dimensional hierarchies. Journal of Clinical Child & Adolescent Psychology, 46(1), 159–169. Adams, Z. W., Danielson, C. K., Sumner, J. A., McCauley, J. L., Cohen, J. R., & Ruggiero, K. J. (2015). Comorbidity of PTSD, major depression, and substance use disorder among adolescent victims of the spring 2011 tornadoes in Alabama and Joplin, Missouri. Psychiatry, 78, 170–185. https://doi.org/10.1080/00332747.2015.1051448 Afzali, M. H., Sunderland, M., Teesson, M., Carragher, N., Mills, K., & Slade, T. (2017). A network approach to the comorbidity between posttraumatic stress disorder and major depressive disorder: The role of overlapping symptoms. Journal of Affective Disorders, 208, 490–496. https://doi.org/10.1016/j.jad.2016.10.037 Akaike, H. (1973). Maximum likelihood identification of Gaussian autoregressive moving average models. Biometrika, 60, 255–265. https://doi.org/10.1093/biomet/60.2.255 American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text rev.). American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596 Andrews, A. R., López, C. M., Snyder, A., Saunders, B., & G Kilpatrick, D. (2019). Polyvictimization, related symptoms, and familial and neighborhood contexts as longitudinal mediators of racial/ethnic disparities in violence exposure across adolescence. Journal of Immigrant and Minority Health, 21, 679–692. https://doi.org/10.1007/s10903-018-0842-2 Armour, C., Elhai, J. D., Layne, C. M., Shevlin, M., Duraković-Belko, E., Djapo, N., & Pynoos, R. S. (2011). Gender differences in the factor structure of posttraumatic stress disorder symptoms in war-exposed adolescents. Journal of Anxiety Disorders, 25, 604–611. Armour, C., Contractor, A., Elhai, J. D., Stringer, M., Lyle, G., Forbes, D., & Richardson, J. D. (2015). Identifying latent profiles of posttraumatic stress and major depression symptoms in Canadian veterans: Exploring differences across profiles in health-related functioning. Psychiatry Research, 228, 1–7. https://doi.org/10.1016/j.psychres.2015.03.011 Asmundson, G. J., Stapleton, J. A., & Taylor, S. (2004). Are avoidance and numbing distinct PTSD symptom clusters? Journal of Traumatic Stress: Official Publication of the International Society for Traumatic Stress Studies, 17, 467–475. https://doi.org/10.1007/s10960-004-5795-7 Au, T. M., Dickstein, B. D., Comer, J. S., Salters-Pedneault, K., & Litz, B. T. (2013). Co-occurring posttraumatic stress and depression symptoms after sexual assault: A latent profile analysis. Journal of Affective Disorders, 149, 209–216. https://doi.org/10.1016/j.jad.2013.01.026 Bartels, L., Berliner, L., Holt, T., Jensen, T., Jungbluth, N., Plener, P., ... & Sachser, C. (2019). The importance of the DSM-5 posttraumatic stress disorder symptoms of cognitions and mood in traumatized children and adolescents: Two network approaches. Journal of Child Psychology and Psychiatry, 60(5), 545–554. Birkeland, M. S., Greene, T., & Spiller, T. R. (2020). The network approach to posttraumatic stress disorder: a systematic review. European Journal of Psychotraumatology, 11, 1700614. https://doi.org/10.1080/20008198.2019.1700614 Blanken, T. F., Deserno, M. K., Dalege, J., Borsboom, D., Blanken, P., Kerkhof, G. A., & Cramer, A. O. (2018). The role of stabilizing and communicating symptoms given overlapping communities in psychopathology networks. Scientific Reports, 8, 1–8. Borsboom, D. (2017). A network theory of mental disorders. World Psychiatry, 16, 5–13. https://doi.org/10.1002/wps.20375 Borsboom, D., & Cramer, A. O. (2013). Network analysis: An integrative approach to the structure of psychopathology. Annual Review of Clinical Psychology, 9, 91–121. Boscarino, J. A., Adams, R. E., & Galea, S. (2006). Alcohol use in New York after the terrorist attacks: A study of the effects of psychological trauma on drinking behavior. Addictive Behaviors, 31, 606–621. https://doi.org/10.1016/j.addbeh.2005.05.035 