Timmermann Dagmar A, Zeldovich Marina, Krenz Ugne, Holloway Ivana, Cunitz Katrin, Koerte Inga K, Buchheim Anna, Salewski Christel, Gioia Gerard A, von Steinbuechel Nicole
Division Medical Psychology and Medical Sociology, Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Goettingen, Goettingen, Germany.
Department of Psychology, University of Innsbruck, Innsbruck, Austria.
PLoS One. 2025 Aug 8;20(8):e0307421. doi: 10.1371/journal.pone.0307421. eCollection 2025.
Adolescents are at an increased risk of sustaining a traumatic brain injury (TBI), which is associated with physical, cognitive, and/or emotional impairments, the so-called post-concussion symptoms (PCS). To fill the gap of German-language instruments for the age-appropriate assessment of PCS, the current study presents the translation, linguistic validation, and psychometric examination of two versions of the Postconcussion Symptom Inventory (PCSI) for adolescents (PCSI-SR13; 21 items) and their parents (PCSI-P; 20 items). Translation included iterative forward and backward translations and cognitive debriefings (CD). A total of 117 adolescents (aged 13-17 years) after TBI (3 months up to 10 years after injury) and 111 parents completed the PCSI. Both German versions were compared descriptively with the corresponding English versions. Analyses were conducted at the item and scale level. Confirmatory factor analyses (CFA) were performed, and internal consistency was examined using Cronbach's α and McDonald's ω. Convergent validity testing used Spearman's ρ correlations with the Rivermead Post-Concussion Symptoms Questionnaire (RPQ). Cohen's κ at the item level and intraclass correlation coefficients (ICC) were calculated to assess adolescent-parent agreement. The original four-factor structure could be replicated for the PCSI-SR13, but not for the PCSI-P. Internal consistency was good to excellent (≥ 0.80). Correlations (ρ ≥ 0.57) indicated a strong association with the RPQ. At the item level, the adolescent-parent agreement was fair to moderate (κ: 0.14-0.58). At the subscale level, interpretation of the ICC (ICC: 0.51-0.71) was limited due to the wide CI95%. In general, the psychometric properties support the applicability of the PCSI-SR13 and the PCSI-P for assessing PCS in German-speaking adolescents in the subacute and chronic phase after TBI. However, given the lack of factorial validity of the PCSI-P and the discrepancies between adolescents' and parents' ratings, self-report is recommended.
青少年遭受创伤性脑损伤（TBI）的风险增加，这与身体、认知和/或情感障碍有关，即所谓的脑震荡后症状（PCS）。为了填补德语工具在针对年龄进行PCS评估方面的空白，本研究展示了针对青少年（PCSI-SR13；21项）及其父母（PCSI-P；20项）的两个版本的脑震荡后症状量表（PCSI）的翻译、语言验证和心理测量学检验。翻译包括反复的正向和反向翻译以及认知反馈（CD）。共有117名TBI后（受伤后3个月至10年）的青少年（年龄在13 - 17岁）和111名父母完成了PCSI。对两个德语版本与相应的英语版本进行了描述性比较。分析在项目和量表层面进行。进行了验证性因素分析（CFA），并使用克朗巴赫α系数和麦克唐纳ω系数检验内部一致性。收敛效度测试使用斯皮尔曼ρ系数与里弗米德脑震荡后症状问卷（RPQ）进行相关性分析。计算项目层面的科恩κ系数和组内相关系数（ICC）以评估青少年与父母的一致性。PCSI-SR13能够复制原来的四因素结构，但PCSI-P不能。内部一致性良好到优秀（≥0.80）。相关性（ρ≥0.57）表明与RPQ有很强的关联。在项目层面，青少年与父母的一致性为中等（κ：0.14 - 0.58）。在子量表层面，由于95%置信区间较宽，ICC（ICC：0.51 - 0.71）的解释受到限制。总体而言，心理测量学特性支持PCSI-SR13和PCSI-P在评估TBI后亚急性期和慢性期德语青少年PCS方面的适用性。然而，鉴于PCSI-P缺乏因素效度以及青少年与父母评分之间的差异，建议采用自我报告。
