Objective:

Current tools available to assess secondary traumatic stress (STS) do not account for whether the symptoms are functionally related to indirect trauma, determine functional impairment caused by the STS symptoms, and/or consider the duration of the disturbance. This prevents delineation of various expressions of traumatic stress related to indirect trauma that may constitute the phenomenon of STS. The STS Clinical Algorithm (STS-CA) was developed to make these distinctions, so that interventions can be tailored to need. This study investigates the following: (1) the diagnostic concordance between the STS-CA findings and scores on the Secondary Traumatic Stress Scale (STSS); (2) reasons for diagnostic discrepancies between the STS-CA and the STSS assessments.

Method:

Three trained interviewers used the STS-CA to guide the determination of clinical outcome (N = 181) in a diverse group of helping professionals.

Results:

There was 100% agreement between the CAPS and the STS-CA, and fair agreement (κ =.426, p = .000) between the STS-CA and the STSS. The STS-CA demonstrated more sensitivity in classifying positive cases, and specificity in delineating those with atypical cluster presentations or little to no functional impairment that prohibited a post-traumatic stress disorder diagnosis than the STSS.

Implications:

Effective treatment of STS requires proper identification and the delivery of protocols that are tailored to the unique ways that STS manifests. This study provides some insights into the utility of the STS-CA in guiding this process and creates STS categories to organize and classify intervention strategies.

中文翻译：

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继发性创伤应激临床算法 (STS-CA) 的诊断和转化效用

客观的：

当前可用于评估继发性创伤性压力 (STS) 的工具并未考虑这些症状是否与间接创伤在功能上有关，无法确定由 STS 症状引起的功能障碍，和/或考虑障碍的持续时间。这可以防止描绘与可能构成 STS 现象的间接创伤相关的创伤压力的各种表达。STS 临床算法 (STS-CA) 的开发旨在区分这些差异，以便可以根据需要定制干预措施。本研究调查了以下内容：(1) STS-CA 结果与继发性创伤应激量表 (STSS) 评分之间的诊断一致性；(2) STS-CA 和 STSS 评估之间诊断差异的原因。

方法：

三名训练有素的采访者使用 STS-CA 来指导不同专业人士的临床结果 ( N = 181)的确定。

结果：

CAPS 和 STS-CA 之间有 100% 的一致性，STS-CA 和 STSS 之间有公平的一致性（κ = .426，p = .000）。与 STSS 相比，STS-CA 在对阳性病例进行分类方面表现出更高的敏感性，在描述那些具有非典型集群表现或很少或没有功能障碍的患者时表现出更高的敏感性。

含义：

STS 的有效治疗需要正确识别和交付适合 STS 表现的独特方式的协议。本研究提供了一些关于 STS-CA 在指导这一过程中的效用的见解，并创建了 STS 类别来组织和分类干预策略。