Background: High levels of post-traumatic stress are well documented among refugees. Yet, refugee adolescents display high heterogeneity in their type of trauma and symptom levels.Objective: Following the recurrent plea for validated trauma screening tools, this study investigated the psychometric properties of the Children\'s Revised Impact of Event Scale (CRIES-8) among refugee adolescents from Afghanistan (n = 148), Syria (n = 234), and Somalia (n = 175) living in Europe.Method: The model fit for the confirmatory factor structures was tested, as well as measurement invariance between the three groups. The robustness of results was evaluated by testing measurement invariance between recently arrived and settled adolescents, and between different response labelling options. Reliability (α, ω, and ordinal α), criterion validity, and prevalence estimates were calculated.Results: The intrusion subscale showed a better stable model fit than the avoidance subscale, but the two-factor structure was mainly supported. Configural measurement invariance was achieved between Afghan and Somali adolescents, and strong measurement invariance between Syrian and Somali adolescents. The results were robust considering the time living in the host country and response labelling styles. Reliability was low among Afghan and Syrian adolescents (.717-.856), whereas it was higher among Somali adolescents (.831-.887). The total score had medium-sized correlations with emotional problems (.303-.418) and low correlations with hyperactivity (.077-.155). There were statistically significant differences in symptom prevalence: Afghan adolescents had higher prevalence (55.5%) than Syrian (42.8%) and Somali (37%) adolescents, and unaccompanied refugee minors had higher symptom prevalence (63.5%) than accompanied adolescents (40.7%).Conclusions: This study mostly supports the use of the CRIES-8 among adolescents from Afghanistan, Syria, and Somalia, and even comparative analyses of group means. Variation in reliability estimates, however, makes diagnostic predictions difficult, as the risk of misclassification is high.
We investigated the psychometric properties of the 8-item Children’s Revised Impact of Event Scale (CRIES-8) among refugee adolescents from Afghanistan, Syria, and Somalia living in Europe.We found support for the CRIES-8 as a suitable assessment tool for Afghan, Syrian, and Somali adolescents.The reliability of the CRIES-8 was low among Afghan and Syrian adolescents, whereas among Somali adolescents, reliability was higher.

Background: In attempts to elucidate PTSD, recent factor analytic studies resulted in complex models with a proliferating number of factors that lack psychometrical and clinical utility. Recently, suggestions have been made to optimize factor analytic practices to meet a refined set of statistical and psychometric criteria.Objective: This study aims to assess the factorial structure of the German version of the PCL-5, implementing recent methodological advancements to address the risk of overfitting models. In doing so we diverge from traditional factor analytical research on PTSD.Method: On a large-scale sample of the German general population (n = 1625), exploratory factor analyses were run to investigate the dimensionality found within the data. Subsequently, we validated and compared all model suggestions from our preliminary analyses plus all standard and common alternative PTSD factor models (including the ICD-11 model) from previous literature with confirmatory factor analyses. We not only consider model fit indices based on WLSMV estimation but also deploy criteria such as favouring less complex models with a parsimonious number of factors, sufficient items per factor, low inter-factor correlations and number of model misspecifications.Results: All tested models showed adequate to excellent fit in respect to traditional model fit indices; however, models with two or more factors increasingly failed to meet other statistical and psychometric criteria.Conclusion: Based on the results we favour a two-factor bifactor model with a strong general PTSD factor and two less dominant specific factors - one factor with trauma-related symptoms (re-experiencing and avoidance) and one factor with global psychological symptoms (describing the trauma\'s higher-order impact on mood, cognition, behaviour and arousal).From the perspective of clinical utility, we recommend the cut-off scoring method for the German version of the PCL-5. Basic psychometric properties and scale characteristics are provided.
We contribute new insights to the debate on the factor structure of the PTSD Checklist (PCL-5) based on a large German general population sample deploying the newest methodological developments in a revised factor-analytical approach.Combining theoretical, statistical and practical considerations, we favour a two-factor bifactor model with a strong general PTSD factor and two less dominant specific factors – one factor with trauma-related symptoms and one factor with global psychological symptoms.For clinical practitioners, we recommend using the cut-off scoring method.

