Institute for Social Research, University of Michigan, 426 Thompson Street, 1006E, Ann Arbor, MI, 48104, USA.
Columbia-WHO Center for Global Mental Health, Department of Psychiatry, Columbia University Irving Medical Center, New York, USA.
Child Psychiatry Hum Dev. 2021 Dec;52(6):1184-1193. doi: 10.1007/s10578-020-01097-z. Epub 2020 Nov 27.
Evidence for a single underlying factor structure of posttraumatic stress disorder (PTSD) in children remains elusive. We assessed the underlying factor structure of the Child PTSD Symptom Scale through exploratory (EFA) and confirmatory factor analyses (CFA) in 570 survivors of the 2015 Gorkha earthquake in Nepal. The EFA suggests that the three-factor DSM-IV model fit these data best. The CFA suggests that while the DSM-IV model adequately fit these data, the four-factor King model fit them better. There was no evidence of differential item functioning by age or gender, and internal consistency of the scale was high. PTSD (overall or by factor) was not correlated with functional impairment. Inconsistent psychometric results across contexts and methodologies suggest that our current theoretical conceptualizations and empirical models of posttraumatic stress are lacking. Future studies must both document the instrument properties to assure internal validity and cross-study comparisons and, bolstered by increased psychometric data and analyses, rework theoretical models of PTSD with improved cross-cultural validity.
创伤后应激障碍（PTSD）在儿童中的单一潜在因素结构的证据仍然难以捉摸。我们通过探索性因素分析（EFA）和验证性因素分析（CFA）评估了尼泊尔 2015 年戈克哈地震幸存者中儿童 PTSD 症状量表的潜在因素结构。EFA 表明，DSM-IV 三因素模型最适合这些数据。CFA 表明，虽然 DSM-IV 模型能充分拟合这些数据，但 King 的四因素模型则更好。年龄或性别对项目功能无差异，量表的内部一致性高。PTSD（整体或因子）与功能障碍无关。不同背景和方法学的不一致心理测量结果表明，我们目前对创伤后应激的理论概念化和实证模型存在不足。未来的研究必须记录仪器特性以确保内部有效性和跨研究比较，并在增加心理测量数据和分析的支持下，重新制定 PTSD 的理论模型，以提高跨文化有效性。
