@2024 Afarand., IRAN
ISSN: 2008-2630 Iranian Journal of War & Public Health 2020;12(2):115-124
ISSN: 2008-2630 Iranian Journal of War & Public Health 2020;12(2):115-124
The Psychometric Properties of the Post-Traumatic Stress Disorder Symptom Scale–Interview Based on DSM-5, in Military Personnel Participated in Warfare
ARTICLE INFO
Article Type
Descriptive & Survey StudyAuthors
Karimi M. (1)Rahnejat A.M. (*1)
Dabaghi P. (1)
Taghva A. (2)
Majdian M. (3)
Donyavi V. (2)
Shahed-HaghGhadam H. (4)
(1) Department of Clinical Psychology, Medicine Faculty, Aja University of Medical Sciences, Tehran, Iran
(2) Psychiatry Department, Medicine Faculty, Aja University of Medical Sciences, Tehran, Iran
(3) Behavioral Sciences Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
(4) Clinical Psychology Department, Varamin Branch, Islamic Azad University, Varamin , Iran
Correspondence
Address: Department of Clinical Psychology, Psychiatric Hospital of the Islamic Republic of Iran Army Ground Forces, Oshan Blvd., Artesh Hwy., Tehran, Iran.Phone: +98 (21) 22195164
Fax: +98 (21) 22197198
arahnedjat@yahoo.com
Article History
Received: January 21, 2020Accepted: May 19, 2020
ePublished: June 17, 2020
ABSTRACT
Aims
This study aimed to investigate the psychometric properties of the Post-Traumatic Stress Disorder (PTSD) symptom scale-interview for DSM-5 (PSS-I-5) in military personnel involved in warfare.
Instrument & Methods This was a validation study. A descriptive research method was used. The participants in this study consisted of 287 veterans with PTSD who referred to (505 Army Psychiatric Hospital) selected using the availability sampling method. The instruments used in this study included the PSS-I-5 scale as the main research tools, Beck Depression Inventory-II (BDI-II) and State-Trait Anxiety Inventory (STAI) assessed the convergent validity, and PTSD Checklist for DSM-5 (PCL-M-5) and Clinician-Administered PTSD Scale for DSM-5 (CAPS-5) were also used to measure simultaneous validity. The data were analyzed using the correlation coefficient and the Cronbach's alpha methods.
Findings The results demonstrated that Cronbach's alpha of the PSS-I-5 scale was at a desirable level (α=0.91). PSS-I-5 had good convergent and divergent validity. The sensitivity of PSS-I-5 was equal to 0.97%, and its specificity was obtained to be 0.62%. Further, the analysis of the results revealed that PSS-I-5 could differentiate between sick and healthy individuals.
Conclusion The PSS-I-5 scale has desirable reliability and validity for military personnel participating in the war and can be used to identify and screen military personnel involved in warfare and military missions.
Instrument & Methods This was a validation study. A descriptive research method was used. The participants in this study consisted of 287 veterans with PTSD who referred to (505 Army Psychiatric Hospital) selected using the availability sampling method. The instruments used in this study included the PSS-I-5 scale as the main research tools, Beck Depression Inventory-II (BDI-II) and State-Trait Anxiety Inventory (STAI) assessed the convergent validity, and PTSD Checklist for DSM-5 (PCL-M-5) and Clinician-Administered PTSD Scale for DSM-5 (CAPS-5) were also used to measure simultaneous validity. The data were analyzed using the correlation coefficient and the Cronbach's alpha methods.
Findings The results demonstrated that Cronbach's alpha of the PSS-I-5 scale was at a desirable level (α=0.91). PSS-I-5 had good convergent and divergent validity. The sensitivity of PSS-I-5 was equal to 0.97%, and its specificity was obtained to be 0.62%. Further, the analysis of the results revealed that PSS-I-5 could differentiate between sick and healthy individuals.
Conclusion The PSS-I-5 scale has desirable reliability and validity for military personnel participating in the war and can be used to identify and screen military personnel involved in warfare and military missions.
