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Karsberg S, Elklit A, Pedersen MM, Pedersen MU, Vang ML. A nationally representative survey of ICD-11 PTSD among Danish adolescents and young adults aged 15-29. Scand J Psychol 2024. [PMID: 38812284 DOI: 10.1111/sjop.13032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 04/03/2024] [Accepted: 05/14/2024] [Indexed: 05/31/2024]
Abstract
Posttraumatic stress disorder (PTSD) is recognized as a debilitating psychiatric disorder affecting populations worldwide. This has inspired many countries to estimate the national prevalence rates of PTSD in Europe and beyond. At present, there are no published representative studies that have assessed the occurrence of trauma exposure and PTSD in Denmark using a valid measurement based on ICD-11 criteria. A national sample of the general population of young Danish residents, ranging in age between 15 to 29 years (n = 2,434), was surveyed cross-sectionally from April to October 2022. Data weights were applied to ensure representativity of the sample. Multiple regression was used to study the relationship between trauma exposure, sex, age, and PTSD. Accidents and violence were the most common types of trauma exposure with females being more likely to experience sexual violence. A total of 7.7% endorsed probable PTSD with women reporting higher rates of clinical and subclinical PTSD (12.3% and 12.7%, respectively) than men (3.5% and 7.3%, respectively). Findings from the multiple regression showed that female gender was associated with higher PTSD-severity, although the strongest predictor was trauma-type with other types of traumas, and sexual violence displaying the strongest relationship to PTSD-severity overall. A dose-response relationship between the number of trauma types and PTSD symptomatology was found. This is the first study of PTSD in a nationally representative Danish sample using a valid measure of ICD-11 PTSD. The identified PTSD rates were higher than Danish official estimates in a representative sample of the Danish adolescent and young adult population (7.7% weighted compared to 1%). The study replicated international findings of sex differences in probable PTSD endorsement.
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Affiliation(s)
- Sidsel Karsberg
- Centre for Alcohol and Drug Research, Department of Psychology, Aarhus University, Aarhus, Denmark
| | - Ask Elklit
- National Centre for Psychotraumatology, Department of Psychology, University of Southern Denmark, Odense, Denmark
| | | | - Mads U Pedersen
- Centre for Alcohol and Drug Research, Department of Psychology, Aarhus University, Aarhus, Denmark
| | - Maria L Vang
- National Centre for Psychotraumatology, Department of Psychology, University of Southern Denmark, Odense, Denmark
- Department for Occupational and Environmental Health, Odense University Hospital, Odense, Denmark
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2
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Sarr R, Quinton A, Spain D, Rumball F. A Systematic Review of the Assessment of ICD-11 Complex Post-Traumatic Stress Disorder (CPTSD) in Young People and Adults. Clin Psychol Psychother 2024; 31:e3012. [PMID: 38894553 DOI: 10.1002/cpp.3012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 05/10/2024] [Accepted: 05/13/2024] [Indexed: 06/21/2024]
Abstract
Complex post-traumatic stress disorder (CPTSD) was introduced in the International Classification of Diseases (ICD) 11 in 2013 to simplify diagnosis and increase clinical utility. Given the recent ICD-11 conceptualisation, there is no standard approach for its assessment, and a review of research is necessary. This systematic review focuses on ICD-11 CPTSD assessment in young people aged 7 to 17 and adults aged 18 and above, examining measures, differentiating features and clinical considerations. Data from five databases are reviewed using a narrative synthesis approach and the quality of evidence is assessed and discussed. A total of 36 studies involving 5901 participants recruited from clinical settings and 1458 professionals with CPTSD assessment experience were included. Studies predominantly focused on adults, and the most used measure for assessment was the International Trauma Questionnaire. Papers focusing on differentiating features highlighted increased symptom severity, impairment and difficulties in individuals with CPTSD, compared to those with PTSD across various characteristics in both young people and adults. This review also identified the importance of a sensitive clinical approach with adaptations based on culture and age. Although gold-standard recommendations cannot be made, this paper offers tentative clinical practice recommendations and considerations regarding ICD-11 CPTSD assessment.
