Traumatic brain injury (TBI) is frequently associated with neuropsychiatric impairments such as symptoms of post-traumatic stress disorder (PTSD), which can be screened using self-report instruments such as the Post-Traumatic Stress Disorder Checklist for DSM-5 (PCL-5). The current study aims to inspect the factorial validity and cross-linguistic equivalence of the PCL-5 in individuals after TBI with differential severity. Data for six language groups (n ≥ 200; Dutch, English, Finnish, Italian, Norwegian, Spanish) were extracted from the CENTER-TBI study database. Factorial validity of PTSD was evaluated using confirmatory factor analyses (CFA), and compared between four concurrent structural models. A multi-group CFA approach was utilized to investigate the measurement invariance (MI) of the PCL-5 across languages. All structural models showed satisfactory goodness-of-fit with small between-model variation. The original DSM-5 model for PTSD provided solid evidence of MI across the language groups. The current study underlines the validity of the clinical DSM-5 conceptualization of PTSD and demonstrates the comparability of PCL-5 symptom scores between language versions in individuals after TBI. Future studies should apply MI methods to other sociodemographic (e.g., age, gender) and injury-related (e.g., TBI severity) characteristics to improve the monitoring and clinical care of individuals suffering from PTSD symptoms after TBI.
Bibliographical noteFunding Information:
Open Access funding enabled and organized by Projekt DEAL. CENTER-TBI was supported by the European Union 7th Framework programme (EC Grant 602150). Additional funding was obtained from the Hannelore Kohl Stiftung (Germany), from OneMind (USA), and from Integra LifeSciences Corporation (USA). The funders of the study had no role in study design, data collection, data analysis, data interpretation, or writing of the report.
All the analyses in the present investigation utilized data from the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) project, supported by the European Union (EU) Framework 7 program (EC grant 602,150; clinicaltrials.gov NCT02210221). This prospective observational cohort study aimed to improve the characterization and clinical care of subjects after TBI. Data was sampled from the CENTER-TBI core study which comprises information on 4509 individuals who participated at 63 institutional sites across 18 countries between December 2014 and December 2017. The inclusion criteria for participation were a clinical diagnosis of TBI, indication for a computed tomography (CT) scan and presentation to the study center within 24 h post injury. Individuals with severe pre-existing neurological disorders (e.g., epilepsy, cerebrovascular accident) were excluded.
© 2022, The Author(s).