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      Development and Evaluation of the Dutch Clinician-Administered PTSD Scale for DSM-5 (CAPS-5) Translated title: 荷兰语版DSM-5 PTSD临床使用量表(CAPS-5)的开发和评估 Translated title: Desarrollo y Evaluación de la Escala Holandesa para el TEPT Aplicada por el Clínico adaptada al DSM-5 (CAPS-5)

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          ABSTRACT

          Background: In 2013, the Clinician-Administered PTSD Scale, the golden standard to assess PTSD, was adapted to the DSM-5 (CAPS-5).

          Objective: This project aimed to develop a clinically relevant Dutch translation of the CAPS-5 and to investigate its psychometric properties.

          Method: We conducted a stepped translation including Delphi rounds with a crowd of 44 Dutch psychotrauma experts and five senior psychotrauma experts. Using partial crowd-translations, two professional translations and the official Dutch translation of the DSM-5, each senior expert aggregated one independent translation. Consensus was reached plenary. After back-translation, comparison with the original CAPS-5 and field testing, a last round with the senior experts resulted in the final version. After implementation clinicians conducted CAPS-5 interviews with 669 trauma-exposed individuals referred for specialized diagnostic assessment. Reliability of the Dutch CAPS-5 was investigated through internal consistency and interrater reliability analyses, and construct validity through confirmatory factor analysis (CFA).

          Results: CAPS-5 total severity score showed high internal consistency ( α = .90) and interrater reliability (ICC = .98, 95% CI: .94–.99). CAPS-5 diagnosis showed modest interrater reliability (kappa = .59, 95% CI: .20–.98). CFA with alternative PTSD models revealed adequate support for the DSM-5 four-factor model, but a six-factor (Anhedonia) model fit the data best.

          Conclusions: The Dutch CAPS-5 is a carefully translated instrument with adequate psychometric properties. Current results add to the growing support for more refined (six and seven) factor models for DSM-5 PTSD indicating that the validity and clinical implications of these models should be objective of further research.

          RESUMEN

          Antecedentes: En el año 2013 la Escala para el TEPT Aplicada por el Clínico, la prueba estándar para evaluar el TEPT, fue adaptada al DSM-5 (CAPS-5).

          Objetivo: Este proyecto apuntó a desarrollar una traducción holandesa clínicamente relevante de la Escala para el TEPT Aplicada por el Clínico adaptada al DSM-5 (CAPS-5) e investigar sus propiedades psicométricas.

          Método: Realizamos una traducción escalonada, incluyendo fases del método Delphi con un grupo de 44 expertos holandeses en psicotrauma y cinco expertos de larga trayectoria en psicotrauma. Utilizando traducciones en grupo parciales, dos traducciones profesionales y la traducción holandesa oficial del DSM-5, cada experto experimentado sumó una traducción independiente. Se alcanzó un conceso pleno. Después de traducciones inversas, comparación con el CAPS-5 original y ensayo de campo, una última fase con los expertos experimentados resultó en la versión definitiva. Tras la implementación, los clínicos realizaron entrevistas aplicando CAPS-5 a 669 individuos expuestos a trauma referidos por evaluación diagnóstica especializada. Se investigó la fiabilidad del CAPS-5 holandés a través de consistencia interna y análisis de confiabilidad, y se estableció su validez a través de análisis factorial de tipo confirmatorio.

          Resultados: El puntaje de severidad total del CAPS-5 mostró alta consistencia interna (α = .90) y confiabilidad (ICC = .98, 95% IC: .94 - .99). El diagnóstico de CAPS-5 mostró una modesta confiabilidad (kappa = .59, 95% CI: .20 - .98). El análisis factorial de tipo confirmatorio con modelos alternativos de TEPT reveló un respaldo adecuado para el modelo de 4 factores del DSM-5, pero un modelo de 6 factores (Anhedonia) se ajusta mejor a los datos.

          Conclusiones: El CAPS-5 holandés es un instrumento cuidadosamente traducido con adecuadas propiedades psicométricas. Nuestros resultados se suman al respaldo creciente para modelos de factores (seis y siete) más refinados para el TEPT según el DSM-5, indicando que la validez y las implicaciones clínicas de estos modelos deberían ser objeto de futuras investigaciones.

          背景:2013年,DSM-5 PTSD临床使用量表(评估PTSD的黄金标准)经过修订适用于DSM-5(CAPS-5)。

          目标:该项目旨在开发荷兰语版本的临床CAPS-5,并考察其心理测量学特性。

          方法:我们采用了一个分步的翻译方法,包括44名荷兰精神创伤专家和5名资深精神创伤专家的Delphi rounds流程。使用不完全‘人群翻译法’(crowd-translations),由两个专业翻译和DSM-5官方的荷兰语翻译进行翻译,每一位资深专家将汇总出一个独立的翻译版本。之后通过全体会议确定一个共同版本。经过反向翻译、与原CAPS-5的比较和田野测试后,在最后一轮中资深专家确定了最终版本。临床医生对669名创伤暴露后需要进行专门诊断评估的个体进行了CAPS-5访谈。通过内部一致性和评分者一致性分析考察荷兰语版CAPS-5的信度,并通过验证性因子分析(CFA)考察其效度。

          结果:CAPS-5严重度总分显示高度的内部一致性(α= .90)和评分者一致性(ICC = .98,95%CI:.94- .99)。 CAPS-5诊断显示中等的评分者一致性(kappa = .59,95%CI:.20 - .98)。对PTSD替代模型进行CFA结果充分支持DSM-5四因子模型,但六因子(Anhedonia)模型最拟合数据。

          结论:荷兰语版CAPS-5是一个经过精心翻译的工具,具有足够良好的心理测量特性。本研究结果支持了DSM-5 PTSD更精细的(6和7)因子模型,表明这些模型的有效性和临床意义影视是进一步研究的目标。

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          Most cited references 43

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          The development of a Clinician-Administered PTSD Scale.