Boschloo, L., van Borkulo, C. D., Rhemtulla, M., Keyes, K. M., Borsboom, D., & Schoevers, R. A. (2015). The network structure of symptoms of the diagnostic and statistical manual of mental disorders. PloS One, 10, e0137621. https://doi.org/10.1371/journal.pone.0137621 Breslau, N. (2009). The epidemiology of trauma, PTSD, and other posttrauma disorders. Trauma, Violence, & Abuse, 10, 198–210. https://doi.org/10.1177/1524838009334448 Breslau, N., Reboussin, B. A., Anthony, J. C., & Storr, C. L. (2005). The structure of posttraumatic stress disorder: latent class analysis in 2 community samples. Archives of General Psychiatry, 62(12), 1343–1351. https://doi.org/10.1001/archpsyc.62.12.1343 Bringmann, L. F., & Eronen, M. I. (2018). Don’t blame the model: Reconsidering the network approach to psychopathology. Psychological Review, 125(4), 606. Broman-Fulks, J. J., Ruggiero, K. J., Green, B. A., Kilpatrick, D. G., Danielson, C. K., Resnick, H. S., & Saunders, B. E. (2006). Taxometric investigation of PTSD: data from two nationally representative samples. Behavior Therapy, 37, 364–380. https://doi.org/10.1016/j.beth.2006.02.006 Brown, T. A. (2015). Confirmatory factor analysis for applied research. Guilford publications. Brown, L. A., Jerud, A., Asnaani, A., Petersen, J., Zang, Y., & Foa, E. B. (2018). Changes in posttraumatic stress disorder (PTSD) and depressive symptoms over the course of prolonged exposure. Journal of Consulting and Clinical Psychology, 86, 452. https://doi.org/10.1037/ccp0000292 Byllesby, B. M., Elhai, J. D., Tamburrino, M., Fine, T. H., Cohen, G., Sampson, L., & Calabrese, J. R. (2017). General distress is more important than PTSD’s cognition and mood alterations factor in accounting for PTSD and depression’s comorbidity. Journal of Affective Disorders, 211, 118–123. https://doi.org/10.1016/j.jad.2017.01.014 Cao, X., Wang, L., Cao, C., Zhang, J., Liu, P., Zhang, B., & Elhai, J. D. (2015). Patterns of DSM-5 posttraumatic stress disorder and depression symptoms in an epidemiological sample of Chinese earthquake survivors: a latent profile analysis. Journal of Affective Disorders, 186, 58–65. https://doi.org/10.1016/j.jad.2015.06.058 Caspi, A., Houts, R. M., Belsky, D. W., Goldman-Mellor, S. J., Harrington, H., Israel, S., Meier, M. H., Ramrakha, S., Shalev, I., Poulton, R., & Moffitt, T. E. (2014). The p factor: one general psychopathology factor in the structure of psychiatric disorders? Clinical Psychological Science, 2, 119–137. https://doi.org/10.1177/2167702613497473 Castro, D., Ferreira, F., de Castro, I., Rodrigues, A. R., Correia, M., Ribeiro, J., & Ferreira, T. B. (2019). The differential role of central and bridge symptoms in deactivating psychopathological networks. Frontiers in Psychology, 10, 2448. https://doi.org/10.3389/fpsyg.2019.02448 Cicchetti, D., & Rogosch, F. (1996). Equifinality and multifinality in developmental psychopathology. Development and Psychopathology, 8(4), 597–600. https://doi.org/10.1017/S0954579400007318 Cisler, J. M., Begle, A. M., Armstadter, A. B., Resnick, H. S., Danielson, C. K., Saunders, B. E., & Kilpatrick, D. G. (2012). Exposure to interpersonal violence and risk for PTSD, depression, delinquency, and binge drinking among adolescents: Data from the NSA-R. Journal of Traumatic Stress, 25, 33–40. https://doi.org/10.1002/jts.21672 Contractor, A. A., Elhai, J. D., Fine, T. H., Tamburrino, M. B., Cohen, G., Shirley, E., & Calabrese, J. R. (2015). Latent profile analyses of posttraumatic stress disorder, depression and generalized anxiety disorder symptoms in trauma-exposed soldiers. Journal of Psychiatric Research, 68, 19–26. https://doi.org/10.1016/j.jpsychires.2015.05.014 Contractor, A. A., Greene, T., Dolan, M., & Elhai, J. D. (2018). Relations between PTSD and depression symptom clusters in samples differentiated by PTSD diagnostic status. Journal of Anxiety Disorders, 59, 