nach oben

Psychiatric Quarterly

Erschienen in:

01.02.2020 | Original Paper

Validation of the Extreme Experiences Scale (EX²) for Armed Conflict Contexts

verfasst von: L. S. Giraldo, D. C. Aguirre-Acevedo, S. Trujillo, J. E. Ugarriza, N. Trujillo

Erschienen in: Psychiatric Quarterly | Ausgabe 2/2020

Einloggen, um Zugang zu erhalten

Abstract

Psychological approaches to the study of armed conflict have focused on analyzing post-traumatic stress outcomes, and on evaluating the intensity of exposure to violent confrontation. Nevertheless, psychometrically valid tools required for measuring these traumatic experiences are scarce To validate the Extreme Experiences scale (EX²) for armed conflict contexts for its use in Colombia, and to provide a framework for validation in conflict contexts around the world This Cross-sectional aims to validate the scale with 187 participants, study of validate with 187 participants, comprising population with high exposure to conflict (former combatants and a set of armed conflict victims) and low conflict-exposed individuals (control group). Structures of two domains and 18 items were confirmed: Direct Extreme Experiences (dEX²) and Indirect Extreme Experiences (iEX²); these dimensions were also validated by expert judgment, producing 14-item version. Good levels of internal consistency were found, with a KR-20 of 0.80 for the 18-item version, and 0.77 for the 14-item. The scale differentiates between population with ‘high exposure to conflict’ from population with ‘low exposure’ (d_np > 0.5 and area under the ROC >0.90). The scale scores have significant correlation with some mental health constructs. The EX² scale has good internal consistency, as well as structural validity with regard to exposed groups. This scale can be potentially validated for its use in countries with armed confrontation history. In future versions, the scale may include additional items in order to improve content validity.

Nur mit Berechtigung zugänglich

The ECAE scale has not been validated, its original authors have used it as a screening test to identify extreme experiences and subsequently with the VIVO instrument (Ontological Vital Impact Assessment) identify strategies and the ability of people to cope to difficult experiences in order to deepen the vital impact of extreme. The instrument can be found on the following page: http://www.psicosocial.info/cuestionario/cuestionario.php

CERAC - Conflict Analysis Resource Center. Data on the armed conflict in Colombia, 2017: http://www.cerac.org.co/es/recursos/datosconflictoscolombia/

Updated figures are available at https://cifras.unidadvictimas.gov.co/.

The National Historical Memory Commission, for instance, suggests the systematic measure of the following categories: 1) displacement of population; 2) land eviction; 3) kidnapping; 4) extortion; 5) illicit recruitment of children; 6) torture; 7) homicide of protected persons, selective assassination, and massacre; 8) threats; 9) crimes against freedom and sexual integrity; 10) forced disappearance; 11) antipersonnel mines, unexploded munitions, and improvised explosive devices; 12) attacks on and losses of civil property; and 13) attacks on public property.

Ávila-Toscano J, Cogollo Ferraro L. Motivos asociados a la conducta violenta contra la pareja en hombres desmovilizados del conflicto armado. Investig Desarro. 2011;19(1):88–115.

Blake D, Weathers F, Nagy L, Kaloupek D, Klauminzer G, Charney D. A clinical rating scale for assessing current and lifetime PTSD: the CAPS-1. Behav Ther. 1990;13:187–8.

Bonett DG. Sample size requirements for testing and estimating coefficient alpha. J Educ Behav Stat. 2002;27(4):335–40. https://doi.org/10.3102/10769986027004335.CrossRef

Bonett D, Wrigth T. Sample size requirements for estimating pearson, kendall and spearman correlations. Psychometrika. 2000:23–8.

