No abstract

The factor structure of DSM-5 posttraumatic stress disorder (PTSD) has been extensively debated, with evidence supporting the recently proposed seven-factor hybrid model. However, few studies examining PTSD symptom structure have assessed the implications of these proposed models on diagnostic criteria and PTSD prevalence. In the present study, we examined seven alternative DSM-5 PTSD models within a confirmatory factor analysis (CFA), using the Child PTSD Symptom Scale-Self-Report for DSM-5 (CPSS-5). Additionally, we generated prevalence rates for each of the seven models by using a symptom-based diagnostic algorithm and assessed whether substance abuse, depression, anxiety symptoms, and daily functioning were differentially associated with PTSD depending on the model used to derive the diagnosis. Participants were 317 adolescents aged 13-17 years (M = 15.93, SD = 1.23) who had experienced a DSM-5 Criterion A trauma and/or childhood adversity. The CFA results showed good fit indices for all models, with the seven-factor hybrid model presenting the best fit. The rates of PTSD diagnosis varied according to each model. The four-factor DSM-5 model presented the highest rate (30.6%), and the seven-factor hybrid model presented the lowest rate (17.4%). Similar to the CFA analysis, the inclusion criteria for the diagnosis based on the hybrid model also presented the strongest associations with daily functional impairment, odds ratio (OR) = 1.48, 95% CI [1.25, 1.75]; and adverse childhood experiences, OR = 1.46, 95% CI [1.16, 1.82]. Research and clinical implications of these results are discussed, and suggestions for future investigation are presented.

The relationship between posttraumatic stress disorder (PTSD) and posttraumatic growth (PTG) has been extensively debated, with evidence supporting that negative and positive outcomes may coexist simultaneously. However, literature consensus has yet to be reached regarding whether the nature of the relationship between these variables is better explained through a linear or curvilinear relationship. In the present study, we examined the psychometric properties of the Posttraumatic Growth Inventory and tested the linear and curvilinear relationship between PTG and PTSD. Participants were 315 adults, with a mean age of 34.66 years (SD = 10.90), and ranged in age between 18 and 68 years; 144 (45.7%) participants were male and 171 (54.3%) were female who had experienced a potentially trauma or adverse event and had a level of education lower than the university education level. The original 5-factor structure of the PTGI was maintained, with satisfactory internal consistency. Exploratory data analysis showed a violation of the normality assumption because the sample reported low levels of PTSD. We used the bootstrap method, which gives an estimate of the sampling distribution (Field, 2018). Results showed a linear positive relationship between PTSD symptoms and PTG, after adjusting for sociodemographic variables. A curvilinear relationship between these variables was not found in the present sample. An overall small positive relationship was found between each PTSD subscale (Intrusion, Avoidance, and Arousal) and the 5 PTGI factors. This study found that PTSD and PTG can coexist. Implications for practice and recommendation for future research are discussed.

Dissociation is a process that often occurs as a sequela of psychological trauma, and it is interrelated with psychological and behavioral problems. In the at-risk adolescent population, dissociation is often underdiagnosed and undertreated. Having reliable measures to assess this phenomenon can help in identifying adolescents at-risk and improve treatment outcomes. This study assessed the psychometric properties of the Adolescent Dissociative Experiences Scale (A-DES) with a sample of 402 Portuguese adolescents recruited from three at-risk populations. Participants completed self-report measures of trauma exposure, posttraumatic symptoms, psychological and behavioral problems, and the A-DES. A subset of the sample also completed test-retest measures. Confirmatory factor analyses revealed a best-fitting 3-factor model. Analyses revealed good internal consistencies and good agreement test-retest reliability for the scale overall and the factor-based sub-scales. Construct and predictive validity was supported with results showing that A-DES discriminates between youth reporting high versus low levels of cumulative trauma exposure and youth who meet or do not meet criteria for a probable PTSD diagnosis. Study findings replicate prior research supporting a 3-factor model of dissociation and the usefulness of A-DES to identify adolescents with dissociative symptoms. Clinical and research implications are discussed.

The objective was to translate, adapt, and analyze the psychometric properties of a shortened version of the HIV Stigma Scale using a sample of 100 HIV+ adults, with a mean age of 49.88 (SD = 12.03) diagnosed for an average of 9.39 (SD = 7.36) years. The psychometric properties of the short version of the Stigma Scale were analyzed through the one-factor structure and the original four-factor structure, showing good fit for this last model. Convergent validity was found to be close to the acceptable for the factors, “concerns about public attitudes” and “negative self-image”, and good for the factors, “disclosure concerns”  and “personalized stigma”. The results showed adequate discriminant validity for all factors, coefficient Omega was above .70  for the four factors, showing adequate reliability. This Portuguese version of the Stigma Scale is a good measure to assess the stigma of people living with HIV.

No abstract

After 45 years, little is known about Portuguese Colonial War veterans’ physical health. This systematic review aimed to fill this gap. Following PRISMA guidelines, searches were conducted, on November 2018, in seven electronic databases for the inclusion of Portuguese or English quantitative, qualitative, or mixed-method published studies, unpublished master’s or doctoral theses and research reports that focused on physical health. Seventy-one studies were identified; 10 were considered eligible. Veterans reported several physical complaints and chronic diseases, as well as risk behaviors and health services use for the relief of psychological symptoms. Differences were found between veterans and nonveterans, and veterans with and without posttraumatic stress disorder (PTSD). Combat exposure and PTSD were associated with physical morbidity, in which PTSD was a full mediator. Implications for practice and recommendation for future research are discussed.

After the Portuguese Colonial War (PCW), some research was conducted to examine PCW veterans' combat exposure, as well as their report of mental and physical health problems. Research revealed that the PCW left, and still presents, deep psychological and physical marks for many veterans. However, after 47 years, there is no available information regarding the most frequently used, as well as the most reliable and valid tools that measure these outcomes. This information is essential for researchers and clinicians to help them choose the most feasible measures to assess current and potential future veterans. To address this issue, this scoping review synthesizes information on preference and psychometric robustness of measures that assess combat exposure, mental and physical health problems in PCW veterans. Following PRISMA-ScR guidelines, searches were conducted, in May 2021; in five electronic databases for the inclusion of Portuguese or English quantitative, qualitative, or mixed-method peer reviewed studies or gray literature. Fifty-six studies were identified; 40 were considered eligible. Of the identified measures, only three were validated for PCW veterans, namely, the Exposure to Combat Severity Scale, Combat Distress Scale, and Posttraumatic Stress Disorder Checklist-Military Version. Currently, these reveal to be the most valid and reliable measures to assess combat exposure, emotional distress, and posttraumatic stress symptoms. However, findings also revealed a need for further development, adaptation or validation of self-report measures, especially regarding physical health problems. These will help clinicians and researchers to enhance their quality of assessment.