CITATION LINKS
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[9]http://ijwph.ir/article-1-600-en.html
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[18]Schneiderman AI, Braver ER, Kang HK. Understanding sequelae of injury mechanisms and mild traumatic brain injury incurred during the conflicts in Iraq and Afghanistan: Persistent postconcussive symptoms and posttraumatic stress disorder. Am J Epidemiol. 2008;167(12):1446-52.
[19]Gates MA, Holowka DW, Vasterling JJ, Keane TM, Marx BP, Rosen RC. Posttraumatic stress disorder in veterans and military personnel: Epidemiology, screening, and case recognition. Psychol Serv. 2012;9(4):361-82.
[20]Lehavot K, Katon JG, Chen JA, Fortney JC, Simpson TL. Post-traumatic stress disorder by gender and veteran status. Am J Prev Med. 2018;54(1):e1-9.
[21]Nichter B, Norman S, Haller M, Pietrzak RH. Psychological burden of PTSD, depression, and their comorbidity in the U.S. veteran population: Suicidality, functioning, and service utilization. J Affect Disord. 2019;256:633-40.
[22]Dillon KH, Hale WJ, LoSavio ST, Wachen JS, Pruiksma KE, Yarvis JS, et al. Weekly changes in blame and PTSD among active-duty military personnel receiving cognitive processing therapy. Behav Ther. 2020;51(3):386-400.
[23]Kudler H. Trauma and the Vietnam War Generation: Report of Findings from the National Vietnam Veterans Readjustment Study. J Nerv Ment Dis. 1991;179(10):644-5.
[24]Prigerson HG, Maciejewski PK, Rosenheck RA. Population attributable fractions of psychiatric disorders and behavioral outcomes associated with combat exposure among US men. Am J Pub Health. 2002;92(1):59-63.
[25]Hoge CW, Castro CA, Messer SC, McGurk D, Cotting DI, Koffman RL. Combat duty in Iraq and Afghanistan, mental health problems, and barriers to care. N Engl J Med. 2004;351(1):13-22.
[26]Seal KH, Metzler TJ, Gima KS, Bertenthal D, Maguen S, Marmar CR. Trends and risk factors for mental health diagnoses among Iraq and Afghanistan veterans using Department of Veterans Affairs health care, 2002-2008. Am J Pub Health. 2009;99(9):1651-8.
[27]Tanielian TL, Tanielian T, Jaycox L. Invisible wounds of war: Psychological and cognitive injuries, their consequences, and services to assist recovery. Santa Monica: Rand Corporation; 2008.
[28]Vasterling JJ, Proctor SP, Friedman MJ, Hoge CW, Heeren T, King LA, et al. PTSD symptom increases in Iraq‐deployed soldiers: Comparison with nondeployed soldiers and associations with baseline symptoms, deployment experiences, and postdeployment stress. J Trauma Stress. 2010;23(1):41-51.
[29]Andrews B, Brewin CR, Philpott R, Stewart L. Delayed-onset posttraumatic stress disorder: A systematic review of the evidence. Am J Psychiatry. 2007;164(9):1319-26.
[30]Booth‐Kewley S, Larson GE, Highfill‐McRoy RM, Garland CF, Gaskin TA. Correlates of posttraumatic stress disorder symptoms in Marines back from war. J Trauma Stress. 2010;23(1):69-77.
[31]Foa EB, Riggs DS, Dancu CV, Rothbaum BO. Reliability and validity of a brief instrument for assessing post‐traumatic stress disorder. J Trauma Stress. 1993;6:459-73.
[32]Hooman HA, Ganji K, Omidifar A. The meta-analysis of the effectiveness of life skills training on mental health. J Dev Psychol Iran Psychol. 2013;10(37):39-50. [Persian]
[33]Foa EB, McLean CP, Zang Y, Zhong J, Rauch S, Porter K, et al. Psychometric properties of the posttraumatic stress disorder symptom scale interview for DSM–5 (PSSI–5). Psychol Assess. 2016;28(10):1159-65.
[34]Sadeghi M, Taghva A, Goudarzi N, Rah Nejat A. Validity and reliability of Persian version of “post-traumatic stress disorder scale” in war veterans. Iran J War Pub Health. 2016;8(4):243-9. [Persian]
[35]Beck AT, Steer RA, Ball R, Ranieri WF. Comparison of Beck Depression Inventories-IA and-II in psychiatric outpatients. J Pers Assess. 1996;67(3):588-97.
