Introduction
Methods
Part 1 translation content validation and pilot testing
Translation and cross-cultural adaptation process
Pilot testing
Part 2 epidemiological survey
Participants and procedure
Instruments
Statistical analyses
Reliability and validity
Screening accuracy
Results
Part 1
Reliability and content validity of the GPS: pilot study
Part 2
Sample characteristics
Variables | Women (n = 356) N (%) | Men (n = 359) N (%) |
---|---|---|
Age (years); mean (SD) | 35.01 (9.22) | 36.42 (11.84) |
Marital status | ||
Single | 103 (38.87) | 162 (61.13) |
Married | 227 (54.05) | 193 (45.95) |
Widow/ Divorced | 26 (92.86) | 2 (7.14) |
Highest level of education | ||
Primary school | 101 (60.12) | 67 (39.88) |
Diploma | 128 (47.06) | 144 (52.94) |
Associate degree | 38 (49.35) | 39 (50.65) |
Bachelor degree | 75 (48.70) | 79 (51.30) |
Master's degree and higher | 13 (30.95) | 29 (69.05) |
Job Title | ||
Housekeeper | 214 (100.0) | 0 (0) |
Self-employed | 60 (21.66) | 217 (78.34) |
Government or private employee | 24 (33.33) | 48 (66.67) |
Retired | 5 (16.67) | 25 (83.33) |
Unemployed | 50 (43.48) | 65 (56.52) |
History of chronic disease | ||
Yes | 30 (43.48) | 39 (56.52) |
No | 325 (50.47) | 319 (49.53) |
Smoke at least 100 cigarettes in lifetime | ||
Yes | 20 (11.76) | 150 (88.24) |
No | 336 (61.65) | 209 (38.35) |
Current Smoking | ||
Yes, daily | 11 (11.70) | 83 (88.30) |
Yes, sometimes | 14 (20.59) | 54 (79.41) |
No | 331 (59.86) | 222 (40.14) |
Prevalence of traumatic events
Trauma Type | N (%) |
---|---|
Natural disaster (for example, flood, hurricane, tornado, earthquake) | 231 (32.31) |
Transportation accident | 28 (3.92) |
Physical assault (e.g., being attacked, hit, slapped, kicked, beaten up) | 2 (0.28) |
Sexual assault (e.g., rape, attempted rape, made to perform any type of sexual act through force or threat of harm) | 5 (0.70) |
Combat or exposure to a war zone (in the military or as a civilian) | 6 (0.84) |
Captivity (e.g., being kidnaped, abducted, held hostage, prisoner of war) | 2 (0.28) |
Life-threatening illness or injury | 65 (9.09) |
Severe human suffering | 104 (14.55) |
Sudden violent death (e.g., homicide, suicide) | 2 (0.28) |
Sudden accidental death | 107 (14.97) |
Any other very stressful event or experience | 139 (19.44) |
No response to the question | 24 (3.36) |
GPS, PCL-5 and GHQ scores
Variables | Women N (%) | Men N (%) | P-value* | Cohen's d Effect size |
---|---|---|---|---|
PTSD; Mean (SD) | 2.77 (1.61) | 2.56 (1.47) | 0.21 | -.13 |
DSO; Mean (SD) | 0.97 (0.80) | 0.88 (0.75) | 0.22 | -.12 |
Complex PTSD; Mean (SD) | 3.73 (2.16) | 3.42 (1.94) | 0.16 | -.14 |
Anxiety; Mean (SD) | 1.45 (0.73) | 1.32 (0.78) | 0.13 | -.16 |
Depression; Mean (SD) | 1.33 (0.77) | 1.29 (0.75) | 0.46 | -.05 |
Sleep Problems (Yes) | 176 (51.46) | 166 (48.54) | 0.53 | -.06 |
Self-Harm (Yes) | 56 (43.75) | 72 (56.25) | 0.22 | -.12 |
Dissociation; Mean (SD) | 0.44 (0.71) | 0.59 (0.77) | 0.65 | .20 |
Substance abuse (Yes) | 59 (27.83) | 153 (72.17) | 0.013 | .60 |
Resilience (Yes) | 275 (48.76) | 289 (51.24) | 0.28 | .08 |
GPS Total Score; Mean (SD) | 10.78 (4.71) | 10.94 (4.57) | 0.69 | .03 |
GPS-Sym; Mean (SD) | 8.39 (4.15) | 8.38 (3.99) | 0.98 | -.001 |
RP-Factor; Mean (SD) | 1.84 (1.23) | 1.94 (1.18) | 0.26 | .08 |
GHQ; Mean (SD) | 26.12 (10.64) | 24.81 (10.16) | 0.09 | -.13 |
PCL; Mean (SD) | 29.90 (16.51) | 28.45 (15.97) | 0.23 | -.09 |
Exploratory factor analysis
Item | Negative Affect | Dissociation | Core-PTSD |
---|---|---|---|
Sometimes things happen to people that are unusually or especially frightening, horrible, or traumatic. In the past month, have you… | |||
had nightmares about the past traumatic life event(s) you have experienced or thought about the event(s) when you did not want to? | 0.28 | ||
tried hard not to think about past traumatic life event(s) or went out of your way to avoid situations that reminded you of the event(s)? | 0.48 | ||
been constantly on guard, watchful, or easily startled? | 0.50 | ||
felt numb or detached from people, activities, or your surroundings? | 0.48 | ||
felt guilty or unable to stop blaming yourself or others for past traumatic life event(s) or any problems the event(s) caused? | 0.52 | ||
tended to feel worthless? | 0.64 | ||
experienced angry outbursts that you could not control? | 0.77 | ||
been feeling nervous, anxious, or on edge? | 0.88 | ||