Background: The Posttraumatic Growth Inventory (PTGI) and its Short Form (PTGI-SF) are two instruments highly used in research on posttraumatic growth. They include a religious growth item that has been demonstrated to be problematic in cultures that are not very religious. Previous research has addressed this issue in other countries, but no attention has been paid to this critical problem in Spanish samples.Objective: Our aim is to address the psychometric issues presented by the religious growth item in Spain.Method: To do so, we reviewed several studies conducted with various populations in Spain.Results: The scores of the religious growth item in Spain present very low means and standard deviations, as well as high skewness and kurtosis, all of which point to a floor effect. The item scores show low item-test correlations, and it has failed to load on a specific dimension in factor analyses, thus casting doubts about its validity.Conclusions: The inventory does not seem to work properly in its current form in Spain. The inappropriateness of the item measuring religious growth in Spain may be due to cultural reasons. We recommend using the PTGI expanded version (PTGI-X) instead of the PTGI and exploring the possible substitution of the religious growth item in the PTGI-SF for an alternative item. In both cases, ascertaining the psychometric properties of the scores in Spain will be necessary.
The religious growth item in the PTGI and the PTGI-SF show serious psychometric validity issues in Spain. The PTGI Expanded version (PTGI-X) should be used instead of the PTGI in Spain. For the PTGI-SF, the religious item needs to be substituted.

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.

To evaluate functional state, it is fundamental to have simple instruments that allow for monitoring the course of symptoms and the commitment of the functional status that adult COVID-19 survivors may present. This study aims to evaluate the psychometric properties of the Post COVID-19 Functional Status (PCFS) scale.
A cross-sectional scale validation study was performed. In the content validation 22-health professionals, whom through expert judgment evaluated the scale in the sufficiency, clarity, coherence and relevance categories. In addition, two professionals performed the retest with 20 people who had been infected with COVID-19. In addition, their observations and comments are revealed. The degree of agreement amongst the experts was determined with the Kendall coefficient. For the retest test, the Spearman coefficient was utilized. In all the analyzes, a P value of <.05 was considered.
In regards to the content validity, there was agreement between raters only for the relevance category (P=.032). A strong agreement was obtained between two evaluators (Spearman\'s Rho=.929 for the score). Some of the content terms were adjusted without affecting the general structure of the scale. Of the original 16 items that make up the PCFS scale, none was eliminated.
The Spanish version of the PCFS (Chile) was adapted to the cultural context of the country, shows good psychometric characteristics in terms of reliability.

BACKGROUND: Most people with persistent tics report an unpleasant sensation (premonitory urge) before the tic. In recent years, interest in these sensory phenomena has increased due to their important role in behavioural therapy. However, instruments for assessing these sensations remain scarce. Among the available instruments, the Premonitory Urge for Tics Scale (PUTS) is the most widely used.
METHODS: We examined the psychometric properties and factor structure of the Spanish-language version of the PUTS in a sample of 72 children and adolescents with Tourette syndrome or persistent tic disorders. We analysed data from the total sample and by age group (children up to 10 years old and children/adolescents over 10).
RESULTS: The PUTS presented good internal consistency and moderate correlations between items on the scale (except for item one). Divergent validity was good, test-retest reliability was adequate, and a bifactorial structure was identified (one dimension related to mental phenomena reported in obsessive-compulsive disorder, and another related to the quality and frequency of premonitory urges). These results were replicated in both age groups, with lower divergent validity and test-retest reliability in the younger group.
CONCLUSIONS: The Spanish-language version of the PUTS is a valid, reliable tool for assessing premonitory urges in both children and adolescents, especially after the age of 10.

BACKGROUND: Psychological pain is understood as an intolerable and disturbing mental state characterized by an internal experience of negative emotions. This study was aimed at making a Spanish adaptation of the Psychache Scale by Holden and colleagues in a sample of young adults.
METHODS: The scale evaluates psychological pain as a subjective experience. It is composed of 13 items with a Likert-type response format. Following the guidelines of the International Tests Commission for the adaptation of the test, we obtained a version conceptually and linguistically equivalent to the original scale. Through an online questionnaire, participants completed the psychological pain scale along with other scales to measure depression (BDI-II), hopelessness (Beck\'s scale of hopelessness) and suicide risk (Plutchik suicide risk scale). The participants were 234 people (94 men, 137 women and three people who identified as a different sex) from 18 to 35 years old.
RESULTS: The EFA showed a one-factor solution, and the FCA revealed adequate indexes of adjustment to the unifactorial model. It also showed good reliability of the test scores. The evidence of validity of the scale in relation to the other variables showed high, positive and statistically significant correlations with depression, hopelessness, suicidal ideation and suicidal risk.
CONCLUSIONS: In summary, this Spanish adaptation of the Psychache Scale could contribute to improving the evaluation of both the patient with suicide risk and the effectiveness of psychological therapy, as well as suicidal behaviour prevention and intervention.

