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Ho GWK, Liu H, Karatzias T, Hyland P, Cloitre M, Lueger-Schuster B, Brewin CR, Guo C, Wang X, Shevlin M. Validation of the International Trauma Questionnaire-Child and Adolescent Version (ITQ-CA) in a Chinese mental health service seeking adolescent sample. Child Adolesc Psychiatry Ment Health 2022; 16:66. [PMID: 35962396 PMCID: PMC9375312 DOI: 10.1186/s13034-022-00497-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 07/13/2022] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND The International Trauma Questionnaire-Child and Adolescent version (ITQ-CA) is a self-report measure that assesses posttraumatic stress disorder (PTSD) and complex PTSD (CPTSD) based on the diagnostic formulation of the 11th version of the International Classification of Diseases (ICD-11). This study aimed to provide a Chinese translation and psychometric evaluation of the ITQ-CA using a sample of mental-health service seeking adolescents in Mainland China. METHODS The ITQ-CA was translated and back-translated from English to simplified Chinese and finalized with consensus from an expert panel. Adolescents ages 12-17 were recruited via convenience sampling from an outpatient psychiatric clinic in Mainland China. Participants completed the ITQ-CA; measures of four criterion variables (depression, anxiety, stress, adverse childhood experiences); and the PTSD Checklist for DSM-5 (PCL-5). Construct validity, concurrent validity, and comparison of PTSD caseness between ICD-11 and DSM-5 measures were assessed. RESULTS The final sample consisted of 111 Chinese adolescents (78% female; mean age of 15.23), all diagnosed with a major depressive disorder. Confirmatory factor analysis indicated the two-factor second-order model provided optimal fit. All criterion variables were positively and significant correlated with the six ITQ-CA symptom cluster summed scores. In the present sample, 69 participants (62.16%) met symptom criteria for ICD-PTSD or CPTSD using the ITQ-CA, and 73 participants (65.77%) met caseness for DSM-5 PTSD using the PCL-5. Rates of PTSD symptom cluster endorsement and caseness deriving from both diagnostic systems were comparable. CONCLUSIONS The Chinese ITQ-CA has acceptable psychometric properties and confers additional benefits in identifying complex presentations of trauma-related responses in younger people seeking mental health services.
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Affiliation(s)
- G. W. K. Ho
- grid.16890.360000 0004 1764 6123School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | - H. Liu
- grid.459419.4Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China ,grid.186775.a0000 0000 9490 772XSchool of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China ,grid.186775.a0000 0000 9490 772XAnhui Psychiatric Center, Anhui Medical University, Hefei, China
| | - T. Karatzias
- grid.20409.3f000000012348339XSchool of Health & Social Care, Edinburgh Napier University, Edinburgh, UK ,grid.39489.3f0000 0001 0388 0742Rivers Centre for Traumatic Stress, NHS Lothian, Edinburgh, UK
| | - P. Hyland
- grid.95004.380000 0000 9331 9029Maynooth University, Maynooth, Ireland
| | - M. Cloitre
- grid.168010.e0000000419368956Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, USA ,grid.280747.e0000 0004 0419 2556National Center for PTSD, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA USA
| | - B. Lueger-Schuster
- grid.10420.370000 0001 2286 1424Department of Clinical and Health Psychology, University of Vienna, Vienna, Austria
| | - C. R. Brewin
- grid.83440.3b0000000121901201Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - C. Guo
- grid.459419.4Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China ,grid.186775.a0000 0000 9490 772XSchool of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China ,grid.186775.a0000 0000 9490 772XAnhui Psychiatric Center, Anhui Medical University, Hefei, China
| | - X. Wang
- grid.459419.4Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China ,grid.186775.a0000 0000 9490 772XSchool of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China ,grid.186775.a0000 0000 9490 772XAnhui Psychiatric Center, Anhui Medical University, Hefei, China
| | - M. Shevlin
- grid.12641.300000000105519715School of Psychology, Ulster University, Derry, Northern Ireland
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Haselgruber A, Sölva K, Lueger-Schuster B. Symptom structure of ICD-11 Complex Posttraumatic Stress Disorder (CPTSD) in trauma-exposed foster children: examining the International Trauma Questionnaire - Child and Adolescent Version (ITQ-CA). Eur J Psychotraumatol 2020; 11:1818974. [PMID: 33244361 PMCID: PMC7678682 DOI: 10.1080/20008198.2020.1818974] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 07/24/2020] [Accepted: 08/24/2020] [Indexed: 01/02/2023] Open
Abstract