Braun-Lewensohn O, Celestin-Westreich S, Celestin LP, Verleye G, Verte D, Ponjaert-Kristoffersen I. Coping styles as moderating the relationships between terrorist attacks and well-being outcomes. J Adolesc. 2009;32(3):585–99. https://doi.org/10.1016/j.adolescence.2008.06.003.CrossRefPubMed

Browne MW. An overview of analytic rotation in exploratory factor analysis. Multivar Behav Res. 2001;36(1):111–50. https://doi.org/10.1207/S15327906MBR3601_05.CrossRef

Brück T, Justino P, Verwimp P, Tedesco A. Measuring conflict exposure in micro-level surveys. Washington, DC: World Bank Group; 2013.

Brugha T, Bebbington P, Tennant C, Hurry J. The list of threatening experiences: a subset of 12 life event categories with considerable long-term contextual threat. Psychol Med. 1985;15(1):189–94. https://doi.org/10.1017/S003329170002105X.CrossRefPubMed

Campo-Arias A, Sanabria AR, Ospino A, Guerra VM, Caamaño H. Multiple-victimization due to armed conflict and emotional distress in the state of Magdalena, Colombia. Rev Colomb Psiquiatr. 2017;46(3):147–53. https://doi.org/10.1016/j.rcpeng.2016.06.002.CrossRefPubMed

10.

Cederman LE, Weidmann NB. Predicting armed conflict: time to adjust our expectations? Science. 2017;355(6324):474–6. https://doi.org/10.1126/science.aal4483.CrossRefPubMed

11.

Colombia and Programa Presidencial de los derechos humanos. Atlas del impacto regional del conflicto armado en Colombia: Dinámicas locales y regionales en el período 1990-2013. Imprenta Nacional de Colombia, 2013; 1.

12.

Colombia, Instituto Nacional de Salud (INS)., & Observatorio Nacional de Salud (ONS). Consecuencias del conflicto armado en salud en Colombia: Informe técnico 9 / 2017. 2017;9, 340, Colombia. Informe.

13.

Curtis A, Ye X, Hachey K, Bourdeaux M, Norris A. A space–time analysis of the WikiLeaks afghan war diary: a resource for analyzing the conflict-health nexus. Int J Health Geogr. 2015;14(1):29. https://doi.org/10.1186/s12942-015-0022-8.CrossRefPubMedPubMedCentral

14.

Davidson JR, Book SW, Colket JT, Tupler LA, Roth S, David D, et al. Assessment of a new self-rating scale for post-traumatic stress disorder. Psychol Med. 1997;27(1):153–60. https://doi.org/10.1017/S0033291796004229.CrossRefPubMed

15.

de Vet, H., Terwee, C. B., Mokkink, L. B., & Knol, D. L. Measurement in medicine: a practical guide. Cambridge University Press, 2011; https://doi.org/10.1017/CBO9780511996214.

16.

Díaz-Granados ETA. Traumas asociados a violencia en excombatientes de grupos armados ilegales. Rev Psicol Univ Antioquia. 2015;7(1):21–34.

17.

Eiroa F. Creación de un perfil de creencias básicas en afectados por accidentes de tráfico. Tesis doctoral Procesos Sociocognitivos en Psicología Social. Madrid: Universidad Nacional de Educación; 2009.

18.

Escrivá VM, Navarro MD, Samper P. La medida de la empatía: análisis del Interpersonal Reactivity Index. Psicothema. 2004;16(2):255–60.

19.

Fritz CO, Morris PE, Richler JJ. Effect size estimates: current use, calculations, and interpretation. J Exp Psychol Gen. 2012;141(1):2–18. https://doi.org/10.1037/a0024338.CrossRefPubMed

20.

Gallaway MS, Fink DS, Millikan AM, Bell MR. Factors associated with physical aggression among US Army soldiers. Aggress Behav. 2012;38(5):357–67. https://doi.org/10.1002/ab.21436.CrossRefPubMed

21.

Garcia-Barrera MA, Karr JE, Trujillo-Orrego N, Trujillo-Orrego S, Pineda DA. Evaluating empathy in Colombian ex-combatants: examination of the internal structure of the interpersonal reactivity index (IRI) in Spanish. Psychol Assess. 2017;29(1):116–22. https://doi.org/10.1037/pas0000331.CrossRefPubMed

22.