BACKGROUND: Although several tools have been developed to assess general HRQoL in children, parental reports are required to supplement this information, especially in very young children. The parents version of the Kiddy-KINDL-R was developed to assess HRQoL in children aged 3 to 7 years through the reports of their parents or legal guardians.
OBJECTIVE: The aim of this study was to validate the parents version of the Kiddy-KINDL-R questionnaire and assess its psychometric properties in a sample of Spanish preschool-aged children.
METHODS: Cross-sectional study in 283 parents or legal guardians of children aged 3 to 6 years that completed the Kiddy-KINDL-R questionnaire and an additional scale to assess anxiety problems. We performed confirmatory factor analysis to assess whether the original Kiddy-KINDL-R version fit the Spanish data; we assessed internal consistency by means of the ordinal alpha and the discriminant validity by means of the Preschool Anxiety Scale.
RESULTS: Although the original six-factor model showed a good fit, we propose a model consisting of 22 items and the same 6 factors for the Spanish version. The reliability was excellent, and the internal consistency values were adequate. Our results showed significant negative correlations between the Kiddy-KINDL-R and the external anxiety measure, which was evidence of discriminant validity.
CONCLUSIONS: We demonstrated that the Spanish version of the Kiddy-KINDL-R had good psychometric properties and that this questionnaire is an adequate assessment tool that could be useful in clinical practice.

BACKGROUND: Negative symptoms are prevalent in schizophrenia and associated with a poorer outcome. Validated newer psychometric instruments could contribute to better assessment and improved treatment of negative symptoms. The Negative Symptom Assessment-16 (NSA-16) has been shown to have strong psychometric properties, but there is a need for validation in non-English languages. This study aimed to examine the psychometric properties of a Spanish version of the NSA-16 (Sp-NSA-16).
METHODS: Observational, cross-sectional validation study in a sample of 123 outpatients with schizophrenia.
METHODS: NSA-16, PANSS, HDRS, CGI-SCH and PSP.
RESULTS: The results indicate appropriate psychometric properties, high internal consistency (Cronbach\'s alpha=0.86), convergent validity (PANSS negative scale, PANSS Marder Negative Factor and CGI-negative symptoms r values between 0.81 and 0.94) and divergent validity (PANSS positive scale and the HDRS r values between 0.10 and 0.34). In addition, the NSA-16 also exhibited discriminant validity (ROC curve=0.97, 95% CI=0.94 to 1.00; 94.3% sensitivity and 83.3% specificity).
CONCLUSIONS: The Sp-NSA-16 is reliable and valid for measuring negative symptoms in patients with schizophrenia. This provides Spanish clinicians with a new tool for clinical practice and research. However, it is necessary to provide further information about its inter-rater reliability.

OBJECTIVE: To examine the psychometric properties of a Spanish version of the C-SSRS (Sp-CSSRS).
METHODS: Data are from a naturalistic, cross-sectional, multicentre, validation study, including 467 psychiatric outpatients, 242 of whom had a history of suicide attempt. The study measures were: C-SSRS; the Hamilton Depression Rating Scale (HDRS); the Beck Suicide Intent Scale; the Medical Damage Scale.
RESULTS: Construct validity: Pearson coefficient between the C-SSRS severity (C-Sev) and intensity (C-Int) of ideation subscale scores was 0.44 (P<.000) for the total sample. Likewise, Pearson coefficient between C-Sev score and HDRS item 3 was 0.56 (P<.000). For the sub-sample of patients with suicide attempt, significant Pearson correlations were found between the C-Sev and the Beck Suicide Intent Scale scores (r=0.22; P=.001). Discriminant validity: Significant differences were found in C-Sev and C-Int scores between patients with and without suicide attempt (P<.000). The C-Sev score discriminated between patients based on HDRS item 3 (P<.009). Sensitivity to change: Linear regression showed that a one-unit decrease in HDRS item 3 corresponded to a decrease of 5.08 units in the C-Sev score (P=.141). A one-unit change in HDRS item 3 corresponded to a change of 13.51 on the C-Int assessments (P=.007). Cronbach\'s alpha was 0.53 for C-Int. The principal component analysis identified 2 components that explain 55.66% of the total variance (C-Int).
CONCLUSIONS: The data support that the Sp-C-SSRS is a reliable and valid instrument for assessing suicidal ideation and behaviour in daily clinical practice and research settings.