[36]Fata L, Birashk B, Atefvahid MK, Dabson KS. Meaning assignment structures/ schema, emotional states and cognitive processing of emotional information: Comparing two conceptual frameworks. Iran J Psychiatry Clin Psychol. 2005;11(3):312-26. [Persian]
[37]Taqavi M, Najafi M, Kianersi F, Aqayan S. Comparing of alexithymia, defensive styles and state-trait anxiety among patients with generalized anxiety disorder major depression disorder and normal individuals. J Clin Psychol. 2013;5(2):67-76. [Persian]
[38]Hoge CW, Riviere LA, Wilk JE, Herrell RK, Weathers FW. The prevalence of post-traumatic stress disorder (PTSD) in US combat soldiers: A head-to-head comparison of DSM-5 versus DSM-IV-TR symptom criteria with the PTSD checklist. Lancet Psychiatry. 2014;1(4):269-77.
[39]Blanchard EB, Jones-Alexander J, Buckley TC, Forneris CA. Psychometric properties of the PTSD Checklist (PCL). Behav Res Ther. 1996;34(8):669-73.
[40]Morley CA, Kohrt BA. Impact of peer support on PTSD, hope, and functional impairment: a mixed-methods study of child soldiers in Nepal. J Aggress Maltreat Trauma. 2013;22(7):714-34.
[41]Renner W, Salem I. Post-traumatic stress in asylum seekers and refugees from Chechnya, Afghanistan, and West Africa: Gender differences in symptomatology and coping. Int J Soc Psychiatry. 2009;55(2):99-108.
[42]Weathers FW, Marx BP, Friedman MJ, Schnurr PP. Posttraumatic stress disorder in DSM-5: New criteria, new measures, and implications for assessment. Psychol Inj Law. 2014;7(2):93-107.
[43]Firoozabadi A, Asgharnejad Farid AA, Mirzaei J, Shareh H. Normalization of clinician administered PTSD scale-version 1 (CAPS-5-1) for psychological effects due to war. Iran J Psychiatry Clin Psychol. 2010;15(4):334-42.
[44]Roche L. An acceptance and commitment therapy-based intervention for PTSD following traumatic brain injury: A case study. Brain Inj. 2020;34(2):290-7.
[45]Hakvoort L, de Jong S, van de Ree M, Kok T, Macfarlane C, de Haan H. Music therapy to regulate arousal and attention in patients with substance use disorder and posttraumatic stress disorder: A feasibility study. J Music Ther. 2020;57(3):353-78.
[46]Weathers FW, Bovin MJ, Lee DJ, Sloan DM, Schnurr PP, Kaloupek DG, et al. The Clinician-Administered PTSD Scale for DSM–5 (CAPS-5): Development and initial psychometric evaluation in military veterans. Psychol Assess. 2018;30(3):383-95.
[47]Blevins CA, Weathers FW, Davis MT, Witte TK, Domino JL. The posttraumatic stress disorder checklist for DSM‐5 (PCL‐5): Development and initial psychometric evaluation. J Trauma Stress. 2015;28(6):489-98.
[48]Wortmann JH, Jordan AH, Weathers FW, Resick PA, Dondanville KA, Hall-Clark B, et al. Psychometric analysis of the PTSD Checklist-5 (PCL-5) among treatment-seeking military service members. Psychol Assess. 2016;28(11):1392-1403.
[49]Shankman SA, Funkhouser CJ, Klein DN, Davila J, Lerner D, Hee D. Reliability and validity of severity dimensions of psychopathology assessed using the Structured Clinical Interview for DSM‐5 (SCID). Int J Method Psychiatr Res. 2018;27(1):e1590.
[50]Osório FL, Loureiro SR, Hallak JEC, Machado‐de‐Sousa JP, Ushirohira JM, Baes CV, et al. Clinical validity and intrarater and test-retest reliability of the Structured Clinical Interview for DSM‐5-Clinician Version (SCID‐5‐CV). Psychiatry Clin Neurosci. 2019;73(12):754-60.
