Predictive validity of the six-dimension structure of the Impact of Event Scale- Revised for PTSD and related-cardiometabolic consequences (hypertension and obesity) among dental healthcare workers during COVID-19

Abstract

The diagnostic criteria of posttraumatic stress disorder (PTSD) have lately expanded beyond the three common symptoms (intrusion, avoidance, and hyperarousal). Simultaneously, four-, five-, and six-dimensional structures of the Impact of Event Scale-Revised (IES-R), a popular PTSD measure, seem to be more robust than the original three-dimension structure. PTSD and/or specific PTSD symptoms may also evoke adverse cardiometabolic events (e.g., hypertension and obesity) in certain groups. Employing a convenience sample of 58 dental healthcare workers (HCWs) from Russia (mean age = 44.1 ± 12.2 years, 82.8% females), this instrumental study examined the criterion and predictive validity of two IES-R structures: the IES-R3 and the IES-R6 (with added symptoms of numbing, sleep disturbance, and irritability). The subscales of the two IES-R structures expressed good internal consistency, strong correlations with the PTSD Symptom Scale (PSS), hypertension diagnosis, and high body mass index (BMI). In receiver-operating characteristic (ROC) curve analysis, all IES-R models perfectly predicted the PSS (all area under the curve (AUC) values > 0.9, p values < 0.001). The IES-R, both hyperarousal subscales, and the IES-R3 intrusion significantly predicted high BMI. The IES-R did not predict hypertension, but the avoidance subscales and the IES-R3 intrusion significantly predicted it. In conclusion, both IES-R structures can reliably measure PTSD symptoms. The IES-R, hyperarousal, and intrusion may be credible criterion variables for predicting high BMI within PTSD while the intrusion and avoidance subscales may more reliably reflect the cardiovascular consequences of the stress reaction associated with PTSD than the IES-R itself. It is pivotal to verify the results in specific groups (e.g., those with confirmed traumatic exposure and comorbid mood dysfunction). Replication of the study in larger samples, which comprise different physical and metal conditions from heterogenous cultural contexts is necessary.