The Child PTSD Symptom Scale: Psychometric Properties among Earthquake Survivors
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ORIGINAL ARTICLE
The Child PTSD Symptom Scale: Psychometric Properties among Earthquake Survivors Sabrina Hermosilla1 · Sarah Forthal2 · Madeline Van Husen2 · Janna Metzler3 · Dirgha Ghimire1 · Alastair Ager3,4 Accepted: 12 November 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Evidence for a single underlying factor structure of posttraumatic stress disorder (PTSD) in children remains elusive. We assessed the underlying factor structure of the Child PTSD Symptom Scale through exploratory (EFA) and confirmatory factor analyses (CFA) in 570 survivors of the 2015 Gorkha earthquake in Nepal. The EFA suggests that the three-factor DSM-IV model fit these data best. The CFA suggests that while the DSM-IV model adequately fit these data, the four-factor King model fit them better. There was no evidence of differential item functioning by age or gender, and internal consistency of the scale was high. PTSD (overall or by factor) was not correlated with functional impairment. Inconsistent psychometric results across contexts and methodologies suggest that our current theoretical conceptualizations and empirical models of posttraumatic stress are lacking. Future studies must both document the instrument properties to assure internal validity and cross-study comparisons and, bolstered by increased psychometric data and analyses, rework theoretical models of PTSD with improved cross-cultural validity. Keywords Posttraumatic stress disorder · Humanitarian · Psychometric · Child psychiatry · Post-disaster
Introduction How, and by whom, posttraumatic stress disorder (PTSD) is defined and ultimately measured is a topic of much debate. As defined by the fifth edition of the Diagnostic Sabrina Hermosilla and Sarah Forthal have contributed equally to this work. Electronic supplementary material The online version of this article (https://doi.org/10.1007/s10578-020-01097-z) contains supplementary material, which is available to authorized users. * Sabrina Hermosilla [email protected] 1
Institute for Social Research, University of Michigan, 426 Thompson Street, 1006E, Ann Arbor, MI 48104, USA
2
Columbia‑WHO Center for Global Mental Health, Department of Psychiatry, Columbia University Irving Medical Center, New York, USA
3
Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York, USA
4
Institute for Global Health and Development, Queen Margaret University, Edinburgh, Scotland, UK
and Statistical Manual of Mental Disorders, PTSD is a composite diagnosis of twenty symptoms across four symptom factor clusters (concerning instruction, avoidance, negative mood and cognition, and arousal) [1]. Given the high levels of exposure to potentially traumatic events (PTE) during childhood [2], PTSD is a common diagnosis among children and adolescents [3]; and has been linked to severe individual, familial, and societal consequences across the lifecourse [4]. Children who have experienced traumatic events can show signs of depression,
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