Validation of a brief measure of posttraumatic stress disorder: the Distressing Event Questionnaire (DEQ)

The Distressing Event Questionnaire (DEQ) is a brief instrument for assessing posttraumatic stress disorder (PTSD) according to criteria provided in Diagnostic and Statistical Manual of Mental Disorders (4th ed.). The DEQ possesses high internal consistency and exhibited satisfactory short-term temporal stability in studies with Vietnam War combat veterans and battered women. In a sample of Vietnam War veterans and 4 separate samples of abused women (with histories of incest, rape, intimate partner abuse, or prostitution and abuse), the DEQ exhibited very good discriminative validity when judged against structured interview assessment of PTSD. The DEQ exhibited strong convergent validity with other PTSD measures and other indexes of adjustment and also exhibited strong convergent validity as a measure of PTSD across ethnic groups in both the veteran sample and the combined women's sample.     

And justice for all: Revisiting the Global Belief in a Just World Scale

The Global Belief in a Just World Scale (GBJWS) has been widely used in measuring the Belief in a Just World (BJW) personality trait. Despite its widespread application across the social sciences, the validity of this scale has not been sufficiently tested in the literature. In this research, the authors examine the internal and external validity of the GBJWS using both standard correlational analyses and structural equation modeling (SEM). Specifically, the authors test the concurrent validity, internal consistency, unidimensional structure, convergent validity, and both measurement and latent mean invariance of the scale across gender and culture. The results of a pilot study suggest strong concurrent validity of the GBJWS with other BJW scales, and the findings of the two main studies support the internal and external validity of GBJWS across gender and culture. The authors’ results further show an overall greater level of BJW of Chinese individuals compared to Americans. The present research provides a much needed investigation of the validity of the GBJWS, and answers calls for research examining the scale’s utility across different populations.     

Evaluating the Persian Translation of the National Stressful Events Survey PTSD Short Scale in a Sample of Iranian Earthquake Survivors

In DSM-5, the APA recommended the use of the National Stressful Events Survey PTSD Short Scale, a new self-report scale for PTSD that is brief, consistent with the revised DSM-5 diagnostic criteria, and free of copyright restrictions. The present study examines the psychometric properties of the Persian translation of the scale in a sample of Iranian adults who survived an earthquake. A sample of 600 people was selected through multistage sampling and subsequently completed the scale. Results indicated that the good reliability, one-factor structure, and convergent validity of the scale observed for the original English language scale were replicated. The Persian version of the NSESSS appears to be a valid and reliable measure to assess the symptoms of DSM-5 PTSD and may contribute to increasing efforts to identify and treat PTSD in Iran.     

Psychometric qualities of the German version of the Posttraumatic Diagnostic Scale (PTDS)

In the present study, the psychometric properties of the German version of the Posttraumatic Diagnostic Scale (PTDS; A. Ehlers, R. Steil, H. Winter, & E. B. Foa, 1996) were evaluated in a sample of 143 trauma survivors. To investigate convergent and discriminant validity of this questionnaire, the authors assessed posttraumatic stress disorder (PTSD), anxiety, depression symptoms, and social phobia. Internal consistencies of the PTDS and its subscales as well as their association with related measures show that the German PTDS is a reliable and valid instrument for the assessment of posttraumatic stress symptoms. A 3-factor structure was found that is, however, not exactly in concordance with the Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.; American Psychiatric Association, 2000) formulation (Reexperiencing, Avoidance, and Hyperarousal) but rather comprises a Reexperiencing/Avoidance factor; an Emotional Numbing/Hyperarousal factor; and a 3rd factor, consisting of Hypervigilance and an Exaggerated Startle Response. The findings are discussed with respect to their equivalency to the original PTDS, core symptoms of PTSD, and desirable future research.     

A new frame for frame-of-reference training: enhancing the construct validity of assessment centers

The authors undertook a comprehensive examination of the construct validity of an assessment center in this study by (a) gathering many different types of evidence to evaluate the strength of the inference between predictor measures and constructs (e.g., reliability, accuracy, convergent and discriminant relationships), (b) introducing a theoretically relevant intervention (frame-of-reference [FOR] training) aimed at improving construct validity, and (c) examining the effect of this intervention on criterion-related validity (something heretofore unexamined in the assessment center literature). Results from 58 assessees and 122 assessors suggested that FOR training was effective at improving the reliability, accuracy, convergent and discriminant validity, and criterion-related validity of assessment center ratings. Findings are discussed in terms of implications and future directions for both FOR training and assessment center practice.     

