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      Psychometric properties and validity of the German version of the Post-Traumatic Diagnostic Scale for DSM-5 (PDS-5) Translated title: Propiedades psicométricas y validez de la versión alemana de la Escala Diagnóstica postraumática del DSM-5 (PDS-5) Translated title: 德语版 DSM-5创伤后诊断量表(PDS-5)的心理测量特性和有效性

      research-article
      a , a , b , c , d , e , f , g
      European Journal of Psychotraumatology
      Taylor & Francis
      Post-traumatic Diagnostic Scale for DSM-5 (PDS-5), Post-Traumatic Stress Disorder, assessment, German translation, convergent validity, discriminant validity, confirmatory factor analysis, Escala de diagnóstico postraumático del DSM-5 (PDS-5), Trastorno de estrés postraumático, evaluación, Traducción al alemán, validez convergente, validez discriminante, análisis factorial confirmatorio, DSM-5 创伤后诊断量表 (PDS-5), 创伤后应激障碍, 评估, 德语翻译, 收敛效度, 区分效度, 验证性因素分析

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          ABSTRACT

          Background

          The availability of psychometrically sound instruments for the assessment of Post-Traumatic Stress Disorder (PTSD) is indispensable for clinical and scientific work with individuals suffering from trauma-related distress.

          Objective

          The aim of the present study was to translate the Post-Traumatic Diagnostic Scale for DSM-5 (PDS-5) into German and to evaluate its psychometric properties as well as convergent, discriminant, and factorial validity.

          Method

          The authorized German translation of the PDS-5 was completed by 270 patients admitted to specialized outpatient trauma clinics. Of these, 57.8% completed the PDS for a second time (mean time between assessments was 12.0 days). In order to examine convergent and discriminant validity of the PDS-5, the Post-traumatic Stress Disorder Checklist for DSM-5 as well as Patient Health Questionnaire subscales assessing depression (PHQ-9), somatization (PHQ-15), and Generalized Anxiety Disorder (GAD-7) were applied.

          Results

          The PDS-5 total score showed excellent internal consistency (α = .91) and re-test reliability (rho = .84). Convergent validity was supported by a strong correlation with the total score of the Post-traumatic Stress Disorder Checklist for DSM-5 (PCL-5; rho = .91). Correlations with Patient Health Questionnaire subscales of depression (rho = .81), anxiety (rho = .72), and somatization (rho = .65) were significantly lower (all p < .001) indicating discriminant validity of the PDS-5. Confirmative Factor Analysis did not result in a clear preference for one of the tested models. Defining a diagnostic cut-off value of ≥36 based on ROC analysis resulted in high sensitivity (.92) and specificity (.96) compared to a probable PTSD diagnosis according to the PCL-5.

          Conclusions

          In summary, our results indicate that the German PDS-5 translation provides valid and reliable information concerning both PTSD severity and diagnosis.

          HIGHLIGHTS

          • The Post-traumatic Diagnostic Scale for DSM-5 (PDS-5) is one of the most frequently applied self-rating scales for assessing PTSD severity.

          • This study indicates that the German PDS-5 version provides valid and reliable information concerning both PTSD severity and diagnosis.

          Translated abstract

          Antecedentes: La disponibilidad de instrumentos psicométricamente sólidos para la evaluación del trastorno de estrés postraumático (TEPT) es indispensable para el trabajo clínico y científico con personas que sufren angustia relacionada con el trauma.

          Objetivo: El objetivo del presente estudio fue traducir la Escala de Diagnóstico Postraumático del DSM-5 (PDS-5) al alemán y evaluar sus propiedades psicométricas, así como su validez convergente, discriminante y factorial.

          Método: La traducción al alemán autorizada del PDS-5 fue completada por 270 pacientes ingresados en clínicas de trauma ambulatorias especializadas. De estos, el 57,8% completó la PDS por segunda vez (el tiempo medio entre evaluaciones fue de 12,0 días). Con el fin de examinar la validez convergente y discriminante del PDS-5, la lista de verificación del trastorno de estrés postraumático para el DSM-5, así como las subescalas de depresión del Cuestionario de salud del paciente (PHQ-9), de somatización (PHQ-15) y de trastorno de ansiedad generalizada (GAD-7) fueron aplicadas.