17–26. https://doi.org/10.1016/j.janxdis.2018.08.004 Conway, C. C., Forbes, M. K., Forbush, K. T., Fried, E. I., Hallquist, M. N., Kotov, R., & Sunderland, M. (2019). A hierarchical taxonomy of psychopathology can transform mental health research. Perspectives on Psychological Science, 14, 419–436. https://doi.org/10.1177/1745691618810696 Copeland, W. E., Shanahan, L., Erkanli, A., Costello, E. J., & Angold, A. (2013). Indirect comorbidity in childhood and adolescence. Frontiers in Psychiatry, 4, 144. https://doi.org/10.3389/fpsyt.2013.00144 Cramer, A. O., Waldorp, L. J., Van Der Maas, H. L., & Borsboom, D. (2010). Comorbidity: a network perspective. Behavioral and Brain Sciences, 33, 137. https://doi.org/10.1017/S0140525X09991567 Cukor, J., Wyka, K., Jayasinghe, N., & Difede, J. A. (2010). The nature and course of subthreshold PTSD. Journal of Anxiety Disorders, 24, 918–923. https://doi.org/10.1016/j.janxdis.2010.06.017 Cuthbert, B. N., & Insel, T. R. (2013). Toward the future of psychiatric diagnosis: the seven pillars of RDoC. BMC Medicine, 11, 126. https://doi.org/10.1186/1741-7015-11-126 De Haan, A., Landolt, M. A., Fried, E. I., Kleinke, K., Alisic, E., Bryant, R., & McKinnon, A. (2020). Dysfunctional posttraumatic cognitions, posttraumatic stress and depression in children and adolescents exposed to trauma: a network analysis. Journal of Child Psychology and Psychiatry, 61, 77–87. https://doi.org/10.1111/jcpp.13101 DiClemente, R. J., Hansen, W. B., & Ponton, L. E. (2013). Handbook of adolescent health risk behavior. Springer Science & Business Media. Djelantik, A. M. J., Robinaugh, D. J., Kleber, R. J., Smid, G. E., & Boelen, P. A. (2020). Symptomatology following loss and trauma: latent class and network analyses of prolonged grief disorder, posttraumatic stress disorder, and depression in a treatment-seeking trauma-exposed sample. Depression and Anxiety, 37, 26–34. https://doi.org/10.1002/da.22880 Djelantik, A. M. J., Smid, G. E., Kleber, R. J., & Boelen, P. A. (2017). Symptoms of prolonged grief, post-traumatic stress, and depression after loss in a Dutch community sample: a latent class analysis. Psychiatry Research, 247, 276–281. https://doi.org/10.1016/j.psychres.2016.11.023 Doom, J. R., Cicchetti, D., Harkness, K., & Hayden, E. P. (2018). The developmental psychopathology of stress exposure in childhood. In K. L. Harkness & E. P. Hayden (Eds.), The Oxford Handbook of Stress and Mental Health (pp. 265–285). Oxford University Press. Drabick, D. A. G., & Kendall, P. C. (2010). Developmental psychopathology and the diagnosis of mental health problems among youth. Clinical Psychology: Science and Practice, 17, 272–280. https://doi.org/10.1111/j.1468-2850.2010.01219.x Elhai, J. D., Grubaugh, A. L., Kashdan, T. B., & Frueh, B. C. (2008). Empirical examination of a proposed refinement to DSM-IV posttraumatic stress disorder symptom criteria using the National Comorbidity Survey Replication data. Journal of Clinical Psychiatry, 69, 597. https://doi.org/10.4088/jcp.v69n0411 Elhai, J. D., de Francisco Carvalho, L., Miguel, F. K., Palmieri, P. A., Primi, R., & Frueh, B. C. (2011). Testing whether posttraumatic stress disorder and major depressive disorder are similar or unique constructs. Journal of Anxiety Disorders, 25, 404–410. https://doi.org/10.1016/j.janxdis.2010.11.003 Epskamp, S., Borsboom, D., & Fried, E. I. (2018). Estimating psychological networks and their accuracy: a tutorial paper. Behavior Research Methods, 50, 195–212. https://doi.org/10.3758/s13428-017-0862-1 Epskamp, S., & Fried, E. I. (2018). A tutorial on regularized partial correlation networks. Psychological Methods, 23, 617. https://doi.org/10.1037/met0000167 First, M. B., Rebello, T. J., Keeley, J. W., Bhargava, R., Dai, Y., Kulygina, M., & Reed, G. M. (2018). Do mental health professionals use diagnostic classifications the way we think they do? A global survey. World Psychiatry, 17, 