Validating a child acute stress measure in English and Spanish

描述(由申请人提供)：这项工作的广泛、长期目标是建立一种实用和经验性可靠的方法来评估潜在创伤性事件(例如，事故、火灾、灾难)后儿童的急性应激反应，并扩大我们对儿童急性创伤性应激反应的理解。简单、可获得的急性应激措施可以通过确定有创伤暴露的儿童立即面临痛苦而需要干预并指导防止长期后遗症的努力，来优化对稀缺精神卫生资源的利用。这项研究建立在美国国立卫生研究院资助的一个项目的基础上，该项目为儿童和青少年的急性应激障碍(ASD)制定了第一个简短的自我报告测量工具(儿童急性应激检查表，或ASC-Kids)，并在随后的工作中利用仪器翻译/适应方面的最佳做法创建了西班牙语版本(Reacciones Agudas Postraumaticas-menore，或RAP-M)。本研究的具体目的是评估ASC-Kids和RAP-M在英语和西班牙语儿童平行样本(各200名)中的信度和效度，检查和比较测量的因素结构，并评估不同语言版本之间潜在的差异项目功能。为了实现这些目标，过去一个月内暴露于潜在创伤事件中的儿童(8至17岁)将被招募到三个州(宾夕法尼亚州、加利福尼亚州、佛罗里达州)的医疗机构进行初步评估和两次简短的跟踪(1-7天和3个月后)。这项研究将评估这些措施的重测信度、与临床医生ASD诊断的同时效度、会聚/区分效度(焦虑/抑郁症状)和预测效度(后来的PTSD症状)。验证性因素分析将评估来自理论和经验文献的三种模型对ASD症状结构的适合性。英语和西班牙语版本之间的测量不变性将通过多样本CFA和项目功能差异的IRT分析进行检验。衡量标准之间的关联性也将在双语分样本中进行审查。该项目解决了在评估创伤和暴力造成的儿童心理健康后果以及评估讲西班牙语的儿童方面存在的一个重大差距。它将推进NIH在医疗保健环境中增加精神健康筛查的目标，尤其适用于儿童急性应激领域，因为医疗提供者是在交通事故、火灾或灾难等创伤事件后第一批为儿童看病的人之一。

DESCRIPTION (provided by applicant): The broad, long-term objectives of this work are to establish a practical and empirically-sound means to assess children's acute stress reactions after potentially traumatic events (eg, accidents, fires, disasters) and to expand our understanding of acute traumatic stress responses in children. Brief, accessible measures of acute stress can optimize use of scarce mental health resources by identifying trauma-exposed children with immediate distress that warrants intervention and guiding efforts to prevent long-term sequelae. This study builds on an NIH-funded project that developed the first brief self-report measure for acute stress disorder (ASD) in children and adolescents (the Acute Stress Checklist for Children, or ASC-Kids), and subsequent work that utilized best practices in instrument translation / adaptation to create a Spanish version (the Reacciones Agudas Postraumaticas - Menores, or RAP-M). Specific aims of the current study are to assess the reliability and validity of the ASC-Kids and RAP-M in parallel samples of English- and Spanish-speaking children (200 each), to examine and compare the factor structures of the measures, and to assess potential differential item functioning between language versions. To achieve these aims, children (8 to 17) exposed to a potentially traumatic event within the past month will be recruited in healthcare settings in three states (PA, CA, FL) for an initial assessment and two brief follow-ups (1-7 days and 3 months later). The study will evaluate the measures' test-retest reliability, concurrent validity with clinician ASD diagnosis, convergent / discriminant validity (anxiety / depression symptoms), and predictive validity (later PTSD symptoms). Confirmatory factor analyses will assess the fit of three models, derived from theory and empirical literature, for the structure of ASD symptoms. Measurement invariance between English and Spanish versions will be examined via multi-sample CFA and by IRT analyses of differential item functioning. Associations between measures will also be examined in a bilingual sub-sample. This project addresses a key gap in assessment of child mental health consequences of trauma and violence and in assessment of Spanish-speaking children. It will advance the NIH objective of increasing mental health screening in health care settings, especially appropriate in the area of child acute stress because medical providers are among the first to see children after traumatic events such as traffic crashes, fires, or disasters.