Factor Structure and Psychometric Properties for the PTSD Checklist of Chinese Adolescents in the Closed Period after the COVID-19 Outbreak

After COVID-19 appeared in China in December 2019, the mental health of adolescents, as a vulnerable group in public health emergencies, was negatively affected by the epidemic and the unprecedented prevention and control measures. The purpose of this study was to investigate the factor structure and psychometric properties of the Posttraumatic Stress Disorder (PTSD) Checklist (PCL) among Chinese adolescents. A total of 915 participants completed the PTSD. Confirmatory factor analyses (CFAs) and multi-group CFAs were used to test the factor structure and psychometric properties of PTSD. The CFA results showed that five-factor PCL was the optimal fitting model with satisfactory reliability and validity; moreover, it was suggested that the properties of PCL were invariant across gender, PTSD and asymptomatic groups, early and late adolescents, as well as over time. In summary, PCL is applicable among Chinese adolescents and can be used for effective measurement of PTSD caused by epidemics and to conduct cross-group studies.

Différences de genre dans la présentation des symptômes post-traumatiques chez les évacués de feux de forêt

Peu d’études ont cherché à identifier les symptômes du trouble de stress post-traumatique (TSPT) du DSM-5 étant plus rapportés en fonction du genre. Il importe de caractériser ces différences pour mieux cibler les besoins selon ce facteur. La présente étude vise à évaluer les différences de genre dans la symptomatologie du TSPT chez 1510 évacués (838 femmes, 672 hommes) des feux de forêt de Fort McMurray un an après l’événement. Les données ont été récoltées via un sondage téléphonique. Les symptômes post-traumatiques ont été évalués par le PTSD Checklist for DSM-5. La sévérité totale et celle des quatre catégories de symptômes (intrusion, évitement, humeur/cognitions et éveil/réactivité) étaient significativement plus élevées chez les femmes de même que la fréquence d’endossement pour 12 symptômes. Les hommes présentaient une fréquence d’endossement significativement plus élevée pour un symptôme (comportements irréfléchis/autodestructeurs). Les résultats ont montré que le profil clinique du TSPT chez les évacués différait selon le genre, ce qui permet de mettre en évidence les particularités liées au genre dans le TSPT. Cela pourrait ultimement aider les cliniciens à planifier un plan de traitement plus approprié en fonction des symptômes qui ont davantage tendance à être exhibés selon le genre.

Clinical Profile on the PTSD Checklist for DSM-5 (PCL-5) of Veterans versus Patients Injured in Motor Vehicle Accidents

Background: The 20 items of PTSD Checklist for DSM-5 (PCL-5) can be rank ordered from highest to the lowest, based on item mean scores in a particular clinical group. Thus, they can provide an overview of the relative importance of each of the symptoms represented by these 20 items, i.e., a clinical profile for the particular type of patients. This study compared such ranking of PCL-5 items by US veterans with those of patients injured in high impact motor vehicle accidents (MVAs). Method: De-identified PCL-5 data were available for 80 post-MVA patients (mean age 38.9 years, SD=12.8) and for 468 US veterans (mean age 55.4 years, SD=13.8). The US veterans’ data are those published by Bovin et al. in 2016. Results and Discussion: The overall rank order of PCL-5 items was significantly similar in the two groups (Spearman’s rho=.83), perhaps due to certain similarities of the two groups (potential threat to life or of severe physical injury). Both groups rated the Item 20 (sleep difficulties) as the most prominent, and they rated Item 16 (taking too many risks) and then Item 8 (trouble remembering details of the stressful event) as least prominent. The largest clinically interesting difference in the item rank was on Item 12 (loss of interest in previously enjoyed activities) which was more prominent in the MVA patients, presumably due to their persistent post-accident pain (all but one MVA patient reported pain, and in 82.5% the pain was rated as more than mild). Conclusions: In both groups, the ratings of sleep difficulties were the most prominent and ratings of taking excessive risks and of not remembering details of stressful evens were least prominent. The overall rank order of the 20 items was significantly similar in the two groups.

715 Insomnia as a Risk for PTSD During the COVID-19 Pandemic

Introduction The COVID-19 pandemic and associated attempts to curb its spread have led to a significant increase in mental health issues. Evidence suggests that sleep provides a protective resilience against the adverse effects of stress. Moreover, sleep disruption is often considered the “hallmark symptom” of posttraumatic stress disorder (PTSD). Here we hypothesized that insomnia would increase during the first six months of the pandemic, and that higher insomnia would be associated with elevated rates of PTSD. Methods A total of 6,190 adults ranging in age from 18 to 84 years (53.6% female), completed an online cross-sectional survey at one of six time points between April and September 2020 (~1,000 per administration). Instruments included the Insomnia Severity Index (ISI), Primary Care PTSD Checklist (PC-PTSD), and the PTSD Checklist-5 (PCL-5). Standard clinical cutoffs were used for ISI (≥10) and PCL-5 (≥38). Data were analyzed with analysis of variance, chi-square contingency tables, and bivariate correlations. Results Over the first six-months of the pandemic, PTSD increased with each passing month on both the PC-PTSD (p=.001) and PCL-5 (p<.0001). Similarly, ISI scores increased month-by-month (p<.0002). Insomnia scores were highly correlated with PCL-5 PTSD scores (r=.62, p<.0001), even when sleep items on the scale were excluded (r=.60, p<.0001). Finally, the rate of PTSD remained below 5% across all months for those without insomnia, but among those with insomnia, the prevalence of PTSD increased between May (26% positive) and September (40% positive), representing an increase of 56% over the data collection period (interaction p=.0004). Conclusion Both insomnia and PTSD have increased dramatically over the first six months of the COVID-19 pandemic. Moreover, insomnia appears to be highly linked with the emergence of PTSD during this time. While it is not possible to make causal attributions from these cross-sectional findings, the steadily increasing rates of PTSD over time only among those with insomnia, raise the possibility that sleep disruption could act as a diathesis for the development of PTSD symptoms in response to the pandemic. Addressing insomnia during the pandemic may be an important aspect of maintaining psychological resilience in the populace. Support (if any):