ABSTRACT

Background: Recent evidence showed adverse mental health outcomes associated with the COVID-19 pandemic, including trauma-related symptoms. The Global Psychotrauma Screen (GPS) is a brief instrument designed to assess a broad range of trauma-related symptoms with no available validation in the Italian population.

Aims: This study aimed to examine the factor structure of the Italian version of the GPS in a general population sample exposed to the COVID-19 pandemic and to evaluate trauma-related symptoms in the context of COVID-19 related risk factors associated with lockdown measures.

Methods: We conducted a cross-sectional web-based observational study as part of a long-term monitoring programme of mental health outcomes in the general population. Eighteen thousand one hundred forty-seven participants completed a self-report online questionnaire to collect key demographic data and evaluate trauma-related symptoms using the GPS, PHQ-9, GAD-7, ISI, and PSS. Validation analyses included both exploratory and confirmatory factor analysis and correlation analyses. The relation with putative COVID-19 related risk factors was explored by multivariate regression analysis.

Results: Exploratory factor analyses supported a two-factor model. Confirmatory factor analysis showed that the best fitting model was a three-factor solution, with core Post-traumatic Stress Symptoms (PTSS) (re-experiencing, avoidance, hyperarousal), Negative Affect (symptoms of depressed mood, anxiety, irritability), and Dissociative symptoms. GPS Risk factors and specific COVID-19 related stressful events were associated with GPS total and the three factor scores.

Conclusions: Our data suggest that a wide range of trauma-spectrum symptoms were reported by a large Italian sample during the COVID-19 pandemic. The GPS symptoms clustered best in three factors: Negative Affect symptoms, Core PTSS, and Dissociative symptoms. In particular, high rates of core PTSS and negative affect symptoms were associated with the COVID-19 pandemic in Italy and should be routinely assessed in clinical practice.

摘要

背景：最近的证据显示与 COVID-19 大流行相关的不良心理健康结果，包括与创伤相关的症状。全球心理创伤筛查 (GPS) 是一种简短的工具，旨在评估广泛的创伤相关症状，但在意大利人群中没有可用的验证。

目的：本研究旨在检查意大利版 GPS 在暴露于 COVID-19 大流行的一般人群样本中的因子结构，并在与锁定措施相关的 COVID-19 相关风险因素的背景下评估创伤相关症状.

方法：我们进行了一项基于网络的横断面观察研究，作为一般人群心理健康结果长期监测计划的一部分。18147 名参与者完成了一份自我报告的在线问卷调查，以收集关键人口统计数据并使用 GPS、PHQ-9、GAD-7、ISI 和 PSS 评估创伤相关症状。验证分析包括探索性和验证性因素分析以及相关性分析。通过多元回归分析探讨了与推定的 COVID-19 相关风险因素的关系。

结果：探索性因素分析支持双因素模型。验证性因素分析表明，最佳拟合模型是三因素解决方案，核心创伤后应激症状 (PTSS)（重新体验、回避、过度觉醒）、负面影响（抑郁情绪、焦虑、易怒的症状）和分离症状。GPS 风险因素和特定的 COVID-19 相关压力事件与 GPS 总分和三个因素得分相关。

结论：我们的数据表明，在 COVID-19 大流行期间，大量意大利样本报告了广泛的创伤谱症状。GPS 症状在三个因素中聚集得最好：负面影响症状、核心 PTSS 和分离症状。特别是，核心 PTSS 和负面影响症状的高发生率与意大利的 COVID-19 大流行有关，应在临床实践中进行常规评估。