187–195. Forbes, M., Tackett, J., Markon, K., & Krueger, R. (2016). Beyond comorbidity: toward a dimensional and hierarchical approach to understanding psychopathology across the life span. Development and Psychopathology, 28, 971–986. https://doi.org/10.1017/S0954579416000651 Fornell, C., & Larcker, D. F. (1981). Evaluating structural equation models with unobservable variables and measurement error. Journal of Marketing Research, 18, 39–50. https://doi.org/10.2307/3151312 Galatzer-Levy, I. R., Nickerson, A., Litz, B. T., & Marmar, C. R. (2013). Patterns of lifetime PTSD comorbidity: a latent class analysis. Depression and Anxiety, 30, 489–496. https://doi.org/10.1002/da.22048 Garabiles, M. R., Lao, C. K., Xiong, Y., & Hall, B. J. (2019). Exploring comorbidity between anxiety and depression among migrant Filipino domestic workers: a network approach. Journal of Affective Disorders, 250, 85–93. https://doi.org/10.1016/j.jad.2019.02.062 Garber, J., & Bradshaw, C. P. (2020). Developmental psychopathology and the research domain criteria: Friend or foe? Journal of Clinical Child & Adolescent Psychology, 49(3), 341–352. https://doi.org/10.1080/15374416.2020.1753205 Gudiño, O. G., Lau, A. S., Yeh, M., McCabe, K. M., & Hough, R. L. (2009). Understanding racial/ethnic disparities in youth mental health services: Do disparities vary by problem type? Journal of Emotional and Behavioral Disorders, 17(1), 3–16. Hagenaars, J. A., & McCutcheon, A. L. (Eds.). (2002). Applied latent class analysis. Cambridge University Press. Haws, J., Brockdorf, A., Gratz, K., Messman, T., Tull, M., & DiLillo, D. (2022). Examining the associations between PTSD symptoms and aspects of emotion dysregulation through network analysis. Journal of Anxiety Disorders, 86, 102536. https://doi.org/10.1016/j.janxdis.2022.102536 Helpman, L., Rachamim, L., Aderka, I. M., Gabai-Daie, A., Schindel-Allon, I., & Gilboa-Schechtman, E. (2015). Posttraumatic symptom structure across age groups. Journal of Clinical Child & Adolescent Psychology, 44, 630–639. https://doi.org/10.1080/15374416.2014.883928 Henseler, J., Ringle, C. M., & Sarstedt, M. (2015). A new criterion for assessing discriminant validity in variance-based structural equation modeling. Journal of the Academy of Marketing Science, 43, 115–135. https://doi.org/10.1007/s11747-014-0403-8 Hofmann, S. G., & Hayes, S. C. (2019). The future of intervention science: Process-based therapy. Clinical Psychological Science, 7, 37–50. https://doi.org/10.1177/2167702618772296 Jakupcak, M., Wagner, A., Paulson, A., Varra, A., & McFall, M. (2010). Behavioral activation as a primary care-based treatment for PTSD and depression among returning veterans. Journal of Traumatic Stress, 23, 491–495. https://doi.org/10.1002/jts.20543 Jenness, J. L., & McLaughlin, K. A. (2015). Towards a person-centered approach to the developmental psychopathology of trauma. Social Psychiatry and Psychiatric Epidemiology, 50, 1219–1221. Jones, P. (2022). networktools: Tools for identifying importan nodes in networks. R package version 1.5.0. Retrieved January 15, 2023, from https://CRAN.R-project.org/package=networktools Jones, P. J., Mair, P., & McNally, R. J. (2018). Visualizing psychological networks: A tutorial in R. Frontiers in Psychology, 9, 1742. https://doi.org/10.3389/fpsyg.2018.01742 Jorgensen, T. D., Pornprasertmanit, S., Schoemann, A. M., Rosseel, Y., Miller, P., Quick, C., & Garnier-Villarreal, M. (2018). semTools: Useful tools for structural equation modeling. R package version 0.5-1. Jung, T., & Wickrama, K. A. (2008). An introduction to latent class growth analysis and growth mixture modeling. Social and Personality Psychology Compass, 2, 302–317. https://doi.org/10.1111/j.1751-9004.2007.00054.x Kar, N., & Bastia, B. K. (2006). Post-traumatic stress disorder, depression and generalised anxiety disorder in adolescents after a natural disaster: a study of