Gómez-Restrepo C, Tamayo-Martínez N, Buitrago G, Guarnizo-Herreño C, Garzón-Orjuela N, Eslava-Schmalbach J, et al. Violencia por conflicto armado y prevalencia de trastornos del estado de ánimo, ansiedad y problemas mentales en la población adulta colombiana. Rev Colomb Psiquiatr. 2016;45(Suppl 1):147–53. https://doi.org/10.1016/j.rcp.2016.11.001.CrossRefPubMed

23.

Gómez-Restrepo C, Cruz-Ramírez V, Medina-Rico M, Rincón CJ. Mental health in displaced children by armed conflict-National Mental Health Survey Colombia 2015. Actas Esp Psiquiatr. 2018;46(2):51–7.PubMed

24.

Hu LT, Bentler PM. Cutoff criteria for fit indexes in covariance structure analysis: conventional criteria versus new alternatives. Struct Equ Model Multidiscip J. 1999;6(1):1–55. https://doi.org/10.1080/10705519909540118.CrossRef

25.

Juárez-Acosta F, Montejo-Hernández M. Propiedades psicométricas del inventario de situaciones y comportamientos agresivos y del inventario de motivos para la agresión. Univ Psychol. 2008;7(1):149–71.

26.

Justino P. Poverty and violent conflict: a micro-level perspective on the causes and duration of warfare. J Peace Res. 2009;46(3):315–33. https://doi.org/10.1177/0022343309102655.CrossRef

27.

Keane TM, Fairbank JA, Zimering RT, Taylor KL, Mora CA. Clinical evaluation of a measure to assess combat exposure. Psychol Assess J Consult Clin Psychol. 1989;1(1):53. https://doi.org/10.1037/1040-3590.1.1.53.CrossRef

28.

Kruskal W. A nonparametric test for the several sample problem. Ann Math Stat. 1941;12:461–3. https://doi.org/10.1214/aoms/1177729332.CrossRef

29.

Kuder GF, Richardson MW. The theory of estimation of test reliability. Psychometrika. 1937;2(3):151–60. https://doi.org/10.1007/BF02288391.CrossRef

30.

Kumar R, Indrayan A. Receiver operating characteristic (ROC) curve for medical researchers. Indian Pediatr. 2011;48(4):277–87. https://doi.org/10.1007/s13312-011-0055-4.CrossRefPubMed

31.

Lawshe CH. A quantitative approach to content validity. Pers Psychol. 1975;28(4):563–75. https://doi.org/10.1111/j.1744-6570.1975.tb01393.x.CrossRef

32.

Loarche, G. (2015). Impacto vital en experiencias extremas. Estudio sobre el trauma psicosocial de los habitantes de la ciudad de Young en relación al siniestro ferroviario del año 2006. Tesis Magíster en Psicología Social. Uruguay: Universidad de la República.

33.

Lynn MR. Determination and quantification of content validity. Nurs Res. 1986;35:382–5. https://doi.org/10.1097/00006199-198611000-00017.CrossRef

34.

McDowell I. The theoretical and technical foundations of health measurement measuring health: a guide to rating scales and questionnaires. New York: Oxford University Press; 2006. https://doi.org/10.1093/acprof:oso/9780195165678.001.0001.CrossRef

35.

Mokkink LB, Terwee CB, Knol DL, Stratford PW, Alonso J, Patrick DL, et al. The COSMIN checklist for evaluating the methodological quality of studies on measurement properties: a clarification of its content. BMC Med Res Methodol. 2010;10(1):22. https://doi.org/10.1186/1471-2288-10-22.CrossRefPubMedPubMedCentral

36.

Morina N, Stam K, Pollet TV, Priebe S. Prevalence of depression and posttraumatic stress disorder in adult civilian survivors of war who stay in war-afflicted regions. A systematic review and meta-analysis of epidemiological studies. J Affect Disord. 2018;239:328–38. https://doi.org/10.1016/j.jad.2018.07.027.CrossRefPubMed

37.

