Nursing Department, Zhongda Hospital, Medical School, Southeast University, Nanjing, China.
Department of Psychosomatics and Psychiatry, Zhongda Hospital, Medical School, Southeast University, Nanjing, China.
Clin Psychol Psychother. 2021 Jul;28(4):882-890. doi: 10.1002/cpp.2542. Epub 2020 Dec 30.
Embitterment and in some cases also post-traumatic embitterment disorder (PTED) are relevant problem in the general population and even more so in psychiatric patients. PTED screening should be an essential component of routine mental health management, which can be done by the 21-item Post-traumatic Embitterment Disorder Self-Rating Scale (C-PTED-21), which measures the intensity of reactive stimulus bound embitterment. The PTED-21 German version was translated into Chinese, and 200 nonpsychiatric inpatients, reporting major negative life events, were recruited through convenience sampling to evaluate test performance. Ninety patients were selected for retest 2 weeks later to examine scale reliability. Factor analysis was used to assess construct validity and receiving operating characteristic curve analysis based on the "PTED standardized diagnostic interview" to assess diagnostic utility. Correlations with depression, somatic symptom, and anxiety scales were examined to assess aggregate validity. The C-PTED-21 demonstrated high internal consistency (Cronbach's α = 0.944) and good test-retest reliability (total score r = 0.783, individual item r value range, 0.635-0.889). Factor analysis revealed three common factors consistent with PTED core features. Total C-PTED-21 score was strongly correlated with the score on the nine-item Patient Health Questionnaire depression scale (PHQ-9, r = 0.735). Mean PTED-21 score ≥1.6 points distinguished clinical PTED as defined by diagnostic interview with 97.6% sensitivity and 90.5% specificity (AUC = 0.988, 95%CI: 0.976-0.999). The results show that the C-PTED-21 can assess the severity of PTED with good reliability and validity.
在普通人群中，尤其是在精神科患者中，痛苦和在某些情况下的创伤后痛苦障碍（PTED）是一个相关的问题。PTED 筛查应该是常规心理健康管理的一个基本组成部分，可以通过 21 项创伤后痛苦障碍自评量表（C-PTED-21）来完成，该量表测量反应性刺激相关痛苦的强度。PTED-21 的德文版已被翻译成中文，通过便利抽样，招募了 200 名报告重大负面生活事件的非精神科住院患者，以评估测试性能。90 名患者被选择在 2 周后进行重测，以检验量表的可靠性。使用因子分析评估结构效度，并基于“PTED 标准化诊断访谈”进行接受者操作特征曲线分析，以评估诊断效用。还检查了与抑郁、躯体症状和焦虑量表的相关性，以评估综合有效性。C-PTED-21 表现出较高的内部一致性（Cronbach's α=0.944）和良好的重测信度（总分 r=0.783，单个项目 r 值范围为 0.635-0.889）。因子分析显示，三个共同因素与 PTED 的核心特征一致。C-PTED-21 总分与九项患者健康问卷抑郁量表（PHQ-9）的得分高度相关（r=0.735）。PTED-21 得分≥1.6 分可区分诊断访谈定义的临床 PTED，敏感性为 97.6%，特异性为 90.5%（AUC=0.988，95%CI：0.976-0.999）。结果表明，C-PTED-21 可以评估 PTED 的严重程度，具有良好的信度和效度。
