Psychometric properties of the revised Ukrainian version of the Continuous Traumatic Stress Response scale (CTSR) in the context of the Russo-Ukrainian war

Abstract

Background: The Continuous Traumatic Stress Response scale (CTSR) was designed to measure symptoms associated with multiple ongoing security threats in the context of Israeli-Palestinian conflict. Since 2014, Ukraine has faced armed invasion and war, with nationwide insecurity since February 2022. Objective: This study aimed to adapt the CTSR scale into Ukrainian and evaluate its psychometric properties within a Ukrainian sample during the ongoing war. Method: The Ukrainian adaptation of the CTSR followed the procedure used in creating the original instrument (Goral, A., Feder-Bubis, P., Lahad, M., Galea, S., O'Rourke, N., & Aharonson-Daniel, L. (2021). Development and validation of the Continuous Traumatic Stress Response scale (CTSR) among adults exposed to ongoing security threats. PLoS One, 16(5), e0251724). To identify a unique context-specific factor structure relevant to the Ukrainian experience, the initial 25 items were tested in a sample of 584 Ukrainians using exploratory and confirmatory factor analyses. Subsequently, the established scale structure was assessed for homogeneity, and convergent validity using measures of depression (PHQ-9), anxiety (GAD-7), perceived stress (PSS-4), resilience (BRS), and PTSD symptoms (PCL-5). Results: A three-factor, 9-item solution, representing the constructs of exhaustion, alienation, and helplessness, demonstrated the most acceptable fit among all the alternative CTSR models, including the original: χ2 = 72.84, df = 24, p