#3113 Evaluating the PCL-C as a measure of trauma and PTSD symptoms in patients with functional neurological symptom disorder

2021 ◽  
Vol 92 (8) ◽  
pp. A6.2-A6
Author(s):  
Umamah Yusufi
Keyword(s):  
Factor Analysis ◽  
Neurological Symptom ◽  
Factor Model ◽  
Emotional Dysregulation ◽  
Traumatic Experiences ◽  
Aetiological Factor ◽  
Ptsd Symptoms ◽  
Mental Hrqol ◽  
High Level ◽  
Functional Neurological Symptom Disorder

AimsFunctional Neurological Symptom Disorder (FNSD) is common and disabling. Historically trauma was considered an essential aetiological factor, but the precise contribution of trauma to the disorder, and resulting disability, remains controversial. The PCL-C is a self-reported screening tool for PTSD symptoms based on DSM-IV criteria. A previous study in patients with FNSD demonstrated high scores on the PCL-C, with a reduction in scores following psychotherapy. However strong correlations with other psychological co-morbidities raised the possibility that the PCL-C may be capturing non-specific distress rather than indicators of previous traumatisation. The present study aimed to investigate (i) whether underlying factors measured by the PCL-C can distinguish specific trauma-memory-related symptoms from less specific emotion-regulation-related symptoms, (ii) the extent to which individual factors correlate with other psychopathology and health-related quality of life (HRQoL) measures and (iii) whether different factors change with psychotherapy, all in patients with FNSD.MethodsAn exploratory factor analysis of PCL-C responses from 473 FNSD patients pre-and post-psychotherapy was performed to generate1-4 factor models. The final factor model was determined through confirmatory factor analysis. Relationships between PCL-C factors, measures of comorbidities (depression, somatisation and anxiety) and HRQoL were assessed using regression analysis. Pre- and post-psychotherapy scores were compared.ResultsThe best model for the PCL-C comprised of two-factors: factor 1 (intrusive symptoms) explained 55.2% of the variance, whilst factor 2 (emotional dysregulation) explained 7.8% of the variance. Both factors reduced in severity after psychotherapy, but factor 2 reduced by more and correlated more strongly with a decrease in depression and anxiety than factor 1. Changes in depression, anxiety, somatic symptoms and mental HRQoL predicted 61.9% of the change in factor 2, but only 49.2% in factor 1. Improvements in mental HRQoL were strongly associated with a decrease in factor 2, but less so in factor 1.DiscussionThe factor analysis revealed the PCL-C represents two correlated but distinguishable symptom clusters in patients with FNSD: intrusive symptoms and emotional dysregulation. Both were elevated in our patient sample. The high level of intrusive symptoms suggests many patients with FNSD experience classical post-traumatic symptoms, which may indicate that subjective traumatic experiences contribute to pathogenesis and resulting disability. These symptoms showed some reduction with psychotherapy, but the greater reduction in emotional dysregulation symptoms and associated improvements in mental HRQoL suggest that psychotherapy may be more effective in reducing the burden of comorbidities and providing better coping strategies than in addressing core symptoms of the underlying disorder.

Assessing Guilt After Traumatic Events

2011 ◽  
Vol 27 (4) ◽  
pp. 251-257 ◽  
Author(s):  
Noemí Pereda ◽  
Mila Arch ◽  
Maribel Peró ◽  
Joan Guàrdia ◽  
Maria Forns
Keyword(s):  
Life Events ◽  
Factor Model ◽  
Internal Validity ◽  
Brief Symptom Inventory ◽  
Traumatic Experiences ◽  
Psychology Research ◽  
Traumatic Life Events ◽  
Confirmatory Factor ◽  
Original Scale ◽  
High Level

Introduction: The assessment of feelings of guilt has become an important area of psychology research, although few specific tools for their evaluation have been designed to date. One of the instruments available is the Trauma-Related Guilt Inventory (TRGI; Kubany & Haynes, 2001 ), which assesses the cognitive and emotional components of the feelings of guilt that arise following traumatic experiences. Method: We analyzed data from a sample of 650 university students aged between 18.0 and 30.6 years (M = 21.71; SD = 2.63), using the TRGI, the Brief Symptom Inventory ( Derogatis, 1993 ), and the Distressing Event Questionnaire ( Kubany, 2001 ). Results: The proposed adaptation of the TRGI to a Spanish population demonstrated more than satisfactory criterion validity. A three-factor model from a confirmatory factor analysis was tested, and the factor structure of the original scale was confirmed by an exceptionally high level of internal validity. Discussion: Our results show that the TRGI is an effective tool for assessing guilt after traumatic life events in the Spanish-speaking context.

