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Trauma, Posttraumatic Stress and Dissociation Among Swedish Adolescents: Evaluation of Questionnaires
Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry.
2007 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The main aim of this thesis has been to investigate trauma and dissociation among Swedish adolescents and to evaluate the psychometric properties such as reliability and various kinds

of validity of three screening instruments for assessment of dissociation and other symptoms of post traumatic stress. The three instruments in question have been Dis-Q-Sweden, A-DES and TSCC, the symptoms measured by these instruments are neither easy to capture nor easy for the adolescent to talk about. Therefore these self report scales are essential. A second aim has been to compare the results with results from other countries and to develop preliminary Swedish norms for the clinician to use. Age and gender differences have been looked upon as well as assessed symptoms connected to known experienced trauma/sexual and/or physical abuse and self-reported trauma in normal and clinical populations.

The populations, in this thesis have been children and adolescents age 10 -19 years old from the general population; the clinical groups have had the same age range. All children and adolescents in the clinical groups have been sexually and/or physically abused. Participants have answered the questionnaires Dis-Q-Sweden, A-DES and/or TSCC and their answers have been statistically analysed.

All three instruments have been shown to have good reliability, such as internal consistency and test-retest. Validity has been established through factor analyses, concurrent, and criterion related validity. Clinical groups with known experienced trauma/sexual abuse and/or physical abuse gave significantly higher scores on all the instruments compared to normative groups. Also self-reported trauma in a normative group gave significantly higher scores even if the significances are not as high as between the normative and clinical groups. Girls scored significantly higher than boys in both the clinical and normative groups. Girls in the age range 14-15 years old gave the significantly highest scores on both Dis-Q-Sweden and ADES. Swedish adolescents gave lower mean scores on all three instruments than have been reported from other studies in other countries. The scores from the clinical groups gave about the same mean as have been reported elsewhere.

The conclusion from this thesis is that all the three questionnaires Dis-Q-Sweden, A-DES and TSCC have shown satisfactory psychometrics properties and can very well be used by Swedish clinicians in Child and Adolescents Psychiatry.

Place, publisher, year, edition, pages
Institutionen för molekylär och klinisk medicin , 2007. , 61 p.
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 979
Keyword [en]
Trauma, Post traumatic stress, Dissociation, Children, Adolescents, Screening instruments
National Category
Psychiatry
Identifiers
URN: urn:nbn:se:liu:diva-8225ISBN: 978-91-85715-96-1 (print)OAI: oai:DiVA.org:liu-8225DiVA: diva2:23059
Public defence
2007-02-09, Berzeliussalen, Campus US, Linköpings Universitet, Linköping, 13:00 (English)
Opponent
Supervisors
Available from: 2007-01-31 Created: 2007-01-31 Last updated: 2009-08-20
List of papers
1. Traumatic experiences and dissociative symptoms among Swedish adolescents: A pilot study using Dis-Q-Sweden
Open this publication in new window or tab >>Traumatic experiences and dissociative symptoms among Swedish adolescents: A pilot study using Dis-Q-Sweden
2004 (English)In: Nordic Journal of Psychiatry, ISSN 0803-9488, Vol. 58, no 5, 349-355 p.Article in journal (Refereed) Published
Abstract [en]

The aim of this study was to explore the occurrence of dissociative symptoms in relation to reported traumatic experiences among adolescents. A normative sample of 216 adolescents and a clinical sample of 30 cases with a history of traumatization were given the Swedish translation of Dissociation Questionnaire, DIS-Q. The results showed that 8.8% of the adolescents reported scores above the cut-off score of 2.5 on the Dis-Q-Sweden, with a female-male ratio of 2.6:1. In the normative sample, 53 (24.5%) of the adolescents reported one or more trauma experiences. The adolescents who self-reported trauma experiences in the normative sample scored higher on the total Dis-Q-Sweden scores and on three of the four subscales compared to the adolescents with no such experiences. The clinical group exhibited significantly higher Dis-Q-Sweden scores than the normative sample on every scale, with 60% above the cut-off score. The study confirms the results from earlier studies that adolescents with a history of trauma exhibit more dissociative symptoms in this study according to Dis-Q-Sweden. The impact of trauma qualities and background factors on the development of dissociative symptoms need to be studied further.

