ABSTRACT

Background: The estimated prevalence rate of comorbid posttraumatic stress disorder (PTSD) is high in trauma-exposed chronic pain patients. At the same time, self-report measures of PTSD tend to be over-inclusive within this specific population due to the high symptom overlap resulting in potential false positives. There is a need for an updated PTSD screening tools with a proper validation against clinical interviews according to the recently published 11^th revision of the World Health Organization’s International Classification of Diseases (ICD-11).

Objective: The present study aimed to validate the Danish International Trauma Questionnaire (ITQ) PTSD part in a sample of trauma-exposed chronic pain patients.

Method: The ITQ was validated using a clinician-rated diagnostic interview of ICD-11 PTSD among chronic pain patients exposed to accident or work-related trauma (N = 40). Construct validity, concurrent and discriminant validity was investigated using confirmatory factor analyses (CFA) and correlation analysis, respectively. Three CFA models of ITQ PTSD part were tested in a sample of trauma-exposed chronic pain patients (N = 1,017) and a subsample of chronic pain patients exposed to accident or work-related trauma only (n = 367).

Results: Diagnostic consistency between the six ICD-11 PTSD symptoms derived from the ITQ and the clinical interview (κ = .59) and the overall accuracy of the scale (AUC = .90) were good. The Danish ITQ showed excellent construct, concurrent and discriminant validity. The ICD-11 three factor PTSD model had excellent fit in both the full sample and the subsample of traffic and work-related accidents.

Conclusions: The results indicate that the ITQ also has good psychometric properties in patients with chronic pain.

摘要

背景：在暴露于创伤的慢性疼痛患者中，创伤后应激障碍（PTSD）的估计患病率很高。与此同时，PTSD 的自我报告措施往往在这一特定人群中过于包容，因为症状重叠率高，导致潜在的误报。根据最近发布的世界卫生组织国际疾病分类 (ICD-11) 第¹¹版，需要更新的 PTSD 筛查工具，并根据临床访谈进行适当验证。

目的：本研究旨在验证丹麦国际创伤问卷 (ITQ) PTSD 部分在创伤暴露慢性疼痛患者样本中的作用。

方法：在暴露于事故或工作相关创伤的慢性疼痛患者 ( N  = 40)中，使用临床医生对 ICD-11 PTSD 的诊断访谈来验证 ITQ 。分别使用验证性因素分析 (CFA) 和相关性分析来研究结构效度、并发效度和区分效度。ITQ PTSD 部分的三个 CFA 模型在一个暴露于创伤的慢性疼痛患者样本 ( N  = 1,017) 和一个仅暴露于事故或工作相关创伤的慢性疼痛患者子样本 ( n  = 367) 中进行了测试。

结果：来自 ITQ 和临床访谈的六种 ICD-11 PTSD 症状之间的诊断一致性 (κ = .59) 和量表的整体准确性 (AUC = .90) 良好。丹麦 ITQ 表现出出色的结构效度、并行效度和区分效度。ICD-11 三因素 PTSD 模型非常适合交通和工作相关事故的完整样本和子样本。

结论：结果表明 ITQ 在慢性疼痛患者中也具有良好的心理测量特性。