Factorial Structure of the Therapist Adherence Measure-Revised (TAM-R) Within Multisystemic Therapy

2020 ◽  
Vol 36 (2) ◽  
pp. 427-431
Author(s):  
Aurelie M. C. Lange ◽  
Marc J. M. H. Delsing ◽  
Ron H. J. Scholte ◽  
Rachel E. A. van der Rijken
Keyword(s):  
Factor Analysis ◽  
Factor Structure ◽  
Factor Model ◽  
Multisystemic Therapy ◽  
Model Fit ◽  
Validity And Reliability ◽  
Adherence Measure ◽  
Therapist Adherence ◽  
Confirmatory Factor ◽  
The Us

Abstract. The Therapist Adherence Measure (TAM-R) is a central assessment within the quality-assurance system of Multisystemic Therapy (MST). Studies into the validity and reliability of the TAM in the US have found varying numbers of latent factors. The current study aimed to reexamine its factor structure using two independent samples of families participating in MST in the Netherlands. The factor structure was explored using an Exploratory Factor Analysis (EFA) in Sample 1 ( N = 580). This resulted in a two-factor solution. The factors were labeled “therapist adherence” and “client–therapist alliance.” Four cross-loading items were dropped. Reliability of the resulting factors was good. This two-factor model showed good model fit in a subsequent Confirmatory Factor Analysis (CFA) in Sample 2 ( N = 723). The current finding of an alliance component corroborates previous studies and fits with the focus of the MST treatment model on creating engagement.

The Factor Structure and Psychometric Properties of the Resiliency Scale in Chinese Undergraduates

2010 ◽  
Vol 26 (3) ◽  
pp. 162-171 ◽  
Author(s):  
Lixia Cui ◽  
Xiujie Teng ◽  
Xupei Li ◽  
Tian P.S. Oei
Keyword(s):  
Factor Analysis ◽  
Psychometric Properties ◽  
Factor Structure ◽  
Undergraduate Students ◽  
Concurrent Validity ◽  
Higher Order ◽  
Criterion Variable ◽  
Confirmatory Factor ◽  
High Level ◽  
Chinese Undergraduates

The current study examined the factor structure and the psychometric properties of Sandra Prince-Embury’s Resiliency Scale for Adolescents (RESA) in Chinese undergraduates. A total of 726 undergraduate students were randomly divided into two subsamples: Sample A was used for the exploratory factor analysis (EFA) and Sample B was used for the confirmatory factor analysis (CFA). The EFA revealed that 56 items and a model of 10 factors with 3 higher order factors (as described by Sandra) were to be retained; CFA with Sample B confirmed this result. The overall scale and the subscales of the Chinese-RESA demonstrated a high level of internal consistency. Furthermore, concurrent validity was demonstrated by the correlation of the scale with other instruments such as the PANAS and the CSS, and the predictive validity was confirmed via three multiple regression analyses using the PANAS as a criterion variable: one for the 10 subscales of the C-RESA, one for the 3 higher order scales, and one for the total C-RESA. We concluded that the C-RESA may be used for research into Chinese undergraduates’ adaptive behaviors.

Portuguese Version of the Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5): Comparison of Latent Models and Other Psychometric Properties in a Sample of Fire Fighters

2019 ◽  
Author(s):  
Teresa Carvalho ◽  
Carolina da Motta ◽  
José Pinto Gouveia
Keyword(s):  
Psychometric Properties ◽  
Externalizing Behavior ◽  
Convergent Validity ◽  
Factor Model ◽  
Latent Structure ◽  
Ptsd Symptoms ◽  
Portuguese Version ◽  
Dsm 5 ◽  
Competing Models ◽  
Arousal Model

<p>The PCL (Weathers et al., 1993) is a useful and widely used measure to assess PTSD symptoms in clinical and research contexts, exhibiting adequate psychometric properties across its several versions and translations (e. g. Carvalho et al., 2015; Wilkins et al., 2011). The current study analyzed the psychometric properties (latent structure, internal consistency, temporal reliability, and convergent validity) of the Portuguese version of the PCL for the DSM-5 (PCL-5, Weathers et al., 2013) in a sample of firefighters. This study also aimed to contribute with empirical data to clarify the best latent structure of DSM-5 PTSD symptoms. Specifically, the DSM-5 four-factor model and other competing models for PTSD symptoms (four-factor Dysphoria model, five-factor Dysphoric Arousal model, six-factor Anhedonia model, six-factor Externalizing Behavior model, and seven-factor Hybrid model) applied to PCL-5 were analyzed and compared in this paper.<br></p>