Psychometric evaluation of trauma and posttraumatic stress disorder assessments in persons with severe mental illness

Interrater reliability, internal consistency, test-retest reliability, and convergent validity were examined for the Trauma History Questionnaire (THQ), the Clinician-Administered Posttraumatic Stress Disorder (PTSD) Scale (CAPS), and the PTSD Checklist (PCL) in 30 clients with severe mental illnesses. Interrater reliability for the THQ and CAPS was high, as was internal consistency of CAPS and PCL subscales. The test-retest reliability of the THQ was moderate to high for different traumas. PTSD diagnoses on the CAPS and PCL showed moderate test-retest reliability. Lower levels of test-retest reliability for PTSD diagnoses were related to psychosis diagnoses and symptoms. However, when more stringent criteria for PTSD were used on the CAPS, it had excellent test-retest reliability across all clients. CAPS and PCL diagnoses of PTSD showed moderate convergent validity. The results support the reliability of trauma and PTSD assessments in clients with severe mental illness.     

Is there more to complicated grief than depression and posttraumatic stress disorder? A test of incremental validity

There is growing interest in complicated grief reactions as a possible new diagnostic category for inclusion in the Diagnostic and Statistical Manual of Mental Disorders. However, no research has yet shown that complicated grief has incremental validity (i.e., predicts unique variance in functioning). The authors addressed this issue in 2 studies by comparing grief, depression, and posttraumatic stress disorder (PTSD) symptoms with different measures of functioning (interviewer ratings, friend ratings, self-report, and autonomic arousal). The 1st study (N = 73) used longitudinal data collected at 4 and 18 months postloss, and the 2nd study (N = 447) used cross-sectional data collected 2.5-3.5 years postloss. With depression and PTSD controlled, grief emerged as a unique predictor of functioning, both cross-sectionally and prospectively. The findings provide convergent support for the incremental validity of complicated grief as an independent marker of bereavement-related psychopathology.     

Psychometric properties of the Brief Symptoms Inventory-18 (Bsi-18) in a Spanish sample of outpatients with psychiatric disorders

This study analyzes the psychometric and structural properties of the BSI-18 in a sample of Spanish outpatients with psychiatric disorders (N = 200), with three basic objectives: (a) to study the structural validity of the instrument; (b) to analyse reliability (internal consistency and test-retest stability) and validity (convergent and discriminant) of the instrument, and (c) to evaluate sensitivity to change in a therapeutic context. Using confirmatory factor analysis, two models were tested: the three-dimensional theoretical model proposed by its authors, and the empirical four-factor model obtained by the same authors through exploratory factor analysis. Our results showed that the best structure was a four-dimensional model, with the General Distress index and Somatization, Depression, General Anxiety and Panic scores. These four scales showed good internal consistency, test-retest reliability, validity and sensitivity to therapeutic change. The BSI-18 has been shown to be a reliable and useful tool for psychiatric assessment of patients, with the added advantage provided by its simplicity and ease of application.     

An examination of the construct validity of posttraumatic stress disorder with veterans using a revised criterion set

Ongoing concerns exist in the literature regarding the construct of posttraumatic stress disorder (PTSD) and how to best conceptualize and measure this disorder. We compared the traditional DSM-IV PTSD symptom criteria (i.e., symptoms from clusters B, C, and D) to a revised criterion set that omits overlapping mood and other anxiety symptoms on PTSD prevalence, PTSD diagnostic caseness, associated psychiatric comorbidity, functional status, and structural validity using a cross-sectional, multi-site primary care sample of 747 veterans. After removing items theorized to overlap with mood and other anxiety disorders, PTSD prevalence was identical using both criterion sets (i.e., 12%). Overall, there were few statistically significant differences in PTSD caseness, associated psychiatric comorbidity, functional status, and structural validity across the two diagnostic criterion sets. These data provide further support that removing items that overlap with other psychiatric disorders does not significantly impact the prevalence of PTSD, its associated comorbidity and functional impairment, or its structural validity. Although the revised criterion set represents a more parsimonious model, the current study findings generally support the strong construct validity of PTSD. The implications of these study findings for research and clinical practice are discussed.     

Type D personality and the development of PTSD symptoms: a prospective study

Psychological trauma and prolonged stress may cause mental disorders such as posttraumatic stress disorder (PTSD). Pretrauma personality is an important determinant of posttraumatic adjustment. Specifically, trait neuroticism has been identified as a risk factor for PTSD. Additionally, the combination of high negative affectivity or neuroticism with marked social inhibition or introversion, also called Type D personality (Denollet, 2000), may compose a risk factor for PTSD. There is no research available that examined pretrauma Type D personality in relation to PTSD. The present study examined the predictive validity of the Type D personality construct in a sample of Dutch soldiers. Data were collected prior to and 6 months after military deployment to Afghanistan. Separate multiple regression analyses were performed to examine the predictive validity of Type D personality. First, Type D personality was defined as the interaction between negative affect and social inhibition (Na × Si). In a second analysis, Type D was defined following cutoff criteria recommended by Denollet (2000). Results showed that negative affectivity was a significant predictor of PTSD symptoms. Social inhibition and the interaction Na × Si did not add to the amount of explained variance in postdeployment PTSD scores over the effects of childhood abuse, negative affectivity, and prior psychological symptoms. A second analysis showed that Type D personality (dichotomous) did not add to the amount of explained variance in postdeployment PTSD scores over the effects of childhood abuse, and prior psychological symptoms. Therefore, Type D personality appears to be of limited value to explain development of combat-related PTSD symptoms.     

