Competence Centre for Transcultural Psychiatry, Mental Health Centre Ballerup, Copenhagen University Hospital - Mental Health Services CPH, Copenhagen, Denmark.
Department of Public Health and Center for Healthy Aging, University of Copenhagen, Copenhagen, Denmark.
Acta Psychiatr Scand. 2023 Sep;148(3):302-309. doi: 10.1111/acps.13592. Epub 2023 Jul 19.
The ICD-11 proposes fundamental changes to the PTSD diagnostic criteria, prompting thorough validation. While this is ideally carried out based on diagnostic interviews, most-and in the case of transcultural psychiatry all-studies have relied on self-reported measures. In this study, we used the International Trauma Interview (ITI) to assess the factor structure of ICD-11 PTSD symptoms in a sample of trauma-affected refugees.
The ITI was administered with a sample of refugees (n = 198), originating mainly from the Greater Middle East. The symptom ratings were subjected to a confirmatory factor analysis (CFA), comparing the ICD-11 concordant three-factor model with alternative two- and one-factor models.
The overall fit was adequate for both the two- and three-factor models, but favored the two-factor model. Results for both models indicated local misspecifications and that item 5, hypervigilance, displayed a suboptimal loading.
The results generally support the use of the ITI in a severely trauma-affected refugee population, albeit with particular attention needed in the administration of item 5. The superior fit of a two-factor model warrants further testing across populations.
ICD-11 对 PTSD 的诊断标准提出了根本性的改变，这需要进行彻底的验证。虽然这理想情况下是基于诊断访谈进行的，但大多数——在跨文化精神病学的情况下，所有研究都依赖于自我报告的测量。在这项研究中，我们使用国际创伤访谈（ITI）在受创伤影响的难民样本中评估 ICD-11 PTSD 症状的因素结构。
ITI 被用于一个难民样本（n=198），他们主要来自大中东地区。症状评分进行了验证性因素分析（CFA），比较了 ICD-11 一致的三因素模型与替代的两因素和一因素模型。
两种模型的整体拟合度都足够，但更倾向于两因素模型。两种模型的结果都表明存在局部指定不当的情况，且第 5 项（警觉过度）的负荷表现不佳。
结果总体上支持在严重受创伤影响的难民群体中使用 ITI，但在管理第 5 项时需要特别注意。两因素模型的更好拟合度需要在不同人群中进一步测试。
