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Abstract：
Background: Trauma exposure is widespread and linked to chronic physical and mental health conditions including posttraumatic stress disorder. However, there are major gaps in our knowledge of trauma exposure in Africa and on the validity of instruments to assess potentially life-threatening trauma exposure.Objective: The Life Events Checklist for the DSM-5 (LEC-5) is a free, widely used questionnaire to assess traumatic events that can be associated with psychopathology. As part of a case-control study on risk factors for psychosis spectrum disorders, we used the LEC-5 to examine the frequency of traumatic events and to assess the questionnaire\'s factor structure in South Africa (N = 6,765).Method: The prevalence of traumatic events was measured by individual items on the LEC-5 across the study sample, by case-control status, and by sex. Cumulative trauma burden was calculated by grouping items into 0, 1, 2, 3, and ≥4 traumatic event types. Psychometric properties of the LEC-5 were assessed through exploratory and confirmatory factor analyses.Results: More than 92% of the study sample reported experiencing ≥1 traumatic event; 38.7% reported experiencing ≥4 traumatic event types. The most endorsed item was physical assault (65.0%), followed by assault with a weapon (50.2%). Almost 94% of cases reported ≥1 traumatic event compared to 90.5% of controls (p < .001) and 94% of male participants reported ≥1 traumatic event compared to 89.5% of female participants (p < .001). Exploratory factor analysis revealed a 6-factor model. Confirmatory factor analyses of three models found that a 7-factor model based on the South African Stress and Health survey was the best fit (standardized root mean square residual of 0.024, root mean square error of approximation of 0.029, comparative fit index of 0.910).Conclusion: Participants reported very high exposure to traumatic events. The LEC-5 has good psychometric priorities and is adequate for capturing trauma exposure in South Africa.
Trauma exposure was extremely prevalent in this South African sample, with less than 8% of participants reporting zero exposure to traumatic events.This was the first time the factor structure of the LEC-5 was assessed in South Africa.A confirmatory factor analysis using a 7-factor model based on a previous study of trauma exposure, the South African Stress and Health study (SASH), was the best fit for the LEC-5.
Trauma exposure was extremely prevalent in this South African sample, with less than 8% of participants reporting zero exposure to traumatic events.This was the first time the factor structure of the LEC-5 was assessed in South Africa.A confirmatory factor analysis using a 7-factor model based on a previous study of trauma exposure, the South African Stress and Health study (SASH), was the best fit for the LEC-5.
摘要：
背景：创伤暴露广泛存在，并与包括创伤后应激障碍在内的慢性身心健康状况有关。然而,我们对非洲创伤暴露的认识和评估可能危及生命的创伤暴露的工具的有效性存在重大差距.目标：DSM-5（LEC-5）的生活事件清单是免费的，广泛使用的问卷来评估可能与精神病理学相关的创伤事件。作为精神病谱系障碍危险因素病例对照研究的一部分，我们使用LEC-5检查南非的创伤事件发生频率并评估问卷的因素结构(N=6,765).方法：通过研究样本中LEC-5的各个项目来测量创伤性事件的发生率，按病例控制状态，和性别。通过将项目分为0、1、2、3和≥4种创伤事件类型来计算累积创伤负担。通过探索性和验证性因素分析评估了LEC-5的心理测量特性。结果：超过92％的研究样本报告经历了≥1个创伤性事件；38.7％报告经历了≥4种创伤性事件类型。最受认可的项目是人身攻击(65.0%)，其次是用武器攻击(50.2%)。几乎94％的病例报告≥1例创伤性事件，而对照组为90.5％（p<.001），94％的男性参与者报告≥1例创伤性事件，而女性参与者为89.5％（p<.001）。探索性因子分析揭示了一个6因素模型。三个模型的验证性因素分析发现，基于南非压力与健康调查的7因素模型是最佳拟合（标准化均方根残差为0.024，均方根误差为0.029，比较拟合指数为0.910）。结论：参与者报告了非常高的创伤事件暴露。LEC-5具有良好的心理测量优先级，足以捕获南非的创伤暴露。
创伤暴露在这个南非样本中非常普遍，不到8%的参与者报告创伤事件为零。这是南非首次评估LEC-5的因子结构。基于先前的创伤暴露研究，使用7因素模型进行验证性因子分析，南非压力与健康研究(SASH)，最适合LEC-5。
创伤暴露在这个南非样本中非常普遍，不到8%的参与者报告创伤事件为零。这是南非首次评估LEC-5的因子结构。基于先前的创伤暴露研究，使用7因素模型进行验证性因子分析，南非压力与健康研究(SASH)，最适合LEC-5。