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Affiliation(s)
- Rachel Sarr
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Alice Quinton
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Debbie Spain
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Freya Rumball
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Adult Autism Service, Oxleas NHS Foundation Trust, Dartford, UK
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3
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Shrira A, Palgi Y. Age differences in acute stress and PTSD symptoms during the 2023 Israel-Hamas war: Preliminary findings. J Psychiatr Res 2024; 173:111-114. [PMID: 38520844 DOI: 10.1016/j.jpsychires.2024.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 02/06/2024] [Accepted: 03/03/2024] [Indexed: 03/25/2024]
Abstract
Traumatic exposure can result in acute stress symptoms in the immediate aftermath and post-traumatic stress disorder (PTSD) symptoms that persist beyond the initial weeks. Both short-term and long-term reactions require research and clinical attention. There is considerable evidence for age differences in PTSD, and older adults frequently present lower rates of PTSD compared to young adults. Much less is known concerning age differences in acute reaction or the extent to which age differences in PTSD are affected by age differences in acute stress. The current study examined acute stress and PTSD symptoms among young and older adult Israelis during the 2023 Israel-Hamas war. A web-based sample of 428 participants (mean age = 48.36 ± 16.29) completed retrospective accounts of pre-war psychological distress and acute stress in the first week of the war and further reported current PTSD symptoms. Rates of elevated levels of acute stress symptoms and probable PTSD were significantly higher among young adults (24.8% and 42.8%, respectively) compared to their older counterparts (3.7% and 13.7%, respectively). Age differences in probable PTSD remained significant even after controlling for other demographics, traumatic exposure, pre-war psychological distress, and acute stress symptoms. These preliminary findings further attest to the impressive resilience manifested by older adults during wartime. Moreover, as age differences in probable PTSD were not fully explained by acute reactions, unique mechanisms may be mobilized by older adults to cope with warfare trauma in the short- and long term.
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Affiliation(s)
- Amit Shrira
- Department of Social and Health Sciences, Bar-Ilan University, Ramat-Gan, Israel.
| | - Yuval Palgi
- Department of Gerontology, University of Haifa, Haifa, Israel
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4
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Translation and validation of the Dari International Trauma Questionnaire (ITQ) in Afghan asylum seekers and refugees. Eur J Psychotraumatol 2023; 14:2158428. [PMID: 37052110 PMCID: PMC9848235 DOI: 10.1080/20008066.2022.2158428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Background: The International Trauma Questionnaire (ITQ) is a standardized and validated measure aligned with the 11th version of the International Classification of Diseases (ICD-11) diagnostic criteria to assess post-traumatic stress disorder (PTSD) and complex post-traumatic stress disorder (CPTSD). It has been translated into 25 different languages, but is yet to be translated into Dari and validated for use in the Afghan population.Objective: This study aimed (1) to translate and culturally adapt the ITQ for use in Dari; (2) to assess the construct validity and composite reliability of ICD-11 PTSD and CPTSD using the Dari ITQ; and (3) to examine the concurrent, convergent, and discriminant validity of the Dari ITQ.Method: The Dari ITQ was validated through the completion of a set of standardized measures by 305 Afghan asylum seekers and refugees in Austria. Factorial analyses and psychometric properties of the Dari ITQ were assessed using confirmatory factor analysis (CFA), bivariate correlations, and multivariate regression.Results: Asylum seekers showed significantly higher levels of ICD-11 CPTSD symptomatology and probable diagnoses of ICD-11 PTSD, Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) PTSD, anxiety, depression, and psychological distress in comparison to refugees. CFA results supported the two-factor second-order model comprised of the PTSD and disturbances in self-organization (DSO) as the best fit to the data. The psychometric adequacy of this model in the Dari ITQ was evidenced by high factor loadings and excellent internal reliability. The Dari ITQ showed satisfactory concurrent, convergent, and discriminant validity.Conclusion: The current study supports the statistical validity and cultural sensitivity of the Dari ITQ in identifying symptoms of ICD-11 PTSD and CPTSD among Afghan asylum seekers and refugees.
