Date of Award

8-20-2026

Document Type

Dissertation

Degree Name

Doctor of Philosophy in Clinical Psychology (PhD)

Department

Clinical Psychology

First Advisor/Committee Member

Thane Erickson

Second Advisor/Committee Member

Yu Chak Sunny Ho

Third Advisor/Committee Member

Sam Rennebohm

Abstract

Several studies have investigated the factor structure of the ICD-11 symptom criteria for PTSD and Complex PTSD (CPTSD) leveraging the International Trauma Questionnaire (ITQ). The ITQ has been validated in a variety of U.S. and international populations with clinical and community samples. However, further validation is needed to determine factor structure and measurement invariance in U.S. insured populations. This study examined the factor structure and evaluated measurement invariance of the ITQ across publicly and privately insured samples. A convenience sample of 402 insured individuals was recruited using an online recruitment platform. Participants were provided with an online survey containing the ITQ, PTSD Checklist (PCL-5), and Life Events Checklist (LEC-5). Initial confirmatory factor analyses were performed, specifying a first-order six correlated factors model and a second-order two factor model reported in the development of the ITQ and widely replicated in prior studies. Next, measurement invariance analyses were conducted using both specified models, each of which were successively constrained at the configural, metric, scalar, and residual levels to determine decrement of fit with each constraint. The first-order model fit well. However, the second-order model yielded implausible values for some parameters (a Heywood case). After correction, the second-order model fit well. Measurement invariance was supported on both specified models across all four levels of invariance. Findings support the use of the ITQ as a tool for identifying ICD-11 PTSD and CPTSD in U.S. insured populations with measurement invariance across publicly and privately insured individuals. Our data support the consideration of both models specified, but further investigation is warranted concerning the Affective Dysregulation factor due to implausible values consistent with previous research.

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