Motrico E, Rodero-Cosano ML, Álvarez Gálvez J, Salinas-Pérez JA, Moreno-Peral P. Measures for the assessment of stressful life events in the Spanish adult population: a systematic review. Ann Psychol. 2017;33(3):556–67. https://doi.org/10.6018/analesps.33.3.236631.CrossRef

38.

Moya A. Violence, psychological trauma, and risk attitudes: evidence from victims of violence in Colombia. J Dev Econ. 2018;131(C):15–27. https://doi.org/10.1016/j.jdeveco.2017.11.001.CrossRef

39.

Muñoz LC, Qualter P, Padgett G. Empathy and bullying: exploring the influence of callous-unemotional traits. Child Psychiatry Hum Dev. 2011;42(2):183–96. https://doi.org/10.1007/s10578-010-0206-1.CrossRefPubMed

40.

Muthén B, Asparouhov T. Latent variable analysis with categorical outcomes: multiple-group and growth modeling in Mplus. Mplus Web Note. 2002;4(5):1–22.

41.

Muthén, L. K. & Muthén, B. O.. MPlus: statistical analysis with latent variables–user’s guide; 2012.

42.

Navarro-Lashayas MA, Eiroa-Orosa FJ. Substance use and psychological distress is related with accommodation status among homeless immigrants. Am J Orthop. 2017;87(1):23–33. https://doi.org/10.1037/ort0000213.CrossRef

43.

Nussio E, Oppenheim B. Anti-social capital in former members of non-state armed groups: a case study of Colombia. Stud Confl Terrorism. 2014;37:999–1023. https://doi.org/10.1080/1057610X.2014.962438.CrossRef

44.

Nuttman-Shwartz O, Shoval-Zuckerman Y. Continuous traumatic situations in the face of ongoing political violence: the relationship between CTS and PTSD. Trauma Violence Abuse. 2016;17(5):562–70. https://doi.org/10.1177/1524838015585316.CrossRefPubMed

45.

Pérez P, Vergara M. Prevención de las secuelas psicológicas crónicas en pacientes víctimas de experiencias vitales extremas: accidentes de tráfico y laborales. Madrid: Fundación Mapfre; 2008.

46.

Pérez, P., Olivos, P., Eiroa, F., and Barbero-Val, E.. Cuestionario V.I.V.O: La medida del impacto psicológico de experiencias extremas. Diseño, Validación y Manual de Aplicación. (1a ed., pp. 24-25). Madrid. Irredentos Libros; 2014.

47.

Piantadosi S, Byar DP, Green SB. The ecological fallacy. Am J Epidemiol. 1988;127(5):893–904. https://doi.org/10.1093/oxfordjournals.aje.a114892.CrossRefPubMed

48.

Pineda DA, Aguirre-Acevedo DC, Trujillo N, Valencia AM, Pareja A, Tobón C, et al. Dimensions of empathy in ex-combatants of the Colombian armed conflict using a standardized scale. Rev Colomb Psiquiatr. 2013;42(1):9–28. https://doi.org/10.1016/S0034-7450(14)60084-6.CrossRefPubMed

49.

Pizarro, E. & León-Gómez, E. P.. Pizarro, E 2015: Leon gómez, E. P. Una lectura múltiple y pluralista de la historia. Contribución al entendimiento del conflicto armado en Colombia, 2015;3–94.

50.

Porter B, Hoge CW, Tobin LE, Donoho CJ, Castro CA, Luxton DD, et al. Measuring aggregated and specific combat exposures: associations between combat exposure measures and posttraumatic stress disorder, depression, and alcohol-related problems. J Trauma Stress. 2018;31(2):296–306. https://doi.org/10.1002/jts.22273.CrossRefPubMed

51.