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Vindbjerg E, Sandahl H, Mortensen EL, Roberts NP, Carlsson J. The structure of ICD-11 post traumatic stress disorder in a clinical sample of refugees based on the International Trauma Interview. Acta Psychiatr Scand 2023; 148:302-309. [PMID: 37469111 DOI: 10.1111/acps.13592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 04/20/2023] [Accepted: 07/02/2023] [Indexed: 07/21/2023]
Abstract
BACKGROUND The ICD-11 proposes fundamental changes to the PTSD diagnostic criteria, prompting thorough validation. While this is ideally carried out based on diagnostic interviews, most-and in the case of transcultural psychiatry all-studies have relied on self-reported measures. In this study, we used the International Trauma Interview (ITI) to assess the factor structure of ICD-11 PTSD symptoms in a sample of trauma-affected refugees. METHOD The ITI was administered with a sample of refugees (n = 198), originating mainly from the Greater Middle East. The symptom ratings were subjected to a confirmatory factor analysis (CFA), comparing the ICD-11 concordant three-factor model with alternative two- and one-factor models. RESULTS The overall fit was adequate for both the two- and three-factor models, but favored the two-factor model. Results for both models indicated local misspecifications and that item 5, hypervigilance, displayed a suboptimal loading. CONCLUSION The results generally support the use of the ITI in a severely trauma-affected refugee population, albeit with particular attention needed in the administration of item 5. The superior fit of a two-factor model warrants further testing across populations.
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Affiliation(s)
- Erik Vindbjerg
- Competence Centre for Transcultural Psychiatry, Mental Health Centre Ballerup, Copenhagen University Hospital - Mental Health Services CPH, Copenhagen, Denmark
| | - Hinuga Sandahl
- Competence Centre for Transcultural Psychiatry, Mental Health Centre Ballerup, Copenhagen University Hospital - Mental Health Services CPH, Copenhagen, Denmark
| | - Erik Lykke Mortensen
- Department of Public Health and Center for Healthy Aging, University of Copenhagen, Copenhagen, Denmark
| | - Neil P Roberts
- Cardiff and Vale University Health Board, Cardiff, UK
- Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - Jessica Carlsson
- Competence Centre for Transcultural Psychiatry, Mental Health Centre Ballerup, Copenhagen University Hospital - Mental Health Services CPH, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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Folke S, Karstoft KI, Andersen SB, Karatzias T, Nissen LR, Nielsen ABS. Risk factors, comorbidity and social impairment of ICD-11 PTSD and complex PTSD in Danish treatment-seeking military veterans. J Psychiatr Res 2023; 163:247-253. [PMID: 37244062 DOI: 10.1016/j.jpsychires.2023.05.055] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 04/26/2023] [Accepted: 05/15/2023] [Indexed: 05/29/2023]
Abstract
PURPOSE While a number of studies have investigated risk factors and comorbidities of ICD-11 post-traumatic stress disorder (PTSD) and complex PTSD (CPTSD) in various trauma exposed samples, few studies have been conducted in military samples. Existing studies with military samples have included rather small samples. The aim of the present study was to identify risk factors and comorbidities of ICD-11 PTSD and CPTSD in a large sample of previously deployed, treatment-seeking soldiers and veterans. METHODS Previously deployed, treatment-seeking Danish soldiers and veterans (N = 599), recruited from the Military Psychology Department of the Danish Defense, completed the International Trauma Questionnaire (ITQ), as well as questionnaires of common mental health difficulties, trauma exposure, functioning and demographics. Multivariate multinomial logistic regression analysis explored differences in self-reported exposure to adversity and health outcomes between those meeting ICD-11 criteria for probable PTSD, CPTSD and no trauma disorder. RESULTS A total of 13.0% met probable ICD-11 criteria for PTSD and 31.4% for CPTSD. Risk factors for CPTSD (compared to those with no trauma disorder) included exposure to warfare or combat, longer duration since the traumatic event and being single. Those with CPTSD were more likely than those with PTSD or no trauma disorder to endorse symptoms of depression, anxiety, stress, use of psychotropic medication, and suicide attempts. CONCLUSION CPTSD is a more common and debilitating condition compared to PTSD in treatment-seeking soldiers and veterans. Further research should focus on testing existing and novel interventions for CPTSD in the military.
