Posttraumatic stress disorder symptomology as measured by PCL‐5 and its relationships to resilience, hostility and stress among paramedics and social professionals

Stress & Health Pub Date : 2024-05-01 DOI:10.1002/smi.3409
Anna Alexandrov, Nóra Román, Petra Kovács, Anna Ritz, Mónika Kissné Viszket, Zsuzsa Kaló
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Abstract

This survey study aimed to contribute to the extensive debate on the dimensionality of the Posttraumatic Stress Disorder Checklist for the DSM‐5 (PCL‐5) questionnaire by examining the psychometric properties and construct validity of its Hungarian version and relying on the inspection of a conceptual network of related variables, that is, perceived stress, hostility, and resilience. Confirmatory factor analysis (CFA), exploratory structural equation modelling (ESEM) and path analysis were applied on data collected from 177 paramedics and 66 professionals from the social field (58.4% male; Mage = 43.5 ± 9.96 years). Despite the acceptable fit indices gained with CFA when testing the original four‐factor DSM‐5 model of PCL‐5, strong associations (r = 0.69–0.90) between subscales were found. Thus, ESEM was applied and as a result a new, three‐factor version of the DSM‐5 model of PCL‐5 was proposed due to significant crossloadings that was theoretically also supported. The Reexperiencing and Avoidance subscales were merged and named Difficulty with Assimilation of Experience (DAE). In the path analysis only two of the tested associations were not significant using the new factor structure, in which stress fully mediated the relationship between resilience and DAE, and resilience and Hyperarousal. Overall, the hypothesised pathways between variables fit the collected data well. (weighted least squares mean‐and variance‐adjusted χ2 = 503.750 (df = 270), comparative fit index = 0.948, Tucker–Lewis index = 0.939, root mean square error of approximation (90% confidence interval) = 0.064 (0.055–0.073), weighted root mean square residual = 1.024). Our analysis of the Hungarian version of PCL‐5 contributes to the testing of a DSM‐5‐based questionnaire measuring posttraumatic stress disorder symptomology.
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用 PCL-5 测量的创伤后应激障碍症状及其与辅助医务人员和社会专业人员的复原力、敌意和压力之间的关系
本调查研究旨在通过检查匈牙利语版本创伤后应激障碍核对表(PCL-5)的心理测量特性和建构效度,并依靠对相关变量(即感知压力、敌意和复原力)的概念网络的检查,为有关该问卷维度的广泛讨论做出贡献。对收集到的 177 名辅助医务人员和 66 名社会领域专业人员(58.4% 为男性;年龄 = 43.5 ± 9.96 岁)的数据进行了确证因子分析(CFA)、探索性结构方程建模(ESEM)和路径分析。尽管在对 PCL-5 的原始四因素 DSM-5 模型进行 CFA 检验时获得了可接受的拟合指数,但仍发现子量表之间存在很强的关联(r = 0.69-0.90)。因此,我们应用了 ESEM,结果发现由于存在显著的交叉负荷,PCL-5 的 DSM-5 模型被提出了一个新的三因素版本,该版本在理论上也得到了支持。重新体验(Reexperiencing)和回避(Avoidance)两个子量表被合并,并命名为 "经验同化困难"(DAE)。在路径分析中,使用新的因子结构测试的关联中只有两个是不显著的,其中压力完全介导了复原力与 DAE 之间的关系,以及复原力与过度虑害之间的关系。总体而言,变量之间的假设路径与收集到的数据非常吻合。(加权最小二乘均方差调整后的χ2=503.750(df=270),比较拟合指数=0.948,塔克-刘易斯指数=0.939,均方根近似误差(90% 置信区间)=0.064(0.055-0.073),加权均方根残差=1.024)。我们对匈牙利版 PCL-5 的分析有助于测试基于 DSM-5 的创伤后应激障碍症状测量问卷。
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