[51]Alghamdi M, Hunt N. Psychometric properties of the Arabic Posttraumatic Diagnostic Scale for DSM–5 (A-PDS-5). Traumatology. 2020;26(1):109-16.
[2]Loignon A, Ouellet MC, Belleville G. A systematic review and meta-analysis on PTSD following TBI among military/veteran and civilian populations. J Head Trauma Rehabil. 2020;35(1):E21-35.
[3]Lukaschek K, Kruse J, Emeny RT, Lacruz ME, von Eisenhart Rothe A, Ladwig KH. Lifetime traumatic experiences and their impact on PTSD: A general population study. Soc Psychiatry Psychiatr Epidemiol. 2013;48(4):525-32.
[4]Amstadter AB, Aggen SH, Knudsen GP, Reichborn-Kjennerud T, Kendler KS. Potentially traumatic event exposure, posttraumatic stress disorder, and Axis I and II comorbidity in a population-based study of Norwegian young adults. Soc Psychiatry Psychiatr Epidemiol. 2013;48(2):215-23.
[5]Carlier IV, Voerman BE, Gersons BP. Intrusive traumatic recollections and comorbid posttraumatic stress disorder in depressed patients. Psychosom Med. 2000;62(1):26-32.
[6]Perrin M, Vandeleur CL, Castelao E, Rothen S, Glaus J, Vollenweider P, et al. Determinants of the development of post-traumatic stress disorder, in the general population. Soc Psychiatry Psychiatr Epidemiol. 2014;49(3):447-57.
[7]Frans Ö, Rimmö PA, Åberg L, Fredrikson M. Trauma exposure and post‐traumatic stress disorder in the general population. Acta Psychiatr Scand. 2005;111(4):291-9.
[8]Rahnejat AM, Dabagi P, Rabiei M, Taghva A, Valipoor H, Donyavi V, et al. Prevalence of post-traumatic stress disorder caused by war in veterans. Iran J War Pub Health. 2017;9(1):15-23. [Persian]
[9]http://ijwph.ir/article-1-600-en.html
[10]Zungu LI. Prevalence of post-traumatic stress disorder in the South African mining industry and outcomes of liability claims submitted to Rand Mutual Assurance Company. Occup Health South Afr. 2013;19(2):22-6.
[11]Ozer EJ, Best SR, Lipsey TL, Weiss DS. Predictors of posttraumatic stress disorder and symptoms in adults: A meta-analysis. Psychol Bull. 2003;129(1):52-73.
[12]Wittchen HU, Gloster A, Beesdo K, Schönfeld S, Perkonigg A. Posttraumatic stress disorder: Diagnostic and epidemiological perspectives. CNS Spectr. 2009;14(1 Suppl 1):5-12.
[13]Wittchen HU, Jacobi F. Size and burden of mental disorders in Europe--a critical review and appraisal of 27 studies. Eur Neuropsychopharmacol. 2005;15(4):357-76.
[14]Kessler RC, Chiu WT, Demler O, Walters EE. Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry. 2005;62(6):617-27.
[15]Alonso J, Angermeyer MC, Bernert S, Bruffaerts R, Brugha TS, Bryson H, et al. Prevalence of mental disorders in Europe: Results from the European Study of the Epidemiology of Mental Disorders (ESEMeD) project. Acta Psychiatr Scand Suppl. 2004;(420):21-7.
[16]Alonso J, Angermeyer MC, Bernert S, Bruffaerts R, Brugha TS, Bryson H, et al. Disability and quality of life impact of mental disorders in Europe: Results from the European Study of the Epidemiology of Mental Disorders (ESEMeD) project. Acta Psychiatr Scand Suppl. 2004;(420):38-46.
[17]Alonso J, Angermeyer MC, Bernert S, Bruffaerts R, Brugha TS, Bryson H, et al. 12‐month comorbidity patterns and associated factors in Europe: Results from the European Study of the Epidemiology of Mental Disorders (ESEMeD) project. Acta Psychiatr Scand Suppl. 2004;(420):28-37.
[18]Schneiderman AI, Braver ER, Kang HK. Understanding sequelae of injury mechanisms and mild traumatic brain injury incurred during the conflicts in Iraq and Afghanistan: Persistent postconcussive symptoms and posttraumatic stress disorder. Am J Epidemiol. 2008;167(12):1446-52.
