ABSTRACT
BACKGROUND: The questionnaire for the assessment of mental pain after traumatic experiences (FESSTE-30) is the first instrument in the German language which can be used for the standardized operationalization of mental pain in research and expert review process. The primary aim of the present study was to present quality criteria of the questionnaire and its preliminary gender-specific comparative values for the German-speaking general population. METHODS: The FESSTE-30 consists of five subscales ("Depression", "Somatization", "Dissociation", "Intrusive Memories" and "Fear"), and the total scale "Mental Pain". In addition, the attached trauma checklist enables a structured assessment of the extent of traumatic experiences. The questionnaire was investigated regarding reliability and validity based on a convenience sample of the German-speaking general population (n=1448; 86.2% female). RESULTS: The reliabilities of the subscales and the total scale ranged between Cronbach's alpha=0.81-0.94. The internal consistency of the scale "extent of traumatic experiences" showed a Cronbach's alpha=0.65. Regarding confirmatory factor analysis, a latent bifactor structure with a general factor and five residual factors showed the following model fit: RMSEA=0.05 (90% CI: 0.05, 0.06); TLI=0.93; CFI=0.94; NFI=0.92; χ²/df=4.94. DISCUSSION: The results indicate that FESSTE-30 is a reliable and valid self-assessment method for assessment of mental pain, suitable for application in research, treatment and expert review processes. The preliminary standard values can be used as a guideline for the evaluation of individual cases. Further investigations with clinical samples are planned.
Subject(s)
Pain , Humans , Female , Male , Psychometrics , Reproducibility of Results , Surveys and Questionnaires , Factor Analysis, Statistical , Pain/diagnosis , Pain/etiologyABSTRACT
Background: Although the term "mental pain" is often the subject of expert opinions regarding claims for damages, there is still no standardized questionnaire in the German-speaking area to operationalize this concept. Therefore, the aim of this work is the development and validation of a self-assessment measurement for psychological pain after traumatic events (FESSTE). Methods: A first version of the questionnaire was applied on a sample of the German speaking general population (N = 425; 88% female). After performing an item analysis and exploratory factor analysis, the questionnaire was shortened and tested on a second German speaking general population sample (N = 619; 89% female). Finally, the newly developed questionnaire was related to the extent of traumatization (measured with a uniquely designed trauma checklist attached to the FESSTE) and already established instruments for the assessment of psychiatric symptom burden, which included the Brief Symptom Inventory-18 (BSI-18) and the Post-traumatic-Stress-Scale (PTSS-10). Results: The final version of the FESSTE consists of a total of 30 items and covers the subscales "Somatization," "Depression," "Intrusive Memories," "Dissociation" and "Anxiety," and a total scale "Mental Pain." Based on the confirmatory factor analysis, it is assumed that the latent factor structure of the FESSTE can be best described as a bifactor-model. The final version shows a satisfactory model fit, high internal consistencies, and strong positive correlations with the BSI-18 and PTSS-10, as well as the extent of traumatic experiences. Discussion: The FESSTE enables an operationalization of mental pain comprising five subscales and one total scale. What is more, the trauma checklist attached to the FESSTE allows for the standardized assessment of potentially traumatic experiences and the corresponding extent of these experiences. The results indicate that the FESSTE is a reliable and valid self-assessment procedure for mental pain, which is suitable for use in research and in expert practice.
ABSTRACT
The relationship between trauma, consequences of trauma and personality structure: A mediation analysis Background: This study deals with the hitherto scarcely explored relationship between the extent of traumatization, psychopathological consequences and personality structure. It is examined whether the structural integrity of the personality has a mediating influence on the relationship between trauma and symptoms of post-traumatic stress disorder (PTSD) and mental pain after traumatization. Methods: The investigated community sample consisted of 381 adults (89 % female) who reported at least one lifetime traumatic experience. The path analysis technique was applied to estimate associations between the degree of traumatization, PTSD symptoms, mental pain and the integrity of personality structure. Results: The extent of experienced traumatization is significantly associated with increased impairment of personality structure (ß = .40; p < .001), severity of the mental pain (ß = .21; p < .001) and PTSD symptoms (ß = .14; p < .01). Deficits in the personality structure were associated with increased mental pain (ß = .67; p < .001) and PTSD symptoms (ß = .73; p < .001). The mediation analysis showed an indirect effect of traumatization on mental pain (ß = .27; p < .001) and PTSD symptoms (ß = .29; p < .001), which is partially mediated by personality structure level. A detailed analysis showed that this mediation relationship can be attributed in particular to deficits in the ability to observe oneself. Discussion: The results of this study emphasize the significance of personality structure in the development of psychological consequences of traumatization. Regarding therapeutic practice, especially the ability to observe oneself seems to offer an important starting point for the treatment of mental pain and PTSD symptoms.