An investigation into the factor structure of the Cognitive Therapy Scale – Revised (CTS-R) in a CBT training sample

2021 ◽  
pp. 1-11
Author(s):  
Sarah Beale ◽  
Silia Vitoratou ◽  
Sheena Liness
Keyword(s):  
Factor Analysis ◽  
Confirmatory Factor Analysis ◽  
Cognitive Therapy ◽  
Exploratory Factor Analysis ◽  
Factor Structure ◽  
Factor Model ◽  
Single Factor ◽  
Behaviour Therapy ◽  
Cognitive Behaviour ◽  
Confirmatory Factor

Abstract Background: Effective monitoring of cognitive behaviour therapy (CBT) competence depends on psychometrically robust assessment methods. While the UK Cognitive Therapy Scale – Revised (CTS-R; Blackburn et al., 2001) has become a widely used competence measure in CBT training, practice and research, its underlying factor structure has never been investigated. Aims: This study aimed to present the first investigation into the factor structure of the CTS-R based on a large sample of postgraduate CBT trainee recordings. Method: Trainees (n = 382) provided 746 mid-treatment audio recordings for depression (n = 373) and anxiety (n = 373) cases scored on the CTS-R by expert markers. Tapes were split into two equal samples counterbalanced by diagnosis and with one tape per trainee. Exploratory factor analysis was conducted. The suggested factor structure and a widely used theoretical two-factor model were tested with confirmatory factor analysis. Measurement invariance was assessed by diagnostic group (depression versus anxiety). Results: Exploratory factor analysis suggested a single-factor solution (98.68% explained variance), which was supported by confirmatory factor analysis. All 12 CTS-R items were found to contribute to this single factor. The univariate model demonstrated full metric invariance and partial scalar invariance by diagnosis, with one item (item 10 – Conceptual Integration) demonstrating scalar non-invariance. Conclusions: Findings indicate that the CTS-R is a robust homogenous measure and do not support division into the widely used theoretical generic versus CBT-specific competency subscales. Investigation into the CTS-R factor structure in other populations is warranted.

scholarly journals Medical artificial intelligence readiness scale for medical students (MAIRS-MS) – development, validity and reliability study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ozan Karaca ◽  
S. Ayhan Çalışkan ◽  
Kadir Demir
Keyword(s):  
Artificial Intelligence ◽  
Factor Analysis ◽  
Medical Students ◽  
Data Science ◽  
Factor Model ◽  
Health Science ◽  
Measurement Tool ◽  
Validity And Reliability ◽  
Mathematical Concepts ◽  
Evaluation And Monitoring

Abstract Background It is unlikely that applications of artificial intelligence (AI) will completely replace physicians. However, it is very likely that AI applications will acquire many of their roles and generate new tasks in medical care. To be ready for new roles and tasks, medical students and physicians will need to understand the fundamentals of AI and data science, mathematical concepts, and related ethical and medico-legal issues in addition with the standard medical principles. Nevertheless, there is no valid and reliable instrument available in the literature to measure medical AI readiness. In this study, we have described the development of a valid and reliable psychometric measurement tool for the assessment of the perceived readiness of medical students on AI technologies and its applications in medicine. Methods To define medical students’ required competencies on AI, a diverse set of experts’ opinions were obtained by a qualitative method and were used as a theoretical framework, while creating the item pool of the scale. Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA) were applied. Results A total of 568 medical students during the EFA phase and 329 medical students during the CFA phase, enrolled in two different public universities in Turkey participated in this study. The initial 27-items finalized with a 22-items scale in a four-factor structure (cognition, ability, vision, and ethics), which explains 50.9% cumulative variance that resulted from the EFA. Cronbach’s alpha reliability coefficient was 0.87. CFA indicated appropriate fit of the four-factor model (χ2/df = 3.81, RMSEA = 0.094, SRMR = 0.057, CFI = 0.938, and NNFI (TLI) = 0.928). These values showed that the four-factor model has construct validity. Conclusions The newly developed Medical Artificial Intelligence Readiness Scale for Medical Students (MAIRS-MS) was found to be valid and reliable tool for evaluation and monitoring of perceived readiness levels of medical students on AI technologies and applications. Medical schools may follow ‘a physician training perspective that is compatible with AI in medicine’ to their curricula by using MAIRS-MS. This scale could be benefitted by medical and health science education institutions as a valuable curriculum development tool with its learner needs assessment and participants’ end-course perceived readiness opportunities.