Keyword
Adolescents, DIS-Q, Dissociation, Measurement, Trauma
National Category
Psychiatry
Identifiers
urn:nbn:se:liu:diva-14266 (URN)10.1080/08039480410005891 (DOI)
Available from: 2007-01-31 Created: 2007-01-31 Last updated: 2013-09-16
2. Evaluation of the Swedish version of Dissociation Questionnaire (DIS-Q), Dis-Q-Sweden, Among Adolescents
Open this publication in new window or tab >>Evaluation of the Swedish version of Dissociation Questionnaire (DIS-Q), Dis-Q-Sweden, Among Adolescents
2006 (English)In: Journal of Trauma & Dissociation, ISSN 1529-9732, Vol. 7, no 3, 65-89 p.Article in journal (Refereed) Published
Abstract [en]

The aim of this study was to investigate the psychometric properties of the Swedish version of the Dissociation Questionnaire in a normative adolescent population and also to investigate dissociative symptoms associated with trauma including sexual and physical abuse. A normative sample of 449 adolescents between the ages of 12 and 19 and a clinical group of 74 adolescents with known experiences of trauma, sexual and/or physical abuse was given Dis-Q-Sweden. A mixed group of 22 abused and non-abused adolescents who answered Dis-Q-Sweden was also interviewed by using the Structural Clinical Interview for DSM-IV Dissociative Disorders (SCID-D). A test-retest procedure was conducted with 90 subjects from the normative group. The results showed good reliability concerning both internal consistency and test-retest stability. Validity was tested in several ways (criterion, predictive, construct and concurrent) and found to be satisfactory. Significant differences for the total sum scores of Dis-Q-Sweden were found between the normative group and the clinical group with known sexual abuse (p < 0.001). The prevalence of dissociative symptoms (cut-off score > 2.5) was 2.3% in the normative group and 50% in the clinical group. Dis-Q-Sweden has proven to be a screening instrument with good psychometric properties and has proven to be able to capture dissociative symptoms in adolescents with self-reported trauma and known trauma (sexual abuse).

Keyword
Dis-Q-Sweden; method; dissociation; adolescents; trauma
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-14267 (URN)10.1300/J229v07n03_05 (DOI)
Available from: 2007-01-31 Created: 2007-01-31
3. Dissociation among Swedish Adolescents and the connection to trauma: An Evaluation of the Swedish version of Adolescent Dissociative Experience Scale
Open this publication in new window or tab >>Dissociation among Swedish Adolescents and the connection to trauma: An Evaluation of the Swedish version of Adolescent Dissociative Experience Scale
2006 (English)In: Journal of Nervous and Mental Disease, ISSN 0022-3018, Vol. 194, no 9, 684-689 p.Article in journal (Refereed) Published
Abstract [en]

The purpose of this study was to investigate the psychometric properties of the Swedish version of Adolescent Dissociative Experience Scale (A-DES), dissociative symptoms among Swedish adolescents, and dissociative symptoms connected to trauma and sexual and physical abuse. A normative group of 400 adolescents aged 12 to 19 years and a clinical group of 20 adolescents with known experienced trauma were given A-DES. A test-retest procedure was conducted with 90 subjects from the normative group. The results showed good reliability, internal consistency and test-retest. Factor analysis in the normative sample (N = 400) resulted in a one factor solution. Correlation between A-DES and other measures of dissociation was high (r = .86). Significant differences for the total sum of A-DES were found in the normative group between adolescents with and without self-reported trauma and between the normative group and the clinical group with known experienced trauma. The Swedish version of A-DES was shown to be a screening instrument with satisfactory psychometric qualities and the capability of capturing dissociative symptoms in adolescents with self-reported trauma as well as clinical cases with identified trauma.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-14268 (URN)10.1097/01.nmd.0000235774.08690.dc (DOI)
Available from: 2007-01-31 Created: 2007-01-31
4. The psychometric properties of the Trauma Symptom Checklist for Children (TSCC) in a sample of Swedish Children
Open this publication in new window or tab >>The psychometric properties of the Trauma Symptom Checklist for Children (TSCC) in a sample of Swedish Children
Manuscript (Other academic)
Identifiers
urn:nbn:se:liu:diva-14269 (URN)
Available from: 2007-01-31 Created: 2007-01-31 Last updated: 2010-01-13

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