PDF(Pubmed)
Abstract：
OBJECTIVE: Dissociative symptoms are both a pathological consequence of exposure to psychological trauma as well as a side effect of N-methyl-d-aspartate (NMDA) receptor antagonist medications; therefore, accurate and valid assessment of these symptoms is important. The psychometric properties of the 23-item Clinician Administered Dissociative States Scale (CADSS) have been characterized in the ketamine and esketamine literatures. Here, we examine its performance in a sample with and without posttraumatic stress disorder (PTSD) and a history of exposure to psychological trauma.
METHODS: Participants with a history of psychological trauma with (N = 148) and without (N = 100) the diagnosis of PTSD and healthy participants without a psychiatric disorder or history of trauma (N = 28) were assessed with the 23-item CADSS and other psychometric and neuropsychological assessments. Analyses were performed to examine internal consistency, convergent and discriminant validity, factor structure, differential performance in populations reported to be more or less likely to report dissociative symptoms (e.g., patients with and without PTSD), and sensitivity to change resulting from exposure to trauma-related sights and sounds.
RESULTS: The 23-item CADSS was found to have high internal consistency (Cronbach\'s alpha 0.91) and a single-factor structure. CADSS total scores in trauma-exposed participants with PTSD were higher than those in trauma-exposed participants without PTSD and non-traumatized non-PTSD participants. Finally, veterans with Iraq combat-related PTSD showed a significant increase in CADSS total score after exposure to combat-related slides and sounds.
CONCLUSIONS: The 23-item CADSS, already validated as a tool to measure dissociation related to administration of NMDA receptor antagonist medication, performs in a reliable and valid manner in the assessment of dissociation in psychologically traumatized participants.
METHODS: Participants with a history of psychological trauma with (N = 148) and without (N = 100) the diagnosis of PTSD and healthy participants without a psychiatric disorder or history of trauma (N = 28) were assessed with the 23-item CADSS and other psychometric and neuropsychological assessments. Analyses were performed to examine internal consistency, convergent and discriminant validity, factor structure, differential performance in populations reported to be more or less likely to report dissociative symptoms (e.g., patients with and without PTSD), and sensitivity to change resulting from exposure to trauma-related sights and sounds.
RESULTS: The 23-item CADSS was found to have high internal consistency (Cronbach\'s alpha 0.91) and a single-factor structure. CADSS total scores in trauma-exposed participants with PTSD were higher than those in trauma-exposed participants without PTSD and non-traumatized non-PTSD participants. Finally, veterans with Iraq combat-related PTSD showed a significant increase in CADSS total score after exposure to combat-related slides and sounds.
CONCLUSIONS: The 23-item CADSS, already validated as a tool to measure dissociation related to administration of NMDA receptor antagonist medication, performs in a reliable and valid manner in the assessment of dissociation in psychologically traumatized participants.
摘要：
目的：解离症状既是暴露于心理创伤的病理结果，也是N-甲基-d-天冬氨酸（NMDA）受体拮抗剂药物的副作用；因此，对这些症状进行准确有效的评估很重要。23项临床医生管理的分离状态量表（CADSS）的心理测量特性已在氯胺酮和艾氯胺酮文献中得到表征。这里,我们在有或没有创伤后应激障碍(PTSD)和心理创伤暴露史的样本中检查了其表现.
方法：有心理创伤史的参与者（N=148）和没有（N=100）诊断为PTSD的参与者以及没有精神障碍或创伤史的健康参与者（N=28）通过23项CADSS和其他心理和神经心理学评估进行评估。进行分析以检查内部一致性，收敛效度和判别效度，要素结构，据报道，人群中的不同表现或多或少可能报告分离症状(例如，有和没有PTSD的患者)，以及对暴露于与创伤相关的视觉和声音而产生的变化的敏感性。
结果：发现23项CADSS具有较高的内部一致性（Cronbach\'salpha0.91）和单因素结构。创伤暴露的PTSD参与者的CADSS总分高于无创伤暴露的PTSD参与者和非创伤非PTSD参与者。最后,与伊拉克战斗有关的PTSD的退伍军人在接触与战斗有关的幻灯片和声音后，CADSS总分显着提高。
结论：23项CADSS，已经验证为测量与NMDA受体拮抗剂药物施用相关的解离的工具，以可靠和有效的方式评估受心理创伤的参与者的分离。
方法：有心理创伤史的参与者（N=148）和没有（N=100）诊断为PTSD的参与者以及没有精神障碍或创伤史的健康参与者（N=28）通过23项CADSS和其他心理和神经心理学评估进行评估。进行分析以检查内部一致性，收敛效度和判别效度，要素结构，据报道，人群中的不同表现或多或少可能报告分离症状(例如，有和没有PTSD的患者)，以及对暴露于与创伤相关的视觉和声音而产生的变化的敏感性。
结果：发现23项CADSS具有较高的内部一致性（Cronbach\'salpha0.91）和单因素结构。创伤暴露的PTSD参与者的CADSS总分高于无创伤暴露的PTSD参与者和非创伤非PTSD参与者。最后,与伊拉克战斗有关的PTSD的退伍军人在接触与战斗有关的幻灯片和声音后，CADSS总分显着提高。
结论：23项CADSS，已经验证为测量与NMDA受体拮抗剂药物施用相关的解离的工具，以可靠和有效的方式评估受心理创伤的参与者的分离。