          Resultados: La puntuación total del PDS-5 mostró una excelente consistencia interna (α = .91) y confiabilidad al reaplicar (rho = .84). La validez convergente fue apoyada por una fuerte correlación con la puntuación total de la lista de verificación de trastorno de estrés postraumático para el DSM-5 (PCL-5; rho = .91). Las correlaciones con las subescalas del Cuestionario de Salud del Paciente de depresión (rho = .81), ansiedad (rho = .72) y somatización (rho = .65) fueron significativamente más bajas (todas p <.001) lindicando validez discriminante del PDS-5. El Análisis Factorial Confirmativo no resultó en una preferencia clara por uno de los modelos probados. La definición de un valour de corte de diagnóstico de ≥36 basado en el análisis ROC resultó en una alta sensibilidad (.92) y especificidad (.96) en comparación con un diagnóstico de TEPT probable según el PCL-5.

          Conclusiones: En resumen, nuestros resultados indican que la traducción al alemán PDS-5 proporciona información válida y confiable sobre la severidad y diagnóstico del TEPT.

          Translated abstract

          背景:评估创伤后应激障碍 (PTSD) 的心理测量学上可靠工具的可用性对于围绕遭受创伤相关痛苦个人进行临床和科学工作是必不可少的。

          目的:本研究旨在将 DSM-5 创伤后诊断量表 (PDS-5) 翻译成德语, 并评估其心理测量特性以及收敛, 区分和因素效度。

          方法: 270 名创伤专科门诊患者完成了德语授权翻译版的PDS-5。其中, 57.8%完成了第二次PDS (评估之间的平均时间为 12.0 天) 。为了考查PDS-5的收敛效度和区分效度, 使用了DSM-5 创伤后应激障碍检查表以及, 躯体化 (PHQ-15) 和患者健康问卷抑郁子量表(PHQ-9)和广泛性焦虑障碍子量表 (GAD-7) 。

          结果:PDS-5 总分展现出极好的内部一致性 (α = .91) 和重测信度 (rho = .84)。与 DSM-5 创伤后应激障碍检查表总分 (PCL-5 ; rho = .91) 的强相关性支持收敛效度。与抑郁 (rho = .81), 焦虑 (rho = .72) 和躯体化 (rho = .65) 的患者健康问卷子量表的相关性显著更低 (所有 p< .001), 表现出PDS-5 的区分效度。验证性因素分析结果没有对某一测试模型的明显偏好。与根据 PCL-5 的可能 PTSD 诊断相比, 根据 ROC 分析确定 ≥ 36 的诊断临界值会导致高的敏感性 (.92) 和特异性 (.96)。

          结论:总而言之, 我们的结果表明德语 PDS-5 翻译提供了关于 PTSD 严重程度和诊断有效和可靠的信息。

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          Most cited references39

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          A brief measure for assessing generalized anxiety disorder: the GAD-7.

          Generalized anxiety disorder (GAD) is one of the most common mental disorders; however, there is no brief clinical measure for assessing GAD. The objective of this study was to develop a brief self-report scale to identify probable cases of GAD and evaluate its reliability and validity. A criterion-standard study was performed in 15 primary care clinics in the United States from November 2004 through June 2005. Of a total of 2740 adult patients completing a study questionnaire, 965 patients had a telephone interview with a mental health professional within 1 week. For criterion and construct validity, GAD self-report scale diagnoses were compared with independent diagnoses made by mental health professionals; functional status measures; disability days; and health care use. A 7-item anxiety scale (GAD-7) had good reliability, as well as criterion, construct, factorial, and procedural validity. A cut point was identified that optimized sensitivity (89%) and specificity (82%). Increasing scores on the scale were strongly associated with multiple domains of functional impairment (all 6 Medical Outcomes Study Short-Form General Health Survey scales and disability days). Although GAD and depression symptoms frequently co-occurred, factor analysis confirmed them as distinct dimensions. Moreover, GAD and depression symptoms had differing but independent effects on functional impairment and disability. There was good agreement between self-report and interviewer-administered versions of the scale. The GAD-7 is a valid and efficient tool for screening for GAD and assessing its severity in clinical practice and research.
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            The PHQ-9: validity of a brief depression severity measure.

            While considerable attention has focused on improving the detection of depression, assessment of severity is also important in guiding treatment decisions. Therefore, we examined the validity of a brief, new measure of depression severity. The Patient Health Questionnaire (PHQ) is a self-administered version of the PRIME-MD diagnostic instrument for common mental disorders. The PHQ-9 is the depression module, which scores each of the 9 DSM-IV criteria as "0" (not at all) to "3" (nearly every day). The PHQ-9 was completed by 6,000 patients in 8 primary care clinics and 7 obstetrics-gynecology clinics. Construct validity was assessed using the 20-item Short-Form General Health Survey, self-reported sick days and clinic visits, and symptom-related difficulty. Criterion validity was assessed against an independent structured mental health professional (MHP) interview in a sample of 580 patients. As PHQ-9 depression severity increased, there was a substantial decrease in functional status on all 6 SF-20 subscales. Also, symptom-related difficulty, sick days, and health care utilization increased. Using the MHP reinterview as the criterion standard, a PHQ-9 score > or =10 had a sensitivity of 88% and a specificity of 88% for major depression. PHQ-9 scores of 5, 10, 15, and 20 represented mild, moderate, moderately severe, and severe depression, respectively. Results were similar in the primary care and obstetrics-gynecology samples. In addition to making criteria-based diagnoses of depressive disorders, the PHQ-9 is also a reliable and valid measure of depression severity. These characteristics plus its brevity make the PHQ-9 a useful clinical and research tool.
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              The Patient Health Questionnaire Somatic, Anxiety, and Depressive Symptom Scales: a systematic review.