Punamäki RL, Palosaari E, Diab M, Peltonen K, Qouta SR. Trajectories of posttraumatic stress symptoms (PTSS) after major war among Palestinian children: trauma, family-and child-related predictors. J Affect Disord. 2015;172:133–40. https://doi.org/10.1016/j.jad.2014.09.021.CrossRefPubMed

52.

Restrepo A, Aponte D. Guerra y violencias en Colombia: herramientas e interpretaciones. Bogotá: Edtorial Universidad Javeriana. Avaliable; 2009. https://www.cerac.org.co/es/assets/files/guerrayviolencias/Libro_CERAC_.pdf

53.

Rodríguez-Calvache MV, Quintero-Zea A, Trujillo-Orrego SP, Trujillo-Orrego N, López-Hincapié JD. Detecting atypical functioning of emotional processing in Colombian ex-combatants. Tecno Lógicas. 2017;20(40):83–93. https://doi.org/10.22430/22565337.710.CrossRef

54.

Rubin OD, Ihle R. Measuring temporal dimensions of the intensity of violent political conflict. Soc Indic Res. 2016;132(2):621–42. https://doi.org/10.1007/s11205-016-1316-3.CrossRef

55.

Siskind DJ, Sawyer E, Lee I, Lie DC, Martin-Khan M, Farrington J, et al. The mental health of older persons after human- induced disasters: a systematic review and meta-analysis of epidemiological data. Am J Geriatr Psychiatry. 2016;24(5):379–88. https://doi.org/10.1016/j.jagp.2015.12.010.CrossRefPubMed

56.

Slone M, Mann S. Effects of war, terrorism and armed conflict on young children: a systematic review. Child Psychiatry Hum Dev. 2016;47(6):950–65. https://doi.org/10.1007/s10578-016-0626-7.CrossRefPubMed

57.

Slone M, Shoshani A. Psychiatric effects of protracted conflict and political life events exposure among adolescents in Israel: 1998–2011. J Trauma Stress. 2014;27(3):353–60. https://doi.org/10.1002/jts.21918.CrossRefPubMed

58.

Slone M, Lavi I, Ozer EJ, Pollak A. The Israeli-Palestinian conflict: meta-analysis of exposure and outcome relations for children of the region. Child Youth Serv Rev. 2017;74:50–61. https://doi.org/10.1016/j.childyouth.2017.01.019.CrossRef

59.

Streiner DL. Figuring out factors: the use and misuse of factor analysis. Can J Psychiatr. 1994;39(3):135–40. https://doi.org/10.1177/070674379403900303.CrossRef

60.

Streiner, D. L., Norman, G. R., & Cairney, J.. Health measurement scales: a practical guide to their development and use. Oxford University Press, USA; 2015. https://doi.org/10.1097/00004356-199112000-00017.

61.

Suárez RS. Trastorno de estrés postraumático, ansiedad y depresión en adolescentes y adultos expuestos al conflicto armado en Colombia 2005–2008. Medicina. 2016;38(2):134–56.

62.

Taft CT, Vogt DS, Marshall AD, Panuzio J, Niles BL. Aggression among combat veterans: relationships with combat exposure and symptoms of posttraumatic stress disorder, dysphoria, and anxiety. J Trauma Stress. 2007;20(2):135–45. https://doi.org/10.1002/jts.20197.CrossRefPubMed

63.

Tamayo Martínez N, Rincón Rodríguez CJ, de Santacruz C, Bautista Bautista N, Collazos J, Gómez-Restrepo C. Mental problems, mood and anxiety disorders in the population displaced by violence in Colombia; results of the National Mental Health Survey 2015. Rev Colomb Psiquiatr. 2016;45:113–8. https://doi.org/10.1016/j.rcp.2016.09.004.CrossRefPubMed

64.

Tobón C, Aguirre-Acevedo DC, Velilla L, Duque J, Ramos CP, Pineda D. Psychiatric, cognitive and emotional profile in ex- combatants of illegal armed groups in Colombia. Rev Colomb Psiquiatr. 2016;45(1):28–36. https://doi.org/10.1016/j.rcp.2015.07.004.CrossRefPubMed

65.