comorbidity. Clinical Practice and Epidemiology in Mental Health, 2, 17. https://doi.org/10.1186/1745-0179-2-17 Kilpatrick, D. G., Ruggiero, K. J., Acierno, R., Saunders, B. E., Resnick, H. S., & Best, C. L. (2003). Violence and risk of PTSD, major depression, substance abuse/dependence, and comorbidity: results from the National Survey of Adolescents. Journal of Consulting and Clinical Psychology, 71, 692. https://doi.org/10.1037/0022-006X.71.4.692 King, D. W., Leskin, G. A., King, L. A., & Weathers, F. W. (1998). Confirmatory factor analysis of the Clinician-Administered PTSD Scale: Evidence for the dimensionality of posttraumatic stress disorder. Psychological Assessment, 10(2), 90. Kotov, R., Krueger, R. F., Watson, D., Achenbach, T. M., Althoff, R. R., Bagby, R. M., & Eaton, N. R. (2017). The hierarchical taxonomy of psychopathology (HiTOP): a dimensional alternative to traditional nosologies. Journal of Abnormal Psychology, 126, 454. https://doi.org/10.1037/abn0000258 La Greca, A. M. L., & Silverman, W. K. (2009). Treatment and prevention of posttraumatic stress reactions in children and adolescents exposed to disasters and terrorism: What is the evidence? Child Development Perspectives, 3(1), 4–10. https://doi.org/10.1111/j.1750-8606.2008.00069.x Lai, B. S., Kelley, M. L., Harrison, K. M., Thompson, J. E., & Self-Brown, S. (2015). Posttraumatic stress, anxiety, and depression symptoms among children after Hurricane Katrina: a latent profile analysis. Journal of Child and Family Studies, 24, 1262–1270. https://doi.org/10.1007/s10826-014-9934-3 Lange, J. (2021). CliquePercolation: An R Package for conducting and visualizing results of the clique percolation network community detection algorithm. Journal of Open Source Software, 6, 3210. https://doi.org/10.21105/joss.03210 Lazarov, A., Suarez-Jimenez, B., Levi, O., Coppersmith, D. D., Lubin, G., Pine, D. S., & Neria, Y. (2019). Symptom structure of PTSD and co-morbid depressive symptoms–a network analysis of combat veteran patients. Psychological Medicine, 50(13), 2154–2170. https://doi.org/10.1017/S0033291719002034 Levitan, R. D., Rector, N. A., Sheldon, T., & Goering, P. (2003). Childhood adversities associated with major depression and/or anxiety disorders in a community sample of Ontario: issues of co-morbidity and specificity. Depression and Anxiety, 17, 34–42. https://doi.org/10.1002/da.10077 McNally, R. J. (2016). Can network analysis transform psychopathology? Behaviour Research and Therapy, 86, 95–104. Muthén, B. (2004). Latent variable analysis. The Sage Handbook of Quantitative Methodology for the Social Sciences, 345(368), 106–109. Muthén, L. K., & Muthén, B. (2017). Mplus user’s guide: statistical analysis with latent variables, user’s guide. Muthén & Muthén. Nöthling, J., Suliman, S., Martin, L., Simmons, C., & Seedat, S. (2019). Differences in abuse, neglect, and exposure to community violence in adolescents with and without PTSD and depression. Journal of Interpersonal Violence, 34, 4357–4383. https://doi.org/10.1177/0886260516674944 O’Neil, K. A., Conner, B. T., & Kendall, P. C. (2011). Internalizing disorders and substance use disorders in youth: comorbidity, risk, temporal order, and implications for intervention. Clinical Psychology Review, 31, 104–112. https://doi.org/10.1016/j.cpr.2010.08.002 Parslow, R. A., & Jorm, A. F. (2006). Tobacco use after experiencing a major natural disaster: Analysis of a longitudinal study of 2063 young adults. Addiction, 101(7), 1044–1050. https://doi.org/10.1111/j.1360-0443.2006.01481.x Price, M., Legrand, A. C., Brier, Z. M., & Hébert-Dufresne, L. (2019). The symptoms at the center: examining the comorbidity of posttraumatic stress disorder, generalized anxiety disorder, and depression with network analysis. Journal of Psychiatric Research, 109, 52–58. https://doi.org/10.1016/j.jpsychires.2018.11.016 Robinaugh, D. J., Millner, A. J., & McNally, R. J. (2016). Identifying