[19]Gates MA, Holowka DW, Vasterling JJ, Keane TM, Marx BP, Rosen RC. Posttraumatic stress disorder in veterans and military personnel: Epidemiology, screening, and case recognition. Psychol Serv. 2012;9(4):361-82.
[20]Lehavot K, Katon JG, Chen JA, Fortney JC, Simpson TL. Post-traumatic stress disorder by gender and veteran status. Am J Prev Med. 2018;54(1):e1-9.
[21]Nichter B, Norman S, Haller M, Pietrzak RH. Psychological burden of PTSD, depression, and their comorbidity in the U.S. veteran population: Suicidality, functioning, and service utilization. J Affect Disord. 2019;256:633-40.
[22]Dillon KH, Hale WJ, LoSavio ST, Wachen JS, Pruiksma KE, Yarvis JS, et al. Weekly changes in blame and PTSD among active-duty military personnel receiving cognitive processing therapy. Behav Ther. 2020;51(3):386-400.
[23]Kudler H. Trauma and the Vietnam War Generation: Report of Findings from the National Vietnam Veterans Readjustment Study. J Nerv Ment Dis. 1991;179(10):644-5.
[24]Prigerson HG, Maciejewski PK, Rosenheck RA. Population attributable fractions of psychiatric disorders and behavioral outcomes associated with combat exposure among US men. Am J Pub Health. 2002;92(1):59-63.
[25]Hoge CW, Castro CA, Messer SC, McGurk D, Cotting DI, Koffman RL. Combat duty in Iraq and Afghanistan, mental health problems, and barriers to care. N Engl J Med. 2004;351(1):13-22.
[26]Seal KH, Metzler TJ, Gima KS, Bertenthal D, Maguen S, Marmar CR. Trends and risk factors for mental health diagnoses among Iraq and Afghanistan veterans using Department of Veterans Affairs health care, 2002-2008. Am J Pub Health. 2009;99(9):1651-8.
[27]Tanielian TL, Tanielian T, Jaycox L. Invisible wounds of war: Psychological and cognitive injuries, their consequences, and services to assist recovery. Santa Monica: Rand Corporation; 2008.
[28]Vasterling JJ, Proctor SP, Friedman MJ, Hoge CW, Heeren T, King LA, et al. PTSD symptom increases in Iraq‐deployed soldiers: Comparison with nondeployed soldiers and associations with baseline symptoms, deployment experiences, and postdeployment stress. J Trauma Stress. 2010;23(1):41-51.
[29]Andrews B, Brewin CR, Philpott R, Stewart L. Delayed-onset posttraumatic stress disorder: A systematic review of the evidence. Am J Psychiatry. 2007;164(9):1319-26.
[30]Booth‐Kewley S, Larson GE, Highfill‐McRoy RM, Garland CF, Gaskin TA. Correlates of posttraumatic stress disorder symptoms in Marines back from war. J Trauma Stress. 2010;23(1):69-77.
[31]Foa EB, Riggs DS, Dancu CV, Rothbaum BO. Reliability and validity of a brief instrument for assessing post‐traumatic stress disorder. J Trauma Stress. 1993;6:459-73.
[32]Hooman HA, Ganji K, Omidifar A. The meta-analysis of the effectiveness of life skills training on mental health. J Dev Psychol Iran Psychol. 2013;10(37):39-50. [Persian]
[33]Foa EB, McLean CP, Zang Y, Zhong J, Rauch S, Porter K, et al. Psychometric properties of the posttraumatic stress disorder symptom scale interview for DSM–5 (PSSI–5). Psychol Assess. 2016;28(10):1159-65.
[34]Sadeghi M, Taghva A, Goudarzi N, Rah Nejat A. Validity and reliability of Persian version of “post-traumatic stress disorder scale” in war veterans. Iran J War Pub Health. 2016;8(4):243-9. [Persian]
[35]Beck AT, Steer RA, Ball R, Ranieri WF. Comparison of Beck Depression Inventories-IA and-II in psychiatric outpatients. J Pers Assess. 1996;67(3):588-97.