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Affiliation(s)
- Sofie Folke
- Research and Knowledge Centre, The Danish Veterans Centre, Ringsted, Denmark; Department of Military Psychology, The Danish Veterans Centre, Copenhagen, Denmark.
| | - Karen-Inge Karstoft
- Research and Knowledge Centre, The Danish Veterans Centre, Ringsted, Denmark; Department of Psychology, University of Copenhagen, Copenhagen, Denmark.
| | - Søren Bo Andersen
- Research and Knowledge Centre, The Danish Veterans Centre, Ringsted, Denmark.
| | - Thanos Karatzias
- School of Health and Social Care, Napier University, Edinburgh, UK; Rivers Centre for Traumatic Stress, NHS, Lothian, Edinburgh, UK.
| | | | - Anni B S Nielsen
- Research and Knowledge Centre, The Danish Veterans Centre, Ringsted, Denmark; The Research Unit and Section of General Practice, Institute of Public Health, University of Copenhagen, Copenhagen, Denmark.
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Hansen M, Vaegter HB, Ravn SL, Andersen TE. Validation of the Danish PTSD Checklist for DSM-5 in trauma-exposed chronic pain patients using the Clinician-Administered PTSD Scale for DSM-5. Eur J Psychotraumatol 2023; 14:2179801. [PMID: 36892217 PMCID: PMC10013435 DOI: 10.1080/20008066.2023.2179801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/10/2023] Open
Abstract
Background: Validation of post-traumatic stress disorder (PTSD) screening tools across various populations to ensure accurate PTSD estimates is important. Because of the high symptom overlap between PTSD and pain, it is particularly important to validate PTSD screening tools in trauma-exposed chronic pain patients.Objective: The present study is the first seeking to validate the PTSD Checklist for DSM-5 (PCL-5) in a sample of trauma-exposed, treatment-seeking chronic pain patients.Method: The validation and optimal scoring of the PCL-5 were investigated using the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5) in chronic pain patients exposed to traffic or work-related traumas (n = 84). Construct validity was investigated using confirmatory factor analyses testing six competing DSM-5 models in a sample of mixed trauma-exposed chronic pain patients (n = 566), and a subsample of chronic pain patients exposed to traffic or work-related trauma only (n = 202). Furthermore, concurrent validity and discriminant validity were investigated using correlation analysis.Results: The results showed moderate (κ = .46) diagnostic consistency between the PCL-5 and the CAPS-5 using the DSM-5 symptom cluster criteria, and the overall accuracy of the scale (area under the curve = .79) was highly acceptable. Furthermore, the Danish PCL-5 showed excellent construct validity both in the full sample and in the subsample of traffic and work-related accidents, with superior fit of the seven-factor hybrid model. Excellent concurrent validity and discriminant validity were also established in the full sample.Conclusion: The PCL-5 appears to have satisfactory psychometric properties in trauma-exposed, treatment-seeking chronic pain patients.
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Affiliation(s)
- Maj Hansen
- THRIVE, Department of Psychology, University of Southern Denmark, Odense, Denmark
| | - Henrik Bjarke Vaegter
- Pain Research Group, Pain Center, Odense University Hospital, Odense, Denmark.,Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - Sophie Lykkegaard Ravn
- Specialized Hospital for Polio and Accident Victims, Roedovre, Denmark.,INSIDE, Department of Psychology, University of Southern Denmark, Odense, Denmark
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8
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Hoffman J, Ben-Zion Z, Arévalo A, Duek O, Greene T, Hall BJ, Harpaz-Rotem I, Liddell B, Locher C, Morina N, Nickerson A, Pfaltz MC, Schick M, Schnyder U, Seedat S, Shatri F, Sit HF, von Känel R, Spiller TR. Mapping the availability of translated versions of posttraumatic stress disorder screening questionnaires for adults: A scoping review. Eur J Psychotraumatol 2022; 13:2143019. [PMID: 38872602 PMCID: PMC9724641 DOI: 10.1080/20008066.2022.2143019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 10/26/2022] [Indexed: 11/26/2022] Open
Abstract
Background: The most used questionnaires for PTSD screening in adults were developed in English. Although many of these questionnaires were translated into other languages, the procedures used to translate them and to evaluate their reliability and validity have not been consistently documented. This comprehensive scoping review aimed to compile the currently available translated and evaluated questionnaires used for PTSD screening, and highlight important gaps in the literature.Objective: This review aimed to map the availability of translated and evaluated screening questionnaires for posttraumatic stress disorder (PTSD) for adults.Methods: All peer-reviewed studies in which a PTSD screening questionnaire for adults was translated, and which reported at least one result of a qualitative and /or quantitative evaluation procedure were included. The literature was searched using Embase, MEDLINE, and APA PsycInfo, citation searches and contributions from study team members. There were no restrictions regarding the target languages of the translations. Data on the translation procedure, the qualitative evaluation, the quantitative evaluation (dimensionality of the questionnaire, reliability, and performance), and open access were extracted.Results: