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创伤后应激障碍症状适应重要他人反应量表(SORTS):对 PTSD 症状适应测量方法的因子分析和项目反应理论的应用。

The significant others' responses to trauma scale (SORTS): applying factor analysis and item response theory to a measure of PTSD symptom accommodation.

机构信息

Behavioral Science Division, National Center for PTSD at VA Boston Healthcare System, Boston, MA, USA.

Department of Psychiatry, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA.

出版信息

Eur J Psychotraumatol. 2024;15(1):2353530. doi: 10.1080/20008066.2024.2353530. Epub 2024 Jun 5.

DOI:10.1080/20008066.2024.2353530
PMID:
38836407
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11155430/
Abstract

Symptom accommodation by family members (FMs) of individuals with posttraumatic stress disorder (PTSD) includes FMs' participation in patients' avoidance/safety behaviours and constraining self-expression to minimise conflict, potentially maintaining patients' symptoms. The Significant Others' Responses to Trauma Scale (SORTS) is the only existing measure of accommodation in PTSD but has not been rigorously psychometrically tested. We aimed to conduct further psychometric analyses to determine the factor structure and overall performance of the SORTS. Method: We conducted exploratory and confirmatory factor analyses using a sample of  = 715 FMs (85.7% female, 62.1% White, 86.7% romantic partners of individuals with elevated PTSD symptoms). After dropping cross-loading items, results indicated good fit for a higher-order model of accommodation with two factors: an anger-related accommodation factor encompassed items related largely to minimising conflict, and an anxiety-related accommodation factor encompassed items related primarily to changes to the FM's activities. Accommodation was positively related to PTSD severity and negatively related to relationship satisfaction, although the factors showed somewhat distinct associations. Item Response Theory analyses indicated that the scale provided good information and robust coverage of different accommodation levels. SORTS data should be analysed as both a single score as well as two factors to explore the factors' potential differential performance across treatment and relationship outcomes.

摘要

创伤后应激障碍(PTSD)患者家属的症状适应包括家属参与患者的回避/安全行为,限制自我表达以减少冲突,从而可能维持患者的症状。创伤后应激障碍患者家属反应量表(SORTS)是唯一现存的用于测量适应行为的量表,但尚未经过严格的心理测量学测试。我们旨在进行进一步的心理测量学分析,以确定 SORTS 的结构和整体性能。方法:我们对  = 715 名家属(85.7%为女性,62.1%为白人,86.7%为 PTSD 症状升高的个体的浪漫伴侣)进行了探索性和验证性因素分析。在删除交叉负荷项目后,结果表明,一个包含两个因素的更高阶适应模型具有良好的拟合度:一个与愤怒相关的适应因素包含了主要与减少冲突相关的项目,一个与焦虑相关的适应因素包含了主要与 FM 活动变化相关的项目。适应与 PTSD 严重程度呈正相关,与关系满意度呈负相关,但两个因素的相关性有些不同。项目反应理论分析表明,该量表提供了良好的信息和对不同适应水平的稳健覆盖。应该将 SORTS 数据作为单一评分以及两个因素进行分析,以探索这些因素在治疗和关系结果方面的潜在差异表现。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3adb/11155430/4f65f2cf3676/ZEPT_A_2353530_F0002_OC.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3adb/11155430/e060aa9cbebf/ZEPT_A_2353530_F0001_OB.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3adb/11155430/4f65f2cf3676/ZEPT_A_2353530_F0002_OC.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3adb/11155430/e060aa9cbebf/ZEPT_A_2353530_F0001_OB.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3adb/11155430/4f65f2cf3676/ZEPT_A_2353530_F0002_OC.jpg

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Clin Psychol (New York). 2023 Dec;30(4):453-464. doi: 10.1111/cpsp.12375. Epub 2020 Aug 30.
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PTSD Symptom Cluster Severity Predicts Momentary Emotion Dynamics During Couple Conversations.创伤后应激障碍症状群严重程度预测夫妻对话期间的情绪动态变化。
Behav Ther. 2023 Mar;54(2):330-345. doi: 10.1016/j.beth.2022.09.004. Epub 2022 Oct 14.
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The role of symptom accommodation in trauma-focused treatment engagement and response.
症状适应在创伤聚焦治疗中的作用。
J Trauma Stress. 2023 Jun;36(3):524-536. doi: 10.1002/jts.22912. Epub 2023 Feb 13.
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Longitudinal Associations Among Service Members' PTSD Symptoms, Partner Accommodation, and Partner Distress.军人 PTSD 症状、伴侣适应和伴侣痛苦之间的纵向关联。
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Effectiveness of cognitive behavioral conjoint therapy for posttraumatic stress disorder (PTSD) in a U.S. Veterans Affairs PTSD clinic.认知行为联合疗法对美国退伍军人事务部创伤后应激障碍(PTSD)诊所中 PTSD 的疗效。
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The Use of a Brief Family Intervention to Reduce Dropout Among Veterans in Individual Trauma-Focused Treatment: A Randomized Controlled Trial.简短家庭干预在减少个体创伤聚焦治疗中退伍军人脱落率的应用:一项随机对照试验。
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