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Development and Psychometric Validation of the Pandemic-related Traumatic Stress Scale

Thu, March 23, 5:00 to 6:30pm, Salt Palace Convention Center, Floor: 2, Meeting Room 251 E

Abstract

Introduction. Evidence on the impact of the COVID-19 pandemic on children and caregiver’s mental health has primarily focused on depression, anxiety, and general stress (Loades et al., 2020; Prati & Mancini, 2021). Few have examined traumatic reactions, despite evidence that isolation/quarantine is associated with an increased risk of post-traumatic stress symptoms (Brooks et al., 2020; Rider et al., 2021). To address this, we developed the Pandemic-related Traumatic Stress Scale (PTSS; Margolis et al., 2021) to assess five domains of stress reaction symptoms based on the DSM-5 Acute Stress Disorder criteria: intrusion, dissociation, avoidance, arousal regulation problems, and negative mood (American Psychiatric Association, 2022). The scale is designed for self-report by adults and adolescents (13-21 years) and caregiver report on symptoms observed in 3-12-year-olds.

Hypotheses. We hypothesized the PTSS was unidimensional, had comparable structure across diverse populations, and was positively associated with general stress, anxiety, and depressive symptoms, and negatively associated with life satisfaction. Further, we hypothesized group differences: (1) postpartum individuals would have higher PTSS scores compared to pregnant individuals (Molgora & Accordini, 2020); (2) adult caregivers of younger children (<5 years) would have higher PTSS scores compared to those of older children (5-12 years) and adolescents (13-21 years; Brooks et al., 2020); (3) female adult caregivers would have higher PTSS scores compared to male adult caregivers (Wang et al., 2020); and (4) older and female children/adolescents would have higher PTSS scores compared to younger and male children/adolescents (Loades et al., 2020; Marques de Miranda et al., 2020).

Study Population and Methods. Data came from four samples drawn from the ECHO Program: pregnant/postpartum individuals (n = 1,656), adult caregivers (n = 11,483), adolescents (n = 1,795), and caregivers reporting on 3-12-year-olds (N = 2,896), all of whom completed the PTSS between April 2020 and August 2021. We used Mokken scale analysis to examine unidimensionality and reliability, Pearson correlations to evaluate construct validity, and ANOVAs to identify age and sex differences.

Results. Mokken analysis resulted in a unidimensional scale that retained nine of the original 10 items (alpha >.8; Table 1). We detected small to moderate positive associations with depression (r = .23 - .47), anxiety (r = .2 - .62), and general stress (r = .46 - .58), and negative associations with life satisfaction (r = -.35- -.37) across the four samples. Adult caregivers had the highest PTSS scores (M = 18.57, SD = 6.46), followed by adolescents (M = 18.32, SD = 7.16), pregnant/postpartum individuals (M = 17.4, SD = 6.38), and children (M = 14.15, SD = 5.62; Figure 1). Caregivers of younger children, females, and older youth had higher PTSS scores compared to caregivers of older children, males, and younger youth.

Results suggest the PTSS is a reliable measure to quantify pandemic-related traumatic stress. The scale will enable researchers and clinicians to differentiate general stress, depression, and anxiety from pandemic-related traumatic stress symptoms and potentially identify individuals with higher levels of traumatic stress symptoms who may require targeted interventions.

Group Authors

The ECHO Consortium

Authors