Schlechter Pascal, Fritz Jessica, Cassels Matthew, Neufeld Sharon A S, Wilkinson Paul O
Department of Psychiatry, University of Cambridge, England, UK.
Eur J Psychotraumatol. 2021;12(1):1981573. doi: 10.1080/20008198.2021.1981573.
: Early adversity (EA) can contribute to the onset, manifestation, and course of various mental disorders. Measuring EA is still conceptually and psychometrically challenging due to issues such as content coverage, item-wording, scaling methods, and validation procedures. Further, despite research demonstrating the importance of the severity of EA, most EA scales solely focused on the 'presence-versus-absence' indicator of adverse events.: To address these potentially relevant gaps, we have developed a 13-item measure of EA, the Youth and Childhood Adversity Scale (YCAS). Beyond a dichotomous assessment of whether a set of adverse events have been experienced, this scale also assesses the respective severity of these events.: We evaluated the YCAS in a sample of 596 adolescent students (ages 16-19) and a second sample of 451 medical students (ages 18-30+). Exploratory factor analysis was used to determine the underlying structure as proposed by the data, which was then tested with confirmatory factor analysis. We psychometrically assessed both factor scores and sum scores.: In both samples, a one-factorial solution was found for both responses to dichotomous items and severity items. Item loadings had a broad range, with minimum loadings of .1-.2 and maximum loadings of .7-.9. Irrespective of the response type, this factor exhibited good reliability (omega total, range: .80 - .89) and was associated with a range of mental-health outcomes, self-esteem, and childhood maltreatment. The fit of the model resembling sum scores was not satisfactory, but the sum score reliability (coefficient alpha, range: .78 - .89) was acceptable and most of the associations with the validation measures held.: The YCAS allows an efficient, reliable, and valid assessment of EA and its severity. It covers a reasonable breadth of events, whilst simultaneously being parsimonious. We discuss next steps of how to improve this measure to fully capture the complexity of EA.
早期逆境(EA)可能导致各种精神障碍的发生、表现和病程。由于内容覆盖范围、项目措辞、量表编制方法和验证程序等问题,测量EA在概念和心理测量方面仍然具有挑战性。此外,尽管研究表明EA的严重程度很重要,但大多数EA量表仅关注不良事件的“有或无”指标。
为了填补这些潜在的相关空白,我们开发了一种13项的EA测量工具,即青少年和儿童期逆境量表(YCAS)。该量表除了对是否经历过一系列不良事件进行二分法评估外,还评估这些事件各自的严重程度。
我们在596名青少年学生(16 - 19岁)样本和451名医学生(18 - 30岁及以上)样本中对YCAS进行了评估。使用探索性因素分析来确定数据所呈现的潜在结构,然后用验证性因素分析进行检验。我们从心理测量学角度评估了因素得分和总分。
在两个样本中,对于二分法项目和严重程度项目的回答均发现了单因素解决方案。项目载荷范围广泛,最小载荷为0.1 - 0.2,最大载荷为0.7 - 0.9。无论回答类型如何,该因素都表现出良好的信度(总体ω系数,范围:0.80 - 0.89),并与一系列心理健康结果、自尊和童年期虐待相关。类似总分的模型拟合度并不令人满意,但总分信度(系数α,范围:0.78 - 0.89)是可以接受的,并且与验证指标的大多数关联成立。
YCAS能够对EA及其严重程度进行有效、可靠且有效的评估。它涵盖了合理广泛的事件,同时又较为简洁。我们将讨论如何改进该测量工具以充分捕捉EA复杂性的后续步骤。