              Depression, anxiety and somatization are the most common mental disorders in primary care as well as medical specialty populations; each is present in at least 5-10% of patients and frequently comorbid with one another. An efficient means for measuring and monitoring all three conditions would be desirable. Evidence regarding the psychometric and pragmatic characteristics of the Patient Health Questionnaire (PHQ)-9 depression, generalized anxiety disorder (GAD)-7 anxiety and PHQ-15 somatic symptom scales are synthesized from two sources: (1) four multisite cross-sectional studies (three conducted in primary care and one in obstetric-gynecology practices) comprising 9740 patients, and (2) key studies from the literature that have studied these scales. The PHQ-9 and its abbreviated eight-item (PHQ-8) and two-item (PHQ-2) versions have good sensitivity and specificity for detecting depressive disorders. Likewise, the GAD-7 and its abbreviated two-item (GAD-2) version have good operating characteristics for detecting generalized anxiety, panic, social anxiety and post-traumatic stress disorder. The optimal cutpoint is > or = 10 on the parent scales (PHQ-9 and GAD-7) and > or = 3 on the ultra-brief versions (PHQ-2 and GAD-2). The PHQ-15 is equal or superior to other brief measures for assessing somatic symptoms and screening for somatoform disorders. Cutpoints of 5, 10 and 15 represent mild, moderate and severe symptom levels on all three scales. Sensitivity to change is well-established for the PHQ-9 and emerging albeit not yet definitive for the GAD-7 and PHQ-15. The PHQ-9, GAD-7 and PHQ-15 are brief well-validated measures for detecting and monitoring depression, anxiety and somatization. Copyright 2010. Published by Elsevier Inc.
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                Author and article information

                Journal
                Eur J Psychotraumatol
                Eur J Psychotraumatol
                European Journal of Psychotraumatology
                Taylor & Francis
                2000-8198
                2000-8066
                24 September 2021
                2021
                24 September 2021
                : 12
                : 1
                : 1965339
                Affiliations
                [a ]Department of Psychology, International Psychoanalytic University; , Berlin, Germany
                [b ]Department of Experimental Psychology, University of Oxford; , Oxford, UK
                [c ]Center for the Treatment and Study of Anxiety, University of Pennsylvania; , Philadephia, PA, USA
                [d ]Department of Psychosomatic Medicine and Psychotherapy, LWL-University Hospital, Ruhr-University Bochum; , Bochum, Germany
                [e ]Department of Psychotherapy and Psychosomatic Medicine, Technical University Dresden; , Dresden, Germany
                [f ]Department of Psychosomatics and Psychotherapy, LWL-Hospital Münster; , Münster, Germany
                [g ]University Hospital Münster; , Münster, Germany
                Author notes
                CONTACT Lutz Wittmann lutz.wittmann@ 123456ipu-berlin.de Department of Psychology, International Psychoanalytic University; , Stromstrasse 1, Berlin 10555, Germany
                Author information
                https://orcid.org/0000-0002-8742-0192
                Article
                1965339
                10.1080/20008198.2021.1965339
                8475123
                34589176
                ba422c34-aaba-4d48-968c-dfce70e97ca2
                © 2021 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.

                History
                Page count
                Figures: 1, Tables: 3, References: 39, Pages: 1
                Categories
                Research Article
                Basic Research Article

                Clinical Psychology & Psychiatry
                post-traumatic diagnostic scale for dsm-5 (pds-5),post-traumatic stress disorder,assessment,german translation,convergent validity,discriminant validity,confirmatory factor analysis,escala de diagnóstico postraumático del dsm-5 (pds-5),trastorno de estrés postraumático,evaluación,traducción al alemán,validez convergente,validez discriminante,análisis factorial confirmatorio,dsm-5 创伤后诊断量表 (pds-5),创伤后应激障碍,评估,德语翻译,收敛效度,区分效度,验证性因素分析

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