scholarly journals Validation of the psychometric properties of the Malay advance care planning questionnaire

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Mun Kit Lim ◽  
Pauline Siew Mei Lai ◽  
Pei Se Wong ◽  
Sajaratulnisah Othman ◽  
Fadzilah Hanum Mohd Mydin
Keyword(s):  
Factor Analysis ◽  
Psychometric Properties ◽  
Advance Care Planning ◽  
Response Rate ◽  
Factor Model ◽  
Tertiary Education ◽  
Primary Care Clinic ◽  
Care Planning ◽  
Care Clinic ◽  
Advance Care

Abstract Background There is a growing interest among the developing countries on advance care planning (ACP) due to the reported benefits of planning ahead in the developed countries. Validated instruments in various languages have been developed to facilitate study on the views of public prior to its implementation. However, instrument to explore the views on ACP in Malay has not been developed and validated yet, even though Malay is spoken extensively by approximately 220 million people in the Malay Archipelago. There is also a need for instrument in Malay language to facilitate the assessment of knowledge, attitude and practice (KAP) of Malaysians regarding ACP. Therefore, the aim of this study was to validate the psychometric properties of the Malay Advance Care Planning Questionnaire (ACPQ-M). Methods The ACPQ was translated according to international guidelines. This validation study was conducted from January to June 2018. Participants who were ≥ 21 years old, and able to understand Malay were recruited from an urban primary care clinic and a tertiary education institution in Malaysia. A researcher administered the ACPQ-M to participants via a face-to-face interview at baseline and 2 weeks later. Each interview took approximately 10–20 min. Results A total of 222/232 participants agreed to participate (response rate = 96.0%). Exploratory factor analysis and confirmatory factor analysis found that the ACPQ-M was a 4-factor model. The Cronbach’s α values for the four domains ranged from 0.674–0.947. Only 157/222 participants completed the test-retest (response rate = 71%). At test-retest, quadratic weighted kappa values for all domains ranged from 0.340–0.674, except for two domains which ranged from − 0.200-0.467. Conclusions The ACPQ-M was found to be a 4-factor model, and a valid and reliable instrument to assess the KAP regarding ACP. This instrument can contribute to profound understanding of the KAP of Malaysians regarding ACP, and assist policy makers in determining the readiness for legislation of ACP in Malaysia.

Childhood trauma moderates morphometric associations between orbitofrontal cortex and amygdala: implications for pathological personality traits

2020 ◽  
pp. 1-10
Author(s):  
Nadia Bounoua ◽  
Rickie Miglin ◽  
Jeffrey M. Spielberg ◽  
Curtis L. Johnson ◽  
Naomi Sadeh
Keyword(s):  
Personality Traits ◽  
Childhood Trauma ◽  
Orbitofrontal Cortex ◽  
Functional Neuroimaging ◽  
Trauma Exposure ◽  
Diagnostic Interview ◽  
Emotional Dysregulation ◽  
Self Report ◽  
Traumatic Experiences ◽  
Pathological Personality Traits

Abstract Background Research has demonstrated that chronic stress exposure early in development can lead to detrimental alterations in the orbitofrontal cortex (OFC)–amygdala circuit. However, the majority of this research uses functional neuroimaging methods, and thus the extent to which childhood trauma corresponds to morphometric alterations in this limbic-cortical network has not yet been investigated. This study had two primary objectives: (i) to test whether anatomical associations between OFC–amygdala differed between adults as a function of exposure to chronic childhood assaultive trauma and (ii) to test how these environment-by-neurobiological effects relate to pathological personality traits. Methods Participants were 137 ethnically diverse adults (48.1% female) recruited from the community who completed a clinical diagnostic interview, a self-report measure of pathological personality traits, and anatomical MRI scans. Results Findings revealed that childhood trauma moderated bilateral OFC–amygdala volumetric associations. Specifically, adults with childhood trauma exposure showed a positive association between medial OFC volume and amygdalar volume, whereas adults with no childhood exposure showed the negative OFC–amygdala structural association observed in prior research with healthy samples. Examination of the translational relevance of trauma-related alterations in OFC–amygdala volumetric associations for disordered personality traits revealed that trauma exposure moderated the association of OFC volume with antagonistic and disinhibited phenotypes, traits characteristic of Cluster B personality disorders. Conclusions The OFC–amygdala circuit is a potential anatomical pathway through which early traumatic experiences perpetuate emotional dysregulation into adulthood and confer risk for personality pathology. Results provide novel evidence of divergent neuroanatomical pathways to similar personality phenotypes depending on early trauma exposure.

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