Background: The 11th edition of the International Classification of Diseases (ICD-11) introduces Posttraumatic Stress Disorder (PTSD) and Complex Posttraumatic Stress Disorder (CPTSD) as two distinct trauma-related disorders. Numerous studies support the proposed symptom structure of ICD-11 CPTSD in adults, but only a few studies have examined CPTSD symptom structure in children, reporting diverging results. To assess ICD-11 CPTSD in children, the International Trauma Questionnaire (ITQ) was recently adapted for children and adolescents (ITQ-CA), with no validated German version available yet. Objective: This study aimed (1) to test the symptom structure of ICD-11 CPTSD in a sample of trauma-exposed foster children using the ITQ-CA, and (2) to examine the concurrent, convergent and discriminant validity of the German ITQ-CA. Method: Altogether, 161 Austrian foster children completed a set of standardized measures, resulting in a final sample of 135 trauma-exposed foster children meeting the inclusion criteria. Psychometric properties of the ITQ-CA were assessed using confirmatory factor analysis (CFA), bivariate correlations and multivariate regression. Results: CFA supported ICD-11 CPTSD symptom structure in children as a two-factor higher-order model with PTSD and Disturbances in Self-Organization (DSO) as correlated factors with very good model fit, while a one-factor higher-order model also fitted the data very well. High factor loadings and excellent levels of internal reliability evidenced the psychometric adequacy of the ITQ-CA. Concurrent and convergent validity were evidenced by high correlations between ITQ-CA scales and criterion variables (PTSD symptoms, depression, anxiety, dissociation, lifetime traumatization). Discriminant validity was partly supported by PTSD and DSO being differently predicted by exogenous criterion variables. Conclusions: CPTSD symptom structure in children is in support of the ICD-11 conceptualization. The reliability and validity of the German ITQ-CA are evidenced for the first time, identifying it as an easy-to-use screening instrument to assess ICD-11 PTSD and CPTSD in children. Further implications and areas for upcoming studies are discussed.
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Affiliation(s)
- A. Haselgruber
- Unit of Psychotraumatology, Faculty of Psychology, University of Vienna, Vienna, Austria
| | - K. Sölva
- Unit of Psychotraumatology, Faculty of Psychology, University of Vienna, Vienna, Austria
| | - B. Lueger-Schuster
- Unit of Psychotraumatology, Faculty of Psychology, University of Vienna, Vienna, Austria
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Haselgruber A, Sölva K, Lueger-Schuster B. Perspective matters: Differences between child- and caregiver-reports of emotion regulation mediating the relationship between cumulative childhood trauma and mental health problems in foster children. Child Abuse Negl 2020; 107:104558. [PMID: 32559554 DOI: 10.1016/j.chiabu.2020.104558] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 05/09/2020] [Accepted: 05/19/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Cumulative childhood trauma predicts mental health problems in children, mediated by emotion regulation (ER). To assess trauma history and mental health in children, different informants may be addressed, assessing data from different perspectives. Despite differences between child- and caregiver-reports as robust finding in child psychology, it remains unclear to which extent perspective matters when examining these variables and related associations. OBJECTIVE The current study was set to (1) examine whether ER mediates the relationship between cumulative childhood trauma and mental health problems in children, (2) test whether results differ with examined perspective, and (3) investigate if meaningful patterns of child-caregiver-reported discrepancies can be identified. METHODS Data were collected from 145 children living in foster care by child- and caregiver-reports using standardized measures to assess trauma history (CTQ), ER (FEEL-KJ), and mental health problems (CBCL). Mediation and latent profile analysis were calculated. RESULTS Mediation analysis identified ER as mediator for internalizing and externalizing mental health problems. Using data from different perspectives, mediation models differed considerably regarding significance, direction, and magnitude of effects. Using latent profile analysis, meaningful patterns of child-caregiver-reported discrepancies were identified and associated with children's sociodemographic and psychopathological characteristics. CONCLUSIONS Adaptive and maladaptive ER distinctively mediate the relationship between cumulative childhood trauma and mental health problems in children. Perspective matters when examining these variables and child- and caregiver-reports are not interchangeable. Practitioners and researchers should be aware of inherent limitations when using data from distinct perspectives. Informant discrepancies can carry meaning and should not be ignored, but examined and interpreted instead.
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Affiliation(s)
- A Haselgruber
- Unit of Psychotraumatology, Faculty of Psychology, University of Vienna, Austria.
| | - K Sölva
- Unit of Psychotraumatology, Faculty of Psychology, University of Vienna, Austria
| | - B Lueger-Schuster
- Unit of Psychotraumatology, Faculty of Psychology, University of Vienna, Austria
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