A total of 866 studies were screened, of which 126 were included. Collectively, 128 translations of 12 different questionnaires were found. Out of these, 105 (83.3%) studies used a forward and backward translation procedure, 120 (95.2%) assessed the reliability of the translated questionnaire, 60 (47.6%) the dimensionality, 49 (38.9%) the performance, and 42 (33.3%) used qualitative evaluation procedures. Thirty-four questionnaires (27.0%) were either freely available or accessible on request.Conclusions: The analyses conducted and the description of the methods and results varied substantially, making a quality assessment impractical. Translations into languages spoken in middle- or low-income countries were underrepresented. In addition, only a small proportion of all translated questionnaires were available. Given the need for freely accessible translations, an online repository was developed.HIGHLIGHTS We mapped the availability of translated PTSD screening questionnaires.The quality of the translation and validation processes is very heterogenous.We created a repository for translated, validated PTSD screening questionnaires.
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Affiliation(s)
- Joel Hoffman
- School of Psychology, UNSW Australia, Sydney, Australia
| | - Ziv Ben-Zion
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- US Department of Veterans Affairs National Center for PTSD, VA Connecticut, Healthcare System, West Haven, CT, USA
| | - Adrián Arévalo
- Facultad de Medicina & Neuron Research Group Lima, Universidad de Piura, Lima, Perú
- Facultad de Medicina "San Fernando", Universidad Nacional Mayor de San Marcos, Lima, Perú
| | - Or Duek
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- US Department of Veterans Affairs National Center for PTSD, VA Connecticut, Healthcare System, West Haven, CT, USA
| | - Talya Greene
- Department of Community Mental Health, University of Haifa, Haifa, Israel
| | - Brian J Hall
- Center for Global Health equity, New York University (Shanghai), Shanghai, People's Republic of China
- School of Global Public Health, New York University, New York, NY, USA
| | - Ilan Harpaz-Rotem
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- US Department of Veterans Affairs National Center for PTSD, VA Connecticut, Healthcare System, West Haven, CT, USA
| | | | - Cosima Locher
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Naser Morina
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | | | - Monique C Pfaltz
- Department of Psychology and Social Work, Mid Sweden University, Östersund, Sweden
| | - Matthis Schick
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | | | - Soraya Seedat
- Department of Psychiatry, Faculty of Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Fatlinda Shatri
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Hao Fong Sit
- Department of Psychology, Faculty of Social Sciences, The University of Hong Kong, Hong Kong, People's Republic of China
| | - Roland von Känel
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Tobias R Spiller
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- US Department of Veterans Affairs National Center for PTSD, VA Connecticut, Healthcare System, West Haven, CT, USA
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
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A Psychometric Evaluation of the International Trauma Questionnaire (ITQ) in a Trauma-Exposed College Sample. EUROPEAN JOURNAL OF TRAUMA & DISSOCIATION 2022. [DOI: 10.1016/j.ejtd.2022.100305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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10
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A systematic review shows minimal evidence for measurement properties of psychological functioning outcomes in whiplash. J Clin Epidemiol 2022; 151:29-44. [PMID: 35934267 DOI: 10.1016/j.jclinepi.2022.07.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 07/07/2022] [Accepted: 07/19/2022] [Indexed: 12/25/2022]
Abstract
OBJECTIVES The aim of this study was to systematically identify, synthesize, and appraise studies on the measurement properties of patient-reported outcome measures (PROMs) for anxiety, depression, fear of movement, pain catastrophizing, post-traumatic stress, self-efficacy, and stress in people with whiplash-associated disorders (WAD). STUDY DESIGN AND SETTING PsycINFO, MEDLINE, EMBASE, CINAHL, PILOTS, Web of Science, and Scopus were searched (November 9, 2021). Studies evaluating any measurement property of relevant PROMs in WAD were included. Two reviewers independently screened the studies and assessed the measurement properties in accordance with the COSMIN guidelines. RESULTS Measurement properties of 10 PROMs were evaluated in WAD: Pictorial Fear of Activity Scale-Cervical (PFActS-C), Tampa Scale of Kinesiophobia-11, Pain Catastrophizing Scale (PCS), Pain Self-Efficacy Questionnaire (PSEQ), PSEQ-4 item, PSEQ-2a, PSEQ-2b, Self-Efficacy Scale, Harvard Trauma Questionnaire, and Post-Traumatic Stress Diagnostic Scale. Content validity was not examined in any of these PROMs in whiplash. Moderate- or high-quality evidence showed adequate internal structure for the PSEQ, PCS, and PFActS-C, whereas the original structures of the remaining seven PROMs were not confirmed in whiplash. CONCLUSION Until further research on the measurement properties of these PROMs is available, researchers may opt to use the PSEQ, PCS, or PFActS-C if the construct is aligned with research aims.