Introduction to the special issue on the personality assessment inventory

This special issue of the Journal of Personality Assessment brings together 13 new research studies on the Personality Assessment Inventory (PAI; Morey, 1991) that should inform users and stimulate future empirical activity with this measure. In 4 articles, authors evaluate the validity scales and indexes of the PAI using both analog and criterion designs and samples from a variety of clinical and forensic settings. In a 5th article, the authors describe a novel approach to profile interpretation using two PAI negative distortion measures. The authors present applications of the PAI to new populations and problems including a German translation of the PAI and profile information for male batterers and victims of head injury. The authors of 2 studies extend research on the validity of the PAI for the assessment of borderline personality disorder. In the final 3 studies, the authors evaluate the validity of PAI measures of violence and aggression to predict subsequent aggressive behavior and institutional misconduct. Finally, the authors offer several suggestions for future research with the PAI.     

Practical Adaptations of Cognitive Processing Therapy with Bosnian Refugees: Implications for Adapting Practice to a Multicultural Clientele

Recent findings suggest that established psychological treatments for PTSD are effective for diverse populations, including war refugees who have experienced multiple and severe losses, deprivations, hardships, and atrocities. Treating non-English-speaking traumatized refugees requires the clinician to overcome linguistic and various cultural dissimilarities with clients that complicate effective engagement. Examples of clinical adaptations for Bosnian clients are presented along with a discussion of the client’s and therapist’s relationship to the larger service delivery system.     

Exploratory and confirmatory factor analyses of the structured interview for disorders of extreme stress

Two studies were conducted to provide the first empirical examination of the factor structure of a revised version of the clinically derived Structured Interview for Disorders of Extreme Stress, a structured interview designed to assess associated features of posttraumatic stress disorder (PTSD) thought to be related to early onset, interpersonal, and prolonged traumatic exposure. Five factors representing demoralization, somatic dysregulation, anger dysregulation, risk/self-harm, and altered sexuality were derived from an exploratory factor analysis conducted with adult trauma survivors in substance abuse treatment. They provided a good fit in a confirmatory factor analysis conducted in a second study with a nonclinical sample of ethnoculturally diverse, socioeconomically disadvantaged, incarcerated adults. Evidence of the derived factors' internal consistency and convergent and discriminant validity is reported. Evidence supported the association of these factors with interpersonal trauma (physical and/or sexual), its repetition, and its earlier onset. Implications for clinical assessment of complex posttraumatic stress disorder are discussed.     

Parent–Adolescent Agreement on Disruptive Behavior Symptoms: A Multitrait-Multimethod Model

This study examined parent–adolescent agreement on reports of inattention, hyperactivity/impulsivity, and conduct disorder in 203 adolescents (94 girls, 109 boys) ranging in age from 13 to 18 years (M = 15.21, SD = 1.37). Results of confirmatory factor analyses provided additional evidence of construct validity for these traits in adolescents. Internal consistency was examined for parent reports and adolescent self-reports. In addition, correlational analyses were used in a multitrait-multimethod format (MTMM; D. T. Campbell & D. W. Fiske, 1959) to examine convergent and discriminant validity. Results showed that parents provided more consistent and valid reports of inattention and hyperactivity/impulsivity, whereas adolescents provided more consistent and valid reports of conduct disorder. In addition, interviews produced higher levels of convergence than rating scales. These findings are discussed in terms of implications for assessment of disruptive behavior disorders.     

Depression Anxiety and Stress Scales (DASS-21): psychometric analysis across four racial groups

Growing cross-cultural awareness has led researchers to examine frequently used research instruments and assessment tools in racially diverse populations. The present study was conducted to assess the psychometric characteristics of the 21-item version of the Depression, Anxiety, and Stress Scales (DASS-21) among different racial groups. The DASS-21 was chosen because it appears to be a reliable and easy to administer measure, ideal for both clinical and research purposes. Results suggest that the internal consistency, and convergent and divergent validity of the DASS-21 are similar across racial groups. Multigroup CFA, however, indicated that item loadings were invariant, while scale covariances were not invariant. This suggests that, although the items may load similarly on the depression, anxiety and stress constructs, these constructs may be differentially inter-related across groups. Implications for application in clinical practice are discussed.     