          Several interviews are available for assessing PTSD. These interviews vary in merit when compared on stringent psychometric and utility standards. Of all the interviews, the Clinician-Administered PTSD Scale (CAPS-1) appears to satisfy these standards most uniformly. The CAPS-1 is a structured interview for assessing core and associated symptoms of PTSD. It assesses the frequency and intensity of each symptom using standard prompt questions and explicit, behaviorally-anchored rating scales. The CAPS-1 yields both continuous and dichotomous scores for current and lifetime PTSD symptoms. Intended for use by experienced clinicians, it also can be administered by appropriately trained paraprofessionals. Data from a large scale psychometric study of the CAPS-1 have provided impressive evidence of its reliability and validity as a PTSD interview.
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            Psychometric properties of the PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition (PCL-5) in veterans.

            This study examined the psychometric properties of the posttraumatic stress disorder (PTSD) Checklist for Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition (PCL-5; Weathers, Litz, et al., 2013b) in 2 independent samples of veterans receiving care at a Veterans Affairs Medical Center (N = 468). A subsample of these participants (n = 140) was used to define a valid diagnostic cutoff score for the instrument using the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5; Weathers, Blake, et al., 2013) as the reference standard. The PCL-5 test scores demonstrated good internal consistency (α = .96), test-retest reliability (r = .84), and convergent and discriminant validity. Consistent with previous studies (Armour et al., 2015; Liu et al., 2014), confirmatory factor analysis revealed that the data were best explained by a 6-factor anhedonia model and a 7-factor hybrid model. Signal detection analyses using the CAPS-5 revealed that PCL-5 scores of 31 to 33 were optimally efficient for diagnosing PTSD (κ(.5) = .58). Overall, the findings suggest that the PCL-5 is a psychometrically sound instrument that can be used effectively with veterans. Further, by determining a valid cutoff score using the CAPS-5, the PCL-5 can now be used to identify veterans with probable PTSD. However, findings also suggest the need for research to evaluate cluster structure of DSM-5. (PsycINFO Database Record
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              Rethinking the mood and anxiety disorders: a quantitative hierarchical model for DSM-V.

               David Watson (2005)
              The fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 1994) groups disorders into diagnostic classes on the basis of the subjective criterion of "shared phenomenological features." There are now sufficient data to eliminate this rational system and replace it with an empirically based structure that reflects the actual similarities among disorders. The existing structural evidence establishes that the mood and anxiety disorders should be collapsed together into an overarching class of emotional disorders, which can be decomposed into 3 subclasses: the bipolar disorders (bipolar I, bipolar II, cyclothymia), the distress disorders (major depression, dysthymic disorder, generalized anxiety disorder, posttraumatic stress disorder), and the fear disorders (panic disorder, agoraphobia, social phobia, specific phobia). The optimal placement of other syndromes (e.g., obsessive-compulsive disorder) needs to be clarified in future research. Copyright (c) 2005 APA, all rights reserved.
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                Author and article information

                Journal
                Eur J Psychotraumatol
                Eur J Psychotraumatol
                ZEPT
                zept20
                European Journal of Psychotraumatology
                Taylor & Francis
                2000-8066
                2018
                22 November 2018
                : 9
                : 1
                Affiliations
                [a ]Foundation Centrum ‘45, Oegstgeest/Diemen, The Netherlands | Partner in Arq Psychotrauma Expert Group , Diemen, The Netherlands
                [b ]Department of Psychiatry, Academic Medical Center , Amsterdam, The Netherlands
                [c ]Psychotrauma Diagnosis Center, Diemen, The Netherlands | partner in Arq Psychotrauma Expert Group , Diemen, The Netherlands
                [d ]Arq Psychotrauma Expert Group , Diemen, The Netherlands
                [e ]PSYTREC, The Netherlands & Radboud University , Nijmegen, The Netherlands
                [f ]Department of Clinical Psychology, Leiden University, Leiden, The Netherlands & Leiden Institute for Brain and Cognition , Leiden, The Netherlands
                Author notes
                CONTACT Manon A. Boeschoten m.boeschoten@ 123456centrum45.nl Foundation Centrum ‘45, Partner in Arq Psychotrauma Expert Group , Nienoord 13, 1112, XE, Diemen, The Netherlands

                Preliminary results of this study were presented at the 15th ESTSS conference 2–4 June 2017 in Odense, Denmark. The data supporting the results can be found at Foundation Centrum ’45, Oegstgeest/Diemen, The Netherlands. Contact: Niels van 1030 der Aa, n.van.der.aa@ 123456centrum45.nl

                Article
                1546085
                10.1080/20008198.2018.1546085
                6263102
                © 2018 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License ( http://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                Page count
                Figures: 1, Tables: 3, References: 61, Pages: 15
                Product
                Funding
                Funded by: Dutch ABBAS Foundation
                This work was partly supported by the Dutch ABBAS Foundation under a development grant.
                Categories
                Clinical Research Article

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