Background
: Children and adolescents are often exposed to traumatic events, which may lead to the development of posttraumatic stress disorder (PTSD). It is therefore important for clinicians to screen for potential symptoms that can be signs of PTSD onset. PTSD in youth is a worldwide problem, thus congruent screening tools in various languages are needed.
Objective
: The aim of this study was to test the general psychometric properties of the Traumatic Stress Disorder Reaction Index for children and adolescents (UCLA PTSD) Reaction Index for DSM-5 (PTSD-RI-5) in adolescents, a self-report instrument intended to screen for trauma exposure and assess PTSD symptoms.
Method
: Data was collected from 4201 adolescents in communities within eleven countries worldwide (i.e. Brazil, Bulgaria, Croatia, Indonesia, Montenegro, Nigeria, Palestine-Gaza, Philippines, Portugal, Romania, and Serbia). Internal consistency, discriminant validity, and a confirmatory factor analysis of a four-factor model representing the main DSM-5 symptoms of the PTSD-RI-5 were evaluated.
Results
: The PTSD-RI-5 total score for the entire sample shows very good reliability (α = .92) as well as across all countries included (α ranged from .90 to .94). The correlations between anxiety/depressive symptoms and the PTSD-RI-5 scores were below .70 indicating on good discriminant validity. The four-factor structure of the scale was confirmed for the total sample and data from six countries. The standardized regression weights for all items varied markedly across the countries. The lack of a common acceptable model across all countries prevented us from direct testing of cross-cultural measurement invariance.
Conclusions
: The four-factor structure of the PTSD-RI-5 likely represents the core PTSD symptoms as proposed by the DSM-5 criteria, but there could be items interpreted in a conceptually different manner by adolescents from different cultural/regional backgrounds and future cross-cultural evaluations need to consider this finding.
Background. In order to compare estimates by one assessment scale across various cultures/ethnic groups, an important aspect that needs to be demonstrated is that its construct across these groups is invariant when measured using a similar and simultaneous approach (i.e., demonstrated cross-cultural measurement invariance). One of the methods for evaluating measurement invariance is testing for differential item functioning (DIF), which assesses whether different groups respond differently to particular items. The aim of this study was to evaluate the cross-cultural measurement invariance of the Revised Child Anxiety and Depression Scale (RCADS) in societies with different socioeconomic, cultural, and religious backgrounds.Methods. The study was organised by the International Child Mental Health Study Group. Self-reported data were collected from adolescents residing in 11 countries: Brazil, Bulgaria, Croatia, Indonesia, Montenegro, Nigeria, Palestinian Territories, the Philippines, Portugal, Romania and Serbia. The multiple-indicators multiple-causes model was used to test the RCADS items for DIF across the countries.Results. Ten items exhibited DIF considering all cross-country comparisons. Only one or two items were flagged with DIF in the head-to-head comparisons, while there were three to five items flagged with DIF, when one country was compared with the others. Even with all cross-culturally non-invariant items removed from nine language versions tested, the original factor model representing six anxiety and depressive symptoms subscales was not significantly violated.Conclusions. There is clear evidence that relatively small number of the RCADS items is non-invariant, especially when comparing two different cultural/ethnic groups, which indicates on its sound cross-cultural validity and suitability for cross-cultural comparisons in adolescent anxiety and depressive symptoms.
Through this research, our main focus was: to investigate the biochemical brain metabolites (NAA-N-acetylaspartate, GABA-Gama-Aminobutyric Acid, Asp-Aspartate, CR-Creatine, Gln-Glutamine, GPC-Glicerophosphocholine, PC-Phosphocholine, PCr-Phosphocreatine, Tau-Taurine, N-MDA-N-Metyl-D-Aspartate, Serine, Glicine, Cho-Choline); the neuroimagistic, the brain biochemical and metabolic abnormalities in children and adolescents with epilepsy before and after treatment; to review the main antiepileptic medication administered to these patients; and to make some correlations with the results obtained through Magnetic Resonance (MR) Spectroscopy, for further proper early detection and intervention in children and adolescents with epilepsy. Our research was performed between 2010-2017, involving 45 children and adolescents with epilepsy. Also, the patients were evaluated through MR Spectroscopy at baseline and after pharmacotherapy. Through the MR Spectroscopy, we investigated key aspects of the brain function and metabolism. The antiepileptic medication was chosen according to the guides and the type of epileptic seizures. The efficacy of the chosen therapy was evaluated through the change of the relevant MR spectroscopy biochemical brain metabolites. Our results, showed statistically significant modified values and concentrations of the biochemical cerebral metabolites. Our research was a proof, which the evaluation of the biochemical brain metabolites through MR Spectroscopy is of high clinical utility in prevention, early detection and intervention in epilepsy in children and adolescents.
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