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对遭受多重创伤的青少年样本中用于《精神疾病诊断与统计手册》第5版的加州大学洛杉矶分校创伤后应激障碍反应指数进行贝叶斯结构方程模型因子分析。

A Bayesian Structural Equation Modeling Factor Analysis of the UCLA Posttraumatic Stress Disorder Reaction Index for DSM-5 in a Polyvictimized Sample of Adolescents.

作者信息

Modrowski Crosby A, Munion Ascher K, Kerig Patricia K, Kilshaw Robyn E

机构信息

Alpert Medical School of Brown University/Bradley Hasbro Children's Research Center.

University of Utah, Department of Psychology.

出版信息

J Psychopathol Behav Assess. 2021 Mar;43(1):119-130. doi: 10.1007/s10862-020-09854-z. Epub 2021 Jan 2.

Abstract

The revised criteria for posttraumatic stress disorder (PTSD) in the fifth edition of the necessitated the development of new screening tools for youth, one of the most widely used of which is the UCLA Posttraumatic Stress Disorder Reaction Index for DSM-5 (RI-5). Thus far, the few studies that have investigated the RI-5's factor structure have supported a four-factor model. However, to date this research has been limited to youth with histories of exposure to single-event traumatic stressors, a significant limitation as evidence suggests many trauma-exposed youth report exposure to multiple types of traumatic stressors, or polyvictimization. It is imperative to determine the generalizability of previous factor models to specific populations which they are purported to represent. We investigated whether the RI-5's four-factor model replicated in a sample of 455 polyvictimized justice-involved adolescents. Initial confirmatory factor analysis demonstrated that the four-factor model did not converge. Therefore, we utilized Bayesian Structural Equations Modeling (BSEM) to determine why the previously proposed factor structure did not converge. The BSEM model suggested that the global factor structure was acceptable and did not require addition or subtraction of any factor or cross-factor loadings. However, small and moderate residual covariances resulted in model misspecification, suggesting there may be additional associations not captured by the current model for polyvictimized youth. Future work should continue examining the RI-5's factor structure in order to better understand whether the current results are unique and how measurements assessing PTSD symptom criteria perform in diverse trauma-exposed youth populations.

摘要

《精神疾病诊断与统计手册》第五版中创伤后应激障碍(PTSD)的修订标准促使人们为青少年开发新的筛查工具,其中使用最广泛的一种是针对《精神疾病诊断与统计手册》第五版的加州大学洛杉矶分校创伤后应激障碍反应指数(RI - 5)。到目前为止,少数研究RI - 5因子结构的研究支持四因子模型。然而,迄今为止,这项研究仅限于有单次事件创伤应激源暴露史的青少年,这是一个重大局限,因为有证据表明,许多暴露于创伤的青少年报告称遭受了多种类型的创伤应激源,即多重受害。确定先前的因子模型对它们声称所代表的特定人群的可推广性至关重要。我们调查了RI - 5的四因子模型在455名涉及司法的多重受害青少年样本中是否能够复制。初步验证性因素分析表明四因子模型未能收敛。因此,我们利用贝叶斯结构方程模型(BSEM)来确定先前提出的因子结构未能收敛的原因。BSEM模型表明整体因子结构是可接受的,不需要添加或减去任何因子或交叉因子负荷。然而,小的和中等程度的残差协方差导致模型设定错误,这表明当前模型可能没有捕捉到多重受害青少年的其他关联。未来的工作应继续研究RI - 5的因子结构,以便更好地理解当前结果是否独特,以及评估PTSD症状标准的测量方法在不同的暴露于创伤的青少年群体中的表现如何。

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