Search

Background: 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. Objective: 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. Method: 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. Results: 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. Conclusions: 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.

Background: International research has established that children and adolescents are at risk for posttraumatic stress disorder (PTSD) and complex PTSD (CPTSD) as defined by the WHO ICD-11. There is a need for a Danish language version of the International Trauma Questionnaire - Child and Adolescent (ITQ-CA) to assess symptoms of PTSD and CPTSD. Objective: To test the ICD-11 formulations of PTSD and DSO (Disturbances of Self-Organization) using the ITQ-CA version in a sample of children exposed to abuse. Additionally, to study the distribution of symptoms and probable prevalence of ICD-11 PTSD and CPTSD among the population of children exposed to violence or sexual abuse. Method: Confirmatory factor analysis of competing models of the dimensionality of the ITQ-CA was tested among a sample of 119 children and adolescents that were referred to the Danish Children Centres on suspicion of physical or sexual abuse or both. Latent class analysis (LCA) was used to study the distribution of symptoms and consequences of different operationalisations of functional impairment were explored. Results: Findings supported a two-factor second-order model corresponding to the operationalisation of CPTSD in ICD-11 as the best representation of the data. Findings from the LCA suggested that symptoms were distributed in a pattern consistent with the ICD-11 proposal for CPTSD. CPTSD was more prevalent than PTSD regardless of the operationalisation of functional impairment. Conclusion: ITQ-CA is a valid tool for identifying symptoms of ICD-11 PTSD and CPTSD among Danish children exposed to physical or sexual abuse. Further research is needed to study the relationship between ICD-11 C/PTSD symptomatology and anxiety and depression in this population.

Background : The 11 th version of the International Classification of Diseases (ICD-11) revised the diagnosis of Posttraumatic Stress Disorder (PTSD) and introduced Complex PTSD as a sibling disorder to PTSD. As the Danish Health Authorities will implement the ICD-11 in 2022, it is more relevant than ever to introduce a measure that enables the identification of ICD-11 PTSD and CPTSD. Objective : The primary aim of the present study was to test the construct validity of the ICD-11 conceptualization of PTSD and DSO in five clinical samples using translated versions of the International Trauma Questionnaire (ITQ). Method : Data from existing studies of adult survivors of sexual abuse ( n  = 385), women in shelters ( n  = 147), psychiatric outpatients endorsing an ICD-10 diagnosis of PTSD ( n  = 111), a heterogenous sample of psychiatric outpatients ( n  = 178) and refugees and torture survivors ( n  = 385) was used for the current study. Confirmatory factor analyses were conducted to test the internal structure of the ITQ, and regression models were conducted to test the convergent and discriminant validity of the factor solutions for each sample. Results : Findings supported the ICD-11 formulation of PTSD and disorders in self-organization (DSO) as a representation of the latent structure of the ITQ across five Danish clinical samples. Uniquely for women in shelters, however, the model displayed an unacceptable fit. A revised operationalization of re-experiencing proved a better fit when 'recurrent nightmares' was exchanged with symptoms of intense emotional reactions to reminders of the trauma for women in shelter as well as ICD-10 PTSD psychiatric outpatients. Conclusion : This study supports the use of a Danish translated version of the ITQ to assess symptoms of ICD-11 PTSD and DSO for the introduction of ICD-11 in 2022. Future research is needed to further explore the operationalization of re-experiencing across different trauma exposed populations., Competing Interests: The authors have no conflicts of interests to declare., (© 2021 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.)

Background: Becoming a parent is viewed as one of the most important transitions in one's life. However, a history of childhood maltreatment may affect the adjustment to parenthood. Objective: The objective of this review was to synthesize the current evidence base to further our understanding of prospective and new parents' experiences in the transition to parenthood (pregnancy to 2 years post-birth), in the context of having a childhood maltreatment history. Method: A scoping review of the literature was conducted using the following online databases: PubMed, PsycINFO, PsycNET, and Published International Literature of Traumatic Stress. Results: The findings were synthesized into a four-component theoretical framework, which included mental health of the parent, physical changes, parental view of the child, and view of the self as a parent. A total of 69 papers, including 181,537 participants (of whom 30,482 mothers and 235 fathers had maltreatment histories), investigated the transition to parenthood. The majority of the studies showed that parents with a maltreatment history may suffer from a range of mental health problems during the transition to parenthood, experience more negative physical changes, and have more negative views of their child (or children). However, they reported both positive and negative experiences regarding their identity as a parent. Conclusions: The findings suggest that maltreatment is a risk factor for a more challenging transition to parenthood. Experiences of fathers with maltreatment histories merit more attention, as do those of parents in low- and middle-income countries. Future directions should include predictors of positive experiences and the development of early interventions to improve outcomes for this population., Competing Interests: No potential conflict of interest was reported by the authors., (© 2018 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.)