Trauma exposure and psychometric properties of the life events checklist among adults in South Africa

Background: Trauma exposure is widespread and linked to chronic physical and mental health conditions including posttraumatic stress disorder. However, there are major gaps in our knowledge of trauma exposure in Africa and on the validity of instruments to assess potentially life-threatening trauma...

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Published in:European journal of psychotraumatology 2023, Vol.14 (1), p.2172257
Main Authors: Stevenson, Anne, Beltran, Marine, Misra, Supriya, Ametaj, Amantia A., Bronkhorst, Aletta, Gelaye, Bizu, Koenen, Karestan C., Pretorius, Adele, Stein, Dan J., Zingela, Zukiswa
Format: Article
Language:English
Subjects:
Adult
Basic
Case-Control Studies
CFA
Checklist
EFA
Estresor
Female
Humans
Life Change Events
Male
Post traumatic stress disorder
posttraumatic stress disorder (PTSD)
Propiedades psicométricas
Psychometric properties
Psychometrics
Quantitative psychology
Questionnaires
South Africa - epidemiology
stressor
Trastorno por estrés postraumático (TEPT)
创伤后应激障碍 (PTSD)
应激源
心理测量特性
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container_title European journal of psychotraumatology
container_volume 14
creator Stevenson, Anne
Beltran, Marine
Misra, Supriya
Ametaj, Amantia A.
Bronkhorst, Aletta
Gelaye, Bizu
Koenen, Karestan C.
Pretorius, Adele
Stein, Dan J.
Zingela, Zukiswa
description Background: Trauma exposure is widespread and linked to chronic physical and mental health conditions including posttraumatic stress disorder. However, there are major gaps in our knowledge of trauma exposure in Africa and on the validity of instruments to assess potentially life-threatening trauma exposure. Objective: The Life Events Checklist for the DSM-5 (LEC-5) is a free, widely used questionnaire to assess traumatic events that can be associated with psychopathology. As part of a case-control study on risk factors for psychosis spectrum disorders, we used the LEC-5 to examine the frequency of traumatic events and to assess the questionnaire's factor structure in South Africa (N = 6,765). Method: The prevalence of traumatic events was measured by individual items on the LEC-5 across the study sample, by case-control status, and by sex. Cumulative trauma burden was calculated by grouping items into 0, 1, 2, 3, and ≥4 traumatic event types. Psychometric properties of the LEC-5 were assessed through exploratory and confirmatory factor analyses. Results: More than 92% of the study sample reported experiencing ≥1 traumatic event; 38.7% reported experiencing ≥4 traumatic event types. The most endorsed item was physical assault (65.0%), followed by assault with a weapon (50.2%). Almost 94% of cases reported ≥1 traumatic event compared to 90.5% of controls (p 
doi_str_mv 10.1080/20008066.2023.2172257
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However, there are major gaps in our knowledge of trauma exposure in Africa and on the validity of instruments to assess potentially life-threatening trauma exposure. Objective: The Life Events Checklist for the DSM-5 (LEC-5) is a free, widely used questionnaire to assess traumatic events that can be associated with psychopathology. As part of a case-control study on risk factors for psychosis spectrum disorders, we used the LEC-5 to examine the frequency of traumatic events and to assess the questionnaire's factor structure in South Africa (N = 6,765). Method: The prevalence of traumatic events was measured by individual items on the LEC-5 across the study sample, by case-control status, and by sex. Cumulative trauma burden was calculated by grouping items into 0, 1, 2, 3, and ≥4 traumatic event types. Psychometric properties of the LEC-5 were assessed through exploratory and confirmatory factor analyses. Results: More than 92% of the study sample reported experiencing ≥1 traumatic event; 38.7% reported experiencing ≥4 traumatic event types. The most endorsed item was physical assault (65.0%), followed by assault with a weapon (50.2%). Almost 94% of cases reported ≥1 traumatic event compared to 90.5% of controls (p &lt; .001) and 94% of male participants reported ≥1 traumatic event compared to 89.5% of female participants (p &lt; .001). Exploratory factor analysis revealed a 6-factor model. Confirmatory factor analyses of three models found that a 7-factor model based on the South African Stress and Health survey was the best fit (standardized root mean square residual of 0.024, root mean square error of approximation of 0.029, comparative fit index of 0.910). Conclusion: Participants reported very high exposure to traumatic events. The LEC-5 has good psychometric priorities and is adequate for capturing trauma exposure in South Africa. Trauma exposure was extremely prevalent in this South African sample, with less than 8% of participants reporting zero exposure to traumatic events. This was the first time the factor structure of the LEC-5 was assessed in South Africa. A confirmatory factor analysis using a 7-factor model based on a previous study of trauma exposure, the South African Stress and Health study (SASH), was the best fit for the LEC-5.</description><identifier>ISSN: 2000-8066</identifier><identifier>EISSN: 2000-8066</identifier><identifier>DOI: 10.1080/20008066.2023.2172257</identifier><identifier>PMID: 37052114</identifier><language>eng</language><publisher>United States: Taylor &amp; Francis</publisher><subject>Adult ; Basic ; Case-Control Studies ; CFA ; Checklist ; EFA ; Estresor ; Female ; Humans ; Life Change Events ; Male ; Post traumatic stress disorder ; posttraumatic stress disorder (PTSD) ; Propiedades psicométricas ; Psychometric properties ; Psychometrics ; Quantitative psychology ; Questionnaires ; South Africa - epidemiology ; stressor ; Trastorno por estrés postraumático (TEPT) ; 创伤后应激障碍 (PTSD) ; 应激源 ; 心理测量特性</subject><ispartof>European journal of psychotraumatology, 2023, Vol.14 (1), p.2172257</ispartof><rights>2023 The Author(s). 