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的、经验合理的方法来评估儿童在潜在创伤事件（如事故、火灾、灾难）后的急性应激反应，并扩大我们对儿童急性创伤应激反应的理解。简单、可获得的急性应激措施可以通过识别暴露于创伤的儿童，确定需要干预的即时痛苦，并指导努力预防长期后遗症，从而优化利用稀缺的精神卫生资源。本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，该项目开发了儿童和青少年急性应激障碍（ASD）的第一个简短自我报告测量（儿童急性应激检查表，或ASC-Kids），随后的工作利用工具翻译/改编的最佳实践创建了西班牙语版本（Reacciones Agudas Postraumaticas - Menores，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（各200人）的平行样本中的信度和效度，检查和比较测量的因素结构，并评估语言版本之间潜在的差异项目功能。为了实现这些目标，将在三个州（PA， CA， FL）的医疗机构招募过去一个月内暴露于潜在创伤性事件的儿童（8至17岁）进行初步评估和两次简短随访（1-7天和3个月后）。本研究将评估量表的重测信度、与临床ASD诊断的同步效度、收敛效度/区别效度（焦虑/抑郁症状）和预测效度（后期PTSD症状）。验证性因素分析将评估从理论和实证文献中得出的ASD症状结构的三个模型的拟合性。英语和西班牙语版本之间的测量不变性将通过多样本CFA和差异项目功能的IRT分析来检验。还将在双语子样本中审查各项措施之间的联系。该项目填补了在评估创伤和暴力对儿童心理健康的影响以及评估讲西班牙语儿童方面的一个关键空白。它将推进NIH在卫生保健机构中增加心理健康筛查的目标，特别是在儿童急性压力领域，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看到儿童的人。

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.