Girma Engida, Ametaj Amantia, Alemayehu Melkam, Milkias Barkot, Yared Mahlet, Misra Supriya, Stevenson Anne, Koenen Karestan C, Gelaye Bizu, Teferra Solomon
Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
Eur J Trauma Dissociation. 2022 Nov;6(4). doi: 10.1016/j.ejtd.2022.100298. Epub 2022 Aug 30.
Traumatic events. e.g., road traffic accidents, violent conflicts, natural and human-made disasters, are common in sub-Saharan Africa. However, validated trauma screening tools to assess trauma at the individual level are lacking in many sub-Saharan African countries, such as Ethiopia, which limits accurate diagnosis and effective care provision.
We sought to measure trauma exposure among cases and controls and evaluate the psychometric properties of the Life Event Checklist for DSM-5 (LEC-5) among Ethiopian adults.
This study included 4,183 participants (2,255 cases with a clinical diagnosis of psychosis and 1,928 controls without a history of psychosis) from the Neuropsychiatric Genetics of African Populations-Psychosis (NeuroGAP-Psychosis) study. We conducted exploratory factor analysis (EFA) to group the items into factors/subscales, and confirmatory factor analysis (CFA) to investigate the best model fit in Ethiopia.
48.7% of participants reported exposure to at least one traumatic event. Physical assault (19.6%), sudden violent death (12.0%), and sudden accidental death (10.9%) were the three most common traumatic experiences. Cases were twice as likely to report experiences of traumatic events compared to controls (p<0.001). EFA revealed a four-factor/subscale model. CFA results indicated a theoretically-driven seven-factor model to be the preferred model by the goodness of fit (comparative fit index of 0.965 and Tucker-Lewis index of 0.951) and accuracy (root mean square error of approximation of 0.019).
Exposure to traumatic events was common in Ethiopia, even more so for individuals with a diagnosis of psychotic disorders. The LEC-5 demonstrated good construct validity for measuring traumatic events among Ethiopian adults. Future studies that examine criterion validity and test-retest reliability of the LEC-5 in Ethiopia are warranted.
创伤性事件，如道路交通事故、暴力冲突、自然和人为灾害，在撒哈拉以南非洲地区很常见。然而，许多撒哈拉以南非洲国家，如埃塞俄比亚，缺乏经过验证的用于个体层面创伤评估的筛查工具，这限制了准确诊断和有效护理的提供。
我们试图测量病例组和对照组的创伤暴露情况，并评估《精神疾病诊断与统计手册》第5版生活事件清单（LEC - 5）在埃塞俄比亚成年人中的心理测量特性。
本研究纳入了来自非洲人群精神病学神经遗传学研究（NeuroGAP - 精神病学研究）的4183名参与者（2255例临床诊断为精神病的病例和1928例无精神病病史的对照）。我们进行探索性因素分析（EFA）将项目分组为因素/子量表，并进行验证性因素分析（CFA）以研究在埃塞俄比亚的最佳模型拟合情况。
48.7%的参与者报告至少经历过一次创伤性事件。身体攻击（19.6%）、突然暴力死亡（12.0%）和突然意外死亡（10.9%）是三种最常见的创伤经历。病例报告创伤性事件经历的可能性是对照组的两倍（p<0.001）。探索性因素分析揭示了一个四因素/子量表模型。验证性因素分析结果表明，从拟合优度（比较拟合指数为0.965，塔克 - 刘易斯指数为0.951）和准确性（近似误差均方根为0.019）来看，理论驱动的七因素模型是首选模型。
在埃塞俄比亚，创伤性事件的暴露很常见，对于诊断为精神障碍的个体更是如此。LEC - 5在测量埃塞俄比亚成年人的创伤性事件方面表现出良好的结构效度。有必要开展进一步研究来检验LEC - 5在埃塞俄比亚的效标效度和重测信度。