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Gelezelyte O, Roberts NP, Kvedaraite M, Bisson JI, Brewin CR, Cloitre M, Kairyte A, Karatzias T, Shevlin M, Kazlauskas E. Validation of the International Trauma Interview (ITI) for the Clinical Assessment of ICD-11 Posttraumatic Stress Disorder (PTSD) and Complex PTSD (CPTSD) in a Lithuanian Sample. Eur J Psychotraumatol 2022; 13:2037905. [PMID: 35222840 PMCID: PMC8881058 DOI: 10.1080/20008198.2022.2037905] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND The 11th revision of the International Classification of Diseases (ICD-11) includes a new diagnosis of complex posttraumatic stress disorder (CPTSD). The International Trauma Interview (ITI) is a novel clinician-administered diagnostic interview for the assessment of ICD-11 PTSD and CPTSD. OBJECTIVE The aim of this study was to evaluate the psychometric properties of the ITI in a Lithuanian sample in relation to interrater agreement, latent structure, internal reliability, as well as convergent and discriminant validity. METHOD In total, 103 adults with a history of various traumatic experiences participated in the study. The sample was predominantly female (83.5%), with a mean age of 32.64 years (SD = 9.36). For the assessment of ICD-11 PTSD and CPTSD, the ITI and the self-report International Trauma Questionnaire (ITQ) were used. Mental health indicators, such as depression, anxiety, and dissociation, were measured using self-report questionnaires. The latent structure of the ITI was evaluated using confirmatory factor analysis (CFA). In order to test the convergent and discriminant validity of the ITI we conducted a structural equation model (SEM). RESULTS Overall, based on the ITI, 18.4% of participants fulfilled diagnostic criteria for PTSD and 21.4% for CPTSD. A second-order two-factor CFA model of the ITI PTSD and disturbances in self-organization (DSO) symptoms demonstrated a good fit. The associations with various mental health indicators supported the convergent and discriminant validity of the ITI. The clinician-administered ITI and self-report ITQ had poor to moderate diagnostic agreement across different symptom clusters. CONCLUSION The ITI is a reliable and valid tool for assessing and diagnosing ICD-11 PTSD and CPTSD.