Placing the mnemonic model in context: diagnostic, theoretical, and clinical considerations

The mnemonic model of posttraumatic stress disorder (PTSD) proposed by D. C. Rubin, D. Berntsen, and M. K. Bohni presents some provocative and potentially insightful ideas about this mental disorder. D. C. Rubin et al. suggested that PTSD is caused and maintained through a "pathogenic memory" (D. C. Rubin et al., 2008, p. 985) of a negative event rather than by exposure to a traumatic event per se. The present authors examine the mnemonic model in the context of relevant diagnostic, theoretical, and clinical considerations. Specifically, to evaluate the arguments and evidence provided in support of the mnemonic model of PTSD, the present authors focus on 4 issues: (a) problems inherent with comparing a theoretical model (i.e., the mnemonic model) with a diagnostic model (i.e., the DSM-IV-TR model), (b) problems with not comparing the mnemonic model with relevant cognitive and memory models of PTSD, (c) problems with the degree to which the research reviewed provides support for the mnemonic model, and (d) concerns that memory in PTSD is confounded with the basic disorder, rather than causing PTSD. The present authors conclude with suggestions for future theory and research to help differentiate between memory's role in the origins of PTSD and memory's role in the clinical course of the disorder.     

Are community studies of psychological trauma's impact accurate? A study among Jews and Palestinians

We evaluated the accuracy of posttraumatic stress disorder (PTSD) and major depression (MD) diagnoses using brief assessment instruments conducted by phone. PTSD and MD were assessed by telephone interview in a randomly selected sample of Jewish and Palestinian residents of Jerusalem (N = 150) during a period of marked threat of terrorism and war. We utilized the PTSD Symptom Scale Interview Format (Foa, Riggs, Dancu, & Rothbaum, 1993) and the Patient Health Questionnaire-9 (PHQ-9; Kroenke, Spitzer, & Williams, 2001). We then conducted in-depth, in-person interviews within 2 weeks, assessing PTSD and MD using the Composite International Diagnostic Interview (CIDI; Kessler et al., 2004). The prevalence of PTSD and MD diagnosis ascertained by the 2 assessment modalities was similar. Indices of classification accuracy for the phone interview, using the in-person interview as the standard, ranged from modest to high. Brief phone and in-depth in-person measures of PTSD and MD also correlated similarly with other demographic, stress, and coping factors, suggesting convergent validity. Brief phone interviews appear useful for estimating the prevalence of psychological disorders in mass casualty contexts and may have a critical role in both epidemiologic work and guiding public health interventions.     

Cognitive ability in virtual reality: Validity evidence for VR game‐based assessments

Virtual reality (VR) technology may provide unique benefits for assessing individual characteristics, in contrast with traditional assessments. This study examined validity evidence for the use of VR game (VRG) scores to indicate specific cognitive abilities. Participants completed three VRGs, three computer‐based assessments (CBAs), and additional scales. To evaluate convergent validity, VRG scores were compared with CBA scores. For divergent validity, VRG scores were compared with five factors of personality based on the Five Factor Model. For criterion‐related validity, VRG scores were compared with academic achievement (i.e., grade point average). Findings generally provided support that the VRG scores are related to certain spatial reasoning subdimensions of cognitive ability. However, further research is needed to examine the qualities of VRGs as assessment tools.     

Psychometric Properties of a Spanish Translation of the Revised Child Anxiety and Depression Scale – Parent Version

The Revised Child Anxiety and Depression Scale – Parent Version (RCADS-P) is a parent-report questionnaire that assesses dimensions of DSM anxiety and depressive disorders in youths. Previous studies have found that the RCADS-P possesses clinical utility and strong psychometric properties in both clinic- and school-based populations. To increase applicability of the measure to a greater proportion of the individuals accessing mental health services, the present study sought to develop and examine the psychometric properties of a Spanish version of the RCADS-P. As completed by parents of 85 publicly referred children and adolescents, the RCADS-P demonstrated good internal consistency and convergent, discriminant, and divergent validity. Confirmatory factor analysis also supported a six-factor model consistent with the measure’s six subscales: separation anxiety disorder, social phobia, generalized anxiety disorder, panic disorder, obsessive-compulsive disorder, and major depressive disorder. A secondary aim of this study was to evaluate the validity and reliability of a shortened, 25-item version of the Spanish translation of the RCADS-P, which also evidenced favorable psychometric properties. Findings provide support for the Spanish version of the RCADS-P as an efficient and informative parent-report measure of youths' internalizing behaviors.