Agorastos Agorastos, Abigail C Angkaw, Dewleen G Baker, Veterans Affairs Center of Excellence for Stress and Mental Health (CESAMH), San Diego, CA 92161, United States.
World J Psychiatry. 2016 Jun 22;6(2):226-32. doi: 10.5498/wjp.v6.i2.226.
To validate the first third-person-rated measure assessing combat-related peritraumatic stress symptoms and evaluate its psychometric properties and war-zone applicability.
The valid assessment of peritraumatic symptoms in the theater of military operations represents a significant challenge in combat-related, mental health research, which mainly relies on retrospective, subjective self-report ratings. This longitudinal observational study used data from actively deployed troops to correlate third-person observer ratings of deployment peritraumatic behaviors [Peritraumatic Behavior Questionnaire - Observer Rated (PBQ-OR)] collected on a bi-monthly basis with post-deployment (1-wk follow-up) ratings of the previously validated PBQ self-rate version (PBQ-SR), and (3-mo follow-up) clinician assessed and self-report posttraumatic stress disorder (PTSD) symptoms (Clinician Administered PTSD Scale, PTSD Checklist). Cronbach's alpha (α) and correlation coefficients were calculated to assess internal reliability and concurrent validity respectively.
Eight hundred and sixty male Marines were included in this study after signing informed consents at pre-deployment (mean age 23.2 ± 2.6 years). Although our findings were limited by an overall sparse return rate of PBQ-OR ratings, the main results indicate satisfactory psychometric properties with good internal consistency for the PBQ-OR (α = 0.88) and high convergent and concurrent validity with 1-wk post-deployment PBQ-SR ratings and 3-mo posttraumatic stress symptoms. Overall, later PBQ-OR report date was associated with higher correlation between PBQ-OR and post-deployment measures. Kappa analysis between PBQ-OR and PBQ-SR single items, showed best agreement in questions relating of mortal peril, desire for revenge, and experience of intense physical reactions. Logistic regression demonstrated satisfactory predictive validity of PBQ-OR total score with respect to PTSD caseness (OR = 1.0513; 95%CI: 1.011-1.093; P = 0.02).
Since no comparable tools have been developed, PBQ-OR could be valuable as real-time screening tool for earlier detection of Service Members at risk.
验证首个评估与战斗相关创伤后应激症状的第三人评定量表，并评估其心理测量学特性和战区适用性。
在军事行动领域，准确评估创伤前症状是战斗相关心理健康研究中的一个重大挑战，该研究主要依赖于回顾性、主观的自我报告评定。本纵向观察性研究使用现役部队的数据，将每两个月收集的一次第三人观察性评定（创伤前行为问卷-观察者评定版（PBQ-OR））与创伤后（1 周随访）以前验证的 PBQ 自评版本（PBQ-SR）的评定和（3 个月随访）临床医生评估和自我报告的创伤后应激障碍（PTSD）症状（临床医生管理 PTSD 量表，PTSD 检查表）进行相关分析。计算克朗巴赫 α（α）和相关系数分别评估内部一致性和同时效度。
在部署前签署知情同意书后，本研究共纳入 860 名男性海军陆战队员（平均年龄 23.2±2.6 岁）。尽管我们的研究结果受到 PBQ-OR 评定总体稀疏返回率的限制，但主要结果表明，PBQ-OR 的心理测量学特性良好，内部一致性良好（α=0.88），与 1 周后创伤后 PBQ-SR 评定和 3 个月后创伤后应激症状具有较高的收敛和同时效度。总体而言，PBQ-OR 报告日期较晚与 PBQ-OR 与创伤后评估结果之间的相关性较高相关。PBQ-OR 与 PBQ-SR 单项之间的 Kappa 分析显示，在与生命危险、复仇欲望和强烈身体反应相关的问题上，两者的一致性最佳。逻辑回归显示 PBQ-OR 总分对 PTSD 发病的预测具有较好的预测效度（OR=1.0513；95%CI：1.011-1.093；P=0.02）。
由于尚未开发出可比工具，因此 PBQ-OR 可以作为实时筛查工具，用于更早发现有风险的服务人员。