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Affiliation(s)
- Odeta Gelezelyte
- Center for Psychotraumatology, Institute of Psychology, Vilnius University, Vilnius, Lithuania
| | - Neil P Roberts
- Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, UK.,Psychology and Psychological Therapies Directorate, Cardiff & Vale University Health Board, Cardiff, UK
| | - Monika Kvedaraite
- Center for Psychotraumatology, Institute of Psychology, Vilnius University, Vilnius, Lithuania
| | - Jonathan I Bisson
- Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, UK
| | - Chris R Brewin
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Marylene Cloitre
- National Center for PTSD Dissemination and Training Division, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA.,Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Agniete Kairyte
- Center for Psychotraumatology, Institute of Psychology, Vilnius University, Vilnius, Lithuania
| | - Thanos Karatzias
- School of Health and Social Care, Edinburgh Napier University, Scotland, UK & Nhs Lothian Rivers Centre for Traumatic Stress, Edinburgh, Scotland
| | - Mark Shevlin
- School of Psychology, Ulster University, Coleraine, Northern Ireland
| | - Evaldas Kazlauskas
- Center for Psychotraumatology, Institute of Psychology, Vilnius University, Vilnius, Lithuania
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12
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Elmose Andersen T, Hansen M, Lykkegaard Ravn S, Bjarke Vaegter H. The association of probable PTSD at baseline and pain-related outcomes after chronic pain rehabilitation: A comparison of DSM-5 and ICD-11 criteria for PTSD. Eur J Pain 2021; 26:709-718. [PMID: 34939270 DOI: 10.1002/ejp.1899] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 12/10/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND There is a high prevalence of posttraumatic stress disorder (PTSD) in patients with chronic pain. However, different patients are identified depending on the diagnostic system used. Moreover, it is unclear if the conceptualizations of PTSD are differently associated with outcomes of pain rehabilitation. Hence, the aims of the present study were first to explore the prevalence rates and diagnostic agreement of probable PTSD according to the ICD-11 and the DSM-5 screening tools (International Trauma Questionnaire [ITQ] vs. PTSD Checklist [PCL-5]), and secondly, to explore the associations of probable PTSD determined by ITQ and PCL-5 with psychological distress measures at baseline, and thirdly, the associations with pain and disability after pain rehabilitation adjusting for psychological covariates. METHODS A consecutive cohort of patients with chronic non-malignant pain (n = 152) referred to a Danish interdisciplinary pain center was assessed at baseline prior to their first visit and at follow-up three days after completed treatment. RESULTS The estimated probable PTSD baseline prevalence rates were 15.8% (ITQ) and 16.4% (PCL-5). However, the diagnostic agreement between the PCL-5 and the ITQ was only moderate (k = 0.64). Overall, compared to the ITQ probable PTSD according to the PCL-5 correlated more strongly with psychological distress. Only the ITQ was associated with poorer outcomes after rehabilitation, explaining alone 7-8% of the variance in disability and pain intensity adjusted for covariates. CONCLUSIONS The results underline the importance of taking the conceptualization and assessment of PTSD into consideration when investigating the impact of PTSD on pain rehabilitation. SIGNIFICANCE There is a high prevalence of probable PTSD in patients with chronic pain. However, different patients with probable PTSD are identified depending on the diagnostic system used. Although similar probable PTSD prevalence rates (about 16%) were found using DSM-5 and ICD-11 PTSD screening tools (PCL-5 and ITQ, respectively), the diagnostic agreement between the systems was only moderate (k = 0.64). At the same time, only probable PTSD estimated according to the ITQ and not the PCL-5 was a significant predictor of disability after pain rehabilitation.
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Affiliation(s)
- Tonny Elmose Andersen
- Department of Psychology, University of Southern Denmark, InCoRE and THRIVE Research Groups, Odense, Denmark
| | - Maj Hansen
- Department of Psychology, University of Southern Denmark, InCoRE and THRIVE Research Groups, Odense, Denmark
| | - Sophie Lykkegaard Ravn
- Department of Psychology, University of Southern Denmark, InCoRE and THRIVE Research Groups, Odense, Denmark.,Specialized Hospital for Polio and Accident Victims, Roedovre, Denmark
| | - Henrik Bjarke Vaegter
- Pain Research Group, Pain Center, University of Southern Denmark, Odense, Denmark.,Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
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Abstract
It is 10 years ago that the European Journal of Psychotraumatology (EJPT) was launched. This was celebrated with a one day symposium on 1 February 2021 with all EJPT's editors presenting on the state of the art developments in the field of psychotraumatology. The European Society for Traumatic Stress Studies (ESTSS) is proud to have all these speakers together sharing their knowledge on a range of topics within the field of psychotraumatology, from genetics to clinical practice. In this editorial the programme with the presentations is presented, including links to both to short summaries of the lectures and to the online session itself. In line with the Open Access format of the journal, access to the symposium content is free of charge and thus available to all around the world without barriers.
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Affiliation(s)
- Miranda Olff
- Department of Psychiatry, Amsterdam University Medical Centers (Location AMC), University of Amsterdam, Amsterdam Neuroscience, Amsterdam, The Netherlands
- ARQ National Psychotrauma Centre, Diemen, The Netherlands
| | - Soraya Seedat
- Department of Psychiatry, Stellenbosch University, Stellenbosch, South Africa
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