The National Centre for Psychotraumatology, University of Southern Denmark, Odense, Denmark.
Department of Applied Research in Education and Social Sciences, UCL University College, Odense, Denmark.
Eur J Psychotraumatol. 2023;14(1):2172256. doi: 10.1080/20008066.2023.2172256.
The ICD-11 post-traumatic stress disorder (PTSD) and complex PTSD diagnoses have been examined in several studies using the International Trauma Questionnaire (ITQ). The cross-cultural validity of the ITQ has not previously been studied using item responses theory methods focused on the issue of equal item functioning and thus comparability of scores across language groups. To investigate the cross-cultural validity of the ITQ scales considering specifically local independence of items and differential item functioning (DIF) in a cross-cultural sample of refugees. Data from 490 treatment-seeking refugees were included, covering Danish, Arabic, and Bosnian languages and different levels of interpreter-assisted administration. Rasch and graphical log-linear Rasch models were used. There was strong local dependence among items from the same symptom clusters in the PTSD and disorders in self-organization (DSO) scales, except between affective dysregulation items. Weak local dependence was discovered between an item from the affective dysregulation cluster and an item from the disturbed relationship cluster. There was no evidence of DIF related to language or interpreter assistance. There was evidence of DIF for two PTSD items relative to gender and time since the traumatic event. The targeting of the scales to the study population was not optimal. Reliability varied from 0.55 to 0.78 for subgroups. The PTSD and the DSO scales have stable psychometric properties across the Danish, Arabic, and Bosnian language versions and different levels of assisted administration. Scores are comparable across these groups. However, DIF relative to gender and time since trauma introduces considerable measurement bias. DIF-adjusted summed scale scores or estimated person parameters should be used to avoid measurement bias. Future research should investigate whether scales including more and/or alternative items that require higher levels of PTSD and DSO to be endorsed will improve targeting and measurement precision for refugee populations.
ICD-11 创伤后应激障碍（PTSD）和复杂创伤后应激障碍的诊断已经在几项使用国际创伤问卷（ITQ）的研究中进行了检查。此前，尚未使用集中于同等项目功能和语言群体分数可比性问题的项目反应理论方法研究 ITQ 的跨文化有效性。在一个难民的跨文化样本中，考虑到项目的局部独立性和项目功能差异（DIF），专门研究 ITQ 量表的跨文化有效性。纳入了 490 名寻求治疗的难民的数据，涵盖丹麦语、阿拉伯语和波斯尼亚语以及不同程度的口译协助管理。使用了 Rasch 和图形对数线性 Rasch 模型。在 PTSD 和自我组织障碍（DSO）量表中，来自同一症状群的项目之间存在很强的局部依赖性，除了情感失调项目之间存在很强的局部依赖性。在情感失调群的一个项目和受干扰关系群的一个项目之间发现了较弱的局部依赖性。没有与语言或口译员协助有关的 DIF 证据。有证据表明，相对于性别和创伤事件发生后的时间，有两个 PTSD 项目存在 DIF。这些量表针对研究人群的针对性不是最佳的。亚组的可靠性从 0.55 到 0.78 不等。PTSD 和 DSO 量表在丹麦语、阿拉伯语和波斯尼亚语版本以及不同程度的辅助管理中具有稳定的心理测量特性。这些群体的分数具有可比性。然而，相对于性别和创伤事件发生后的时间的 DIF 会引入相当大的测量偏差。应使用 DIF 调整后的总和量表分数或估计的人员参数，以避免测量偏差。未来的研究应该调查是否包括更多和/或需要更高水平的 PTSD 和 DSO 来认可的替代项目的量表将提高针对难民群体的针对性和测量精度。