highly influential nodes in the complicated grief network. Journal of Abnormal Psychology, 125, 747. https://doi.org/10.1037/abn0000181 Rosellini, A. J., Stein, M. B., Colpe, L. J., Heeringa, S. G., Petukhova, M. V., Sampson, N. A., & Army STARRS Collaborators. (2015). Approximating a DSM-5 diagnosis of PTSD using DSM-IV criteria. Depression and Anxiety, 32, 493–501. https://doi.org/10.1002/da.22364 Rothenberger, A., Banaschewski, T., Becker, A., & Roessner, V. (2010). Comorbidity: The case of developmental psychopathology. Behavioral and Brain Sciences, 33(2–3), 167–168. Ruggiero, K. J., Davidson, T. M., McCauley, J., Gros, K. S., Welsh, K., Price, M., Resnick, H. S., Danielson, C. K., Soltis, K., Galea, S., Kilpatrick, D. G., Saunders, B. E., Nissenboim, J., Muzzy, W., Fleeman, A., & Amstadter, A. B. (2015). Bounce back now! Protocol of a population-based randomized controlled trial to examine the efficacy of a web-based intervention with disaster-affected families. Contemporary Clinical Trials, 40, 138–149. https://doi.org/10.1016/j.cct.2014.11.018 Sachser, C., Berliner, L., Holt, T., Jensen, T., Jungbluth, N., Risch, E., & Goldbeck, L. (2018). Comparing the dimensional structure and diagnostic algorithms between DSM-5 and ICD-11 PTSD in children and adolescents. European Child & Adolescent Psychiatry, 27, 181–190. https://doi.org/10.1007/s00787-017-1032-9 Schmid, M., Petermann, F., & Fegert, J. M. (2013). Developmental trauma disorder: pros and cons of including formal criteria in the psychiatric diagnostic systems. BMC Psychiatry, 13, 1–12. https://doi.org/10.1186/1471-244X-13-3 Schwarz, G. (1978). Estimating the dimension of a model. The Annals of Statistics, 461–464. Seballos, F., Tanner, T., Tarazona, M., & Gallegos, J. (2011). Children and disasters: Understanding impact and enabling agency. Institute of Development Studies (IDS). Simms, L. J., Watson, D., & Doebbelling, B. N. (2002). Confirmatory factor analyses of posttraumatic stress symptoms in deployed and nondeployed veterans of the Gulf War. Journal of Abnormal Psychology, 111, 637. https://doi.org/10.1037/0021-843X.111.4.637 Stander, V. A., Thomsen, C. J., & Highfill-McRoy, R. M. (2014). Etiology of depression comorbidity in combat-related PTSD: a review of the literature. Clinical Psychology Review, 34, 87–98. https://doi.org/10.1016/j.cpr.2013.12.002 Tackett, J. L., & Hallquist, M. (2022). The need to grow: developmental considerations and challenges for modern psychiatric taxonomies. Journal of Psychopathology and Clinical Science, 131, 660–663. https://doi.org/10.1037/abn0000751 van Buitenen, N., van den Berg, C. J., Meijers, J., & Harte, J. M. (2020). The prevalence of mental disorders and patterns of comorbidity within a large sample of mentally ill prisoners: a network analysis. European Psychiatry, 63, E63. https://doi.org/10.1192/j.eurpsy.2020.63 Watson, D., & Stasik, S. M. (2014). Examining the comorbidity between depression and the anxiety disorders from the perspective of the quadripartite model. In C. S. Richards & M. W. O’Hara (Eds.), The Oxford Handbook of Depression and Comorbidity (pp. 46–65). Oxford University Press. Zahn-Waxler, C., Shirtcliff, E. A., & Marceau, K. (2008). Disorders of childhood and adolescence: gender and psychopathology. Annual Review of Clinical Psychology., 4, 275–303. https://doi.org/10.1146/annurev.clinpsy.3.022806.091358 Zhen, R., Quan, L., & Zhou, X. (2018). Co-occurring patterns of post-traumatic stress disorder and depression among flood victims: a latent profile analysis. Journal of Health Psychology, 25, 1543–1555. https://doi.org/10.1177/1359105318763505 Zhen, R., Zhou, X., & Wu, X. (2019). Patterns of posttraumatic stress disorder and depression among adolescents following an earthquake: a latent profile analysis. Child Indicators Research, 12, 2173–2187. https://doi.org/10.1007/s12187-019-09634-6