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Results: More than 92% of the study sample reported experiencing ≥1 traumatic event; 38.7% reported experiencing ≥4 traumatic event types. The most endorsed item was physical assault (65.0%), followed by assault with a weapon (50.2%). Almost 94% of cases reported ≥1 traumatic event compared to 90.5% of controls (p &lt; .001) and 94% of male participants reported ≥1 traumatic event compared to 89.5% of female participants (p &lt; .001). Exploratory factor analysis revealed a 6-factor model. Confirmatory factor analyses of three models found that a 7-factor model based on the South African Stress and Health survey was the best fit (standardized root mean square residual of 0.024, root mean square error of approximation of 0.029, comparative fit index of 0.910). Conclusion: Participants reported very high exposure to traumatic events. The LEC-5 has good psychometric priorities and is adequate for capturing trauma exposure in South Africa. Trauma exposure was extremely prevalent in this South African sample, with less than 8% of participants reporting zero exposure to traumatic events. This was the first time the factor structure of the LEC-5 was assessed in South Africa. 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Beltran, Marine ; Misra, Supriya ; Ametaj, Amantia A. ; Bronkhorst, Aletta ; Gelaye, Bizu ; Koenen, Karestan C. ; Pretorius, Adele ; Stein, Dan J. ; Zingela, Zukiswa</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c562t-1fd3517b085600ca1ab7ee348035ee7c93117212818340473da34b9fb3ca0b453</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Adult</topic><topic>Basic</topic><topic>Case-Control Studies</topic><topic>CFA</topic><topic>Checklist</topic><topic>EFA</topic><topic>Estresor</topic><topic>Female</topic><topic>Humans</topic><topic>Life Change Events</topic><topic>Male</topic><topic>Post traumatic stress disorder</topic><topic>posttraumatic stress disorder (PTSD)</topic><topic>Propiedades psicométricas</topic><topic>Psychometric properties</topic><topic>Psychometrics</topic><topic>Quantitative psychology</topic><topic>Questionnaires</topic><topic>South Africa - epidemiology</topic><topic>stressor</topic><topic>Trastorno por estrés postraumático (TEPT)</topic><topic>创伤后应激障碍 (PTSD)</topic><topic>应激源</topic><topic>心理测量特性</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Stevenson, Anne</creatorcontrib><creatorcontrib>Beltran, Marine</creatorcontrib><creatorcontrib>Misra, Supriya</creatorcontrib><creatorcontrib>Ametaj, Amantia A.</creatorcontrib><creatorcontrib>Bronkhorst, Aletta</creatorcontrib><creatorcontrib>Gelaye, Bizu</creatorcontrib><creatorcontrib>Koenen, Karestan C.</creatorcontrib><creatorcontrib>Pretorius, Adele</creatorcontrib><creatorcontrib>Stein, Dan J.</creatorcontrib><creatorcontrib>Zingela, Zukiswa</creatorcontrib><collection>Taylor &amp; 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However, there are major gaps in our knowledge of trauma exposure in Africa and on the validity of instruments to assess potentially life-threatening trauma exposure. Objective: The Life Events Checklist for the DSM-5 (LEC-5) is a free, widely used questionnaire to assess traumatic events that can be associated with psychopathology. As part of a case-control study on risk factors for psychosis spectrum disorders, we used the LEC-5 to examine the frequency of traumatic events and to assess the questionnaire's factor structure in South Africa (N = 6,765). Method: The prevalence of traumatic events was measured by individual items on the LEC-5 across the study sample, by case-control status, and by sex. Cumulative trauma burden was calculated by grouping items into 0, 1, 2, 3, and ≥4 traumatic event types. Psychometric properties of the LEC-5 were assessed through exploratory and confirmatory factor analyses. Results: More than 92% of the study sample reported experiencing ≥1 traumatic event; 38.7% reported experiencing ≥4 traumatic event types. The most endorsed item was physical assault (65.0%), followed by assault with a weapon (50.2%). Almost 94% of cases reported ≥1 traumatic event compared to 90.5% of controls (p &lt; .001) and 94% of male participants reported ≥1 traumatic event compared to 89.5% of female participants (p &lt; .001). Exploratory factor analysis revealed a 6-factor model. Confirmatory factor analyses of three models found that a 7-factor model based on the South African Stress and Health survey was the best fit (standardized root mean square residual of 0.024, root mean square error of approximation of 0.029, comparative fit index of 0.910). Conclusion: Participants reported very high exposure to traumatic events. The LEC-5 has good psychometric priorities and is adequate for capturing trauma exposure in South Africa. Trauma exposure was extremely prevalent in this South African sample, with less than 8% of participants reporting zero exposure to traumatic events. This was the first time the factor structure of the LEC-5 was assessed in South Africa. 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source Open Access: PubMed Central; Taylor & Francis Open Access; ProQuest - Publicly Available Content Database
subjects Adult
Basic
Case-Control Studies
CFA
Checklist
EFA
Estresor
Female
Humans
Life Change Events
Male
Post traumatic stress disorder
posttraumatic stress disorder (PTSD)
Propiedades psicométricas
Psychometric properties
Psychometrics
Quantitative psychology
Questionnaires
South Africa - epidemiology
stressor
Trastorno por estrés postraumático (TEPT)
创伤后应激障碍 (PTSD)
应激源
心理测量特性
title Trauma exposure and psychometric properties of the life events checklist among adults in South Africa
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