been unable to stop or control worrying? | 0.74 | ||
been feeling down, depressed, or hopeless? | 0.88 | ||
been experiencing little interest or pleasure in doing things? | 0.43 | ||
had any problems falling or staying asleep? | 0.22 | ||
tried to intentionally hurt yourself? | 0.27 | ||
perceived or experienced the world or other people differently, so that things seem dreamlike, strange or unreal? | 0.40 | ||
felt detached or separated from your body (for example, feeling like you are looking down on yourself from above, or like you are an outside observer of your own body)? | 0.55 | ||
had any other physical, emotional or social problems that bothered you? | 0.63 | ||
tried to reduce tensions by using alcohol, tobacco, drugs or medication? | 0.22 |
Confirmatory factor analysis
Reliability
Corrected Item-Total Correlation | |
---|---|
had nightmares about the past traumatic life event(s) you have experienced or thought about the event(s) when you did not want to? | .52 |
tried hard not to think about past traumatic life event(s) or went out of your way to avoid situations that reminded you of the event(s)? | .29 |
been constantly on guard, watchful, or easily startled? | .37 |
felt numb or detached from people, activities, or your surroundings? | .43 |
felt guilty or unable to stop blaming yourself or others for past traumatic life event(s) or any problems the event(s) caused? | .47 |
tended to feel worthless? | .49 |
experienced angry outbursts that you could not control? | .48 |
been feeling nervous, anxious, or on edge? | .49 |
been unable to stop or control worrying? | .47 |
been feeling down, depressed, or hopeless? | .58 |
been experiencing little interest or pleasure in doing things? | .33 |
had any problems falling or staying asleep? | .44 |
tried to intentionally hurt yourself? | .34 |
perceived or experienced the world or other people differently, so that things seem dreamlike, strange or unreal? | .37 |
felt detached or separated from your body (e.g., feeling like you are looking down on yourself from above, or like you are an outside observer of your own body)? | .34 |
had any other physical, emotional or social problems that bothered you? | .42 |
tried to reduce tensions by using alcohol, tobacco, drugs or medication? | .23 |
Convergent validity
GPS Total | GPS-Sym | RP-Factor | PTSD | DSO | Complex PTSD | Anxiety | Depression | Sleep problems | Self-harm behaviour | Dissociation | Substance abuse | Resilience | |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Total PCL-5 | 0.63*** | 0.64*** | 0.38*** | 0.58*** | 0.54*** | 0.61** | 0.39*** | 0.39*** | 0.33*** | 0.26*** | 0.30*** | 0.15*** | -0.19*** |
Intrusions | 0.44** | .45** | .25** | .45** | .35** | .47** | .28** | .26** | .28** | .16** | .17** | .02 | -.09* |
Avoidance | 0.26** | .26** | .25** | .29** | .19** | .19** | .19** | .15** | .07 | .12** | .10** | -.01 | -.02 |
Negative Alterations in Cognitions and Mood | 0.54** | .56** | .32** | .51** | .48** | .56** | .35** | .35** | .24** | .21** | .27** | .13** | -.19** |
Hyperarousal | 0.52** | .52** | .34** | .45** | .42** | .49** | .32** | .32** | .28** | .22** | .26** | .14** | -.17** |
Total GHQ | 0.56*** | 0.59*** | 0.30** | 0.50*** | 0.47*** | 0.55*** | 0.36*** | 0.33*** | 0.37*** | 0.31*** | 0.31*** | 0.18*** | -0.19*** |
Somatic Symptoms | .48** | .50** | .32** | .42** | .38** | .45** | .30** | .31** | .29** | .27** | .26** | .15** | -.21** |
Anxiety and Insomnia | .63** | .66** | .34** | .57** | .55** | .63** | .43** | .37** | .44** | .38** | .29** | .17** | -.22** |
Social Dysfunction | -.17** | -.19** | -.19** | -.13** | -.19** | -.17** | -.15** | -.12** | -.09* | -.13** | -.02 | -.03 | .22** |
Severe Depression | .55** | .59** | .35** | .47** | .50** | .54** | .37** | .33** | .31** | .41** | .38** | .18** | -.32** |
Screening accuracy
GPS-Sym Cut-off | Sensitivity | Specificity |
---|---|---|
% | % | |
> = 0 | 100.00% | 0.00% |
> = 1 | 99.68% | 6.00% |
> = 2 | 99.04% | 10.75% |
> = 3 | 98.72% | 18.00% |
> = 4 | 97.76% | 23.75% |
> = 5 | 96.17% | 30.25% |
> = 6 | 95.21% | 41.00% |
> = 7 | 93.61% | 51.25% |
> = 8 | 86.90% | 61.00% |
> = 9 | 78.59% | 68.50% |
> = 10 | 68.05% | 76.75% |
> = 11 | 58.15% | 83.75% |
> = 12 | 44.73% | 90.25% |
> = 13 | 30.03% | 95.25% |
> = 14 | 18.85% | 97.75% |
> = 15 | 10.54% | 99.00% |
> = 16 | 5.43% | 99.50% |
> = 17 | 1.60% | 100% |
> 17 | 0.00% | 100% |