Tristán-López A. Modificación al modelo de Lawshe para el dictamen cuantitativo de la validez de contenido de un instrumento objetivo. Av Med. 2008;6:37–48.

66.

Ugarriza JE, Pabón N. Militares y guerrillas: la memoria histórica del conflicto armado en Colombia desde los archivos militares, 1958–2016. Bogotá: Editorial Universidad del Rosario; 2017. https://doi.org/10.12804/tj9789587388596.CrossRef

67.

Weidmann NB, Ward MD. Predicting conflict in space and time. J Confl Resolut. 2010;54(6):883–901. https://doi.org/10.1177/0022002710371669.CrossRef

68.

Weierstall R, Castellanos CPB, Neuner F, Elbert T. Relations among appetitive aggression, post-traumatic stress and motives for demobilization: a study in former Colombian combatants. Confl Heal. 2013;7(1):9. https://doi.org/10.1186/1752-1505-7-9.CrossRef

69.

Xue C, Ge Y, Tang B, Liu Y, Kang P, Wang M, et al. A meta-analysis of risk factors for combat-related PTSD among military personnel and veterans. PLoS One. 2015;10(3):0120270. https://doi.org/10.1371/journal.pone.0120270.CrossRef

Titel: Validation of the Extreme Experiences Scale (EX2) for Armed Conflict Contexts
verfasst von: L. S. Giraldo
D. C. Aguirre-Acevedo
S. Trujillo
J. E. Ugarriza
N. Trujillo
Publikationsdatum: 01.02.2020
Verlag: Springer US
Erschienen in: Psychiatric Quarterly / Ausgabe 2/2020
Print ISSN: 0033-2720
Elektronische ISSN: 1573-6709
DOI: https://doi.org/10.1007/s11126-020-09710-z

Neu im Fachgebiet Psychiatrie

Demenzkranke durch Antipsychotika vielfach gefährdet

23.04.2024 Demenz Nachrichten

Wenn Demenzkranke aufgrund von Symptomen wie Agitation oder Aggressivität mit Antipsychotika behandelt werden, sind damit offenbar noch mehr Risiken verbunden als bislang angenommen.

Weniger postpartale Depressionen nach Esketamin-Einmalgabe

23.04.2024 Depression antepartal oder postpartal Nachrichten

Bislang gibt es kein Medikament zur Prävention von Wochenbettdepressionen. Das Injektionsanästhetikum Esketamin könnte womöglich diese Lücke füllen.

„Psychotherapie ist auch bei sehr alten Menschen hochwirksam!“

22.04.2024 DGIM 2024 Kongressbericht

Die Kombination aus Medikamenten und Psychotherapie gilt als effektivster Ansatz bei Depressionen. Das ist bei betagten Menschen nicht anders, trotz Besonderheiten.

Auf diese Krankheiten bei Geflüchteten sollten Sie vorbereitet sein

22.04.2024 DGIM 2024 Nachrichten

Um Menschen nach der Flucht aus einem Krisengebiet bestmöglich medizinisch betreuen zu können, ist es gut zu wissen, welche Erkrankungen im jeweiligen Herkunftsland häufig sind. Dabei hilft eine Internetseite der CDC (Centers for Disease Control and Prevention).

Update Psychiatrie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

Abstract

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 2/2020

Age Trends in Well-Being and Depressive Symptoms: the Role of Social Desirability

Linking Rejection Sensitivity, Shyness and Unsociability with Posttraumatic Stress Disorder and Psychiatric Co-Morbidity among Chinese Adolescents

Time from the Admission as the Predictor of Aggressive Behavior of Inpatients with Schizophrenia Spectrum Disorder

Exposure to Family Violence of Israeli Inmates: Does Sex Make a Difference?

Pilot Study of a Video-Based Educational Program to Reduce Family Violence for Parents of Adult Children with Schizophrenia