[36]Fata L, Birashk B, Atefvahid MK, Dabson KS. Meaning assignment structures/ schema, emotional states and cognitive processing of emotional information: Comparing two conceptual frameworks. Iran J Psychiatry Clin Psychol. 2005;11(3):312-26. [Persian]
[37]Taqavi M, Najafi M, Kianersi F, Aqayan S. Comparing of alexithymia, defensive styles and state-trait anxiety among patients with generalized anxiety disorder major depression disorder and normal individuals. J Clin Psychol. 2013;5(2):67-76. [Persian]
[38]Hoge CW, Riviere LA, Wilk JE, Herrell RK, Weathers FW. The prevalence of post-traumatic stress disorder (PTSD) in US combat soldiers: A head-to-head comparison of DSM-5 versus DSM-IV-TR symptom criteria with the PTSD checklist. Lancet Psychiatry. 2014;1(4):269-77.
[39]Blanchard EB, Jones-Alexander J, Buckley TC, Forneris CA. Psychometric properties of the PTSD Checklist (PCL). Behav Res Ther. 1996;34(8):669-73.
[40]Morley CA, Kohrt BA. Impact of peer support on PTSD, hope, and functional impairment: a mixed-methods study of child soldiers in Nepal. J Aggress Maltreat Trauma. 2013;22(7):714-34.
[41]Renner W, Salem I. Post-traumatic stress in asylum seekers and refugees from Chechnya, Afghanistan, and West Africa: Gender differences in symptomatology and coping. Int J Soc Psychiatry. 2009;55(2):99-108.
[42]Weathers FW, Marx BP, Friedman MJ, Schnurr PP. Posttraumatic stress disorder in DSM-5: New criteria, new measures, and implications for assessment. Psychol Inj Law. 2014;7(2):93-107.
[43]Firoozabadi A, Asgharnejad Farid AA, Mirzaei J, Shareh H. Normalization of clinician administered PTSD scale-version 1 (CAPS-5-1) for psychological effects due to war. Iran J Psychiatry Clin Psychol. 2010;15(4):334-42.
[44]Roche L. An acceptance and commitment therapy-based intervention for PTSD following traumatic brain injury: A case study. Brain Inj. 2020;34(2):290-7.
[45]Hakvoort L, de Jong S, van de Ree M, Kok T, Macfarlane C, de Haan H. Music therapy to regulate arousal and attention in patients with substance use disorder and posttraumatic stress disorder: A feasibility study. J Music Ther. 2020;57(3):353-78.
[46]Weathers FW, Bovin MJ, Lee DJ, Sloan DM, Schnurr PP, Kaloupek DG, et al. The Clinician-Administered PTSD Scale for DSM–5 (CAPS-5): Development and initial psychometric evaluation in military veterans. Psychol Assess. 2018;30(3):383-95.
[47]Blevins CA, Weathers FW, Davis MT, Witte TK, Domino JL. The posttraumatic stress disorder checklist for DSM‐5 (PCL‐5): Development and initial psychometric evaluation. J Trauma Stress. 2015;28(6):489-98.
[48]Wortmann JH, Jordan AH, Weathers FW, Resick PA, Dondanville KA, Hall-Clark B, et al. Psychometric analysis of the PTSD Checklist-5 (PCL-5) among treatment-seeking military service members. Psychol Assess. 2016;28(11):1392-1403.
[49]Shankman SA, Funkhouser CJ, Klein DN, Davila J, Lerner D, Hee D. Reliability and validity of severity dimensions of psychopathology assessed using the Structured Clinical Interview for DSM‐5 (SCID). Int J Method Psychiatr Res. 2018;27(1):e1590.
[50]Osório FL, Loureiro SR, Hallak JEC, Machado‐de‐Sousa JP, Ushirohira JM, Baes CV, et al. Clinical validity and intrarater and test-retest reliability of the Structured Clinical Interview for DSM‐5-Clinician Version (SCID‐5‐CV). Psychiatry Clin Neurosci. 2019;73(12):754-60.
[51]Alghamdi M, Hunt N. Psychometric properties of the Arabic Posttraumatic Diagnostic Scale for DSM–5 (A-PDS-5). Traumatology. 2020;26(1):109-16.