PCL-5(DSM-5 기준 외상 후 스트레스 장애 체크리스트) 한국판 종단 타당화 연구
A Longitudinal Validation Study of The Korean Version of PCL-5 (Posttraumatic Stress Disorder Checklist for DSM-5)
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초록
본 연구는 한국판 외상 후 스트레스 장애 체크리스트-5(PCL-5)의 타당화 연구를 진행하였다. 이를 위해 성인을 대상으로 두 시점에서 온라인 설문을 1년 간격으로 실시하였고, 1시점에서는 1,077명, 2시점에서는 563명의 자료를 본 연구에서 사용하였다. 확인적 요인분석을 통해 1요인, 4요인, 6요인, 7요인의 모형 적합도를 확인한 결과, 4, 6, 7요인이 수용가능한 수준으로 나타났으며 그 중, 7, 6, 4요인 순으로 우수한 적합도를 보였다. 다음으로 내적일치도, 오메가 계수, 개념신뢰도, 분산추출지수, 검사-재검사 신뢰도를 확인한 결과 모두 양호한 것으로 나타났다. 타당도를 확인하기 위해 한국판 외상 후 스트레스 선별 평가지(K-PC-PTSD-5)와 단축형 간이정신진단 검사-18(BSI-18)와의 상관분석을 실시한 결과, 두 검사 모두와 정적상관이 나타났다. 한국판 PCL-5가 향후 PTSD, 우울, 불안, 신체화 증상을 예측할 수 있는지 확인하고자 위계적 다중회귀분석을 실시한 결과, 1시점에서 한국판 PCL-5로 측정한 PTSD 증상이 2시점의 PTSD, 우울, 불안, 신체화 증상을 예측하는 것으로 나타났다. 본 연구에서는 ROC 곡선 분석을 통해 PCL-5의 PTSD 증상집단 구분에 대한 변별력을 확인하고 최적 절단점을 제시하였다. PCL-5의 한국판 종단타당화 결과, 본 척도가 한국인에게 신뢰롭고 타당한 척도인 것으로 나타났다. 본 연구는 예측타당도 분석을 통해 한국판 PCL-5가 PTSD 증상 뿐만 아니라 우울, 불안, 신체화 같은 PTSD 관련 증상을 예측가능함을 제시하였으며, PTSD 증상집단에 대한 변별이 가능한 절단점을 제시하였다는 점에서 PTSD 증상을 측정하는 기존 타당화 연구와 차별점을 지닌다.
Abstract
The aim of this study is to examine the psychometric properties of the Korean version of the Post-traumatic Stress Disorder Checklist for DSM-5(PCL-5). To this end, online surveys were conducted two times at 1-year interval with 1,077 Korean adults at time 1, and 563 Korean adults at time 2. First, as a result of confirmatory factor analysis, factor 1 was found to be not acceptable, while factor 4, 6 and 7 were found to be acceptable and showing the best model fit in the order of factor 7, 6, 4. Second, as a result of examining reliability of Korean version of PCL-5, Korean version of PCL-5 showed good reliability. Third, as a result of correlation analysis with K-PC-PTSD-5 and sub-factors of BSI-18, Korean Version of PCL-5 had positve correlation with both K-PC-PTSD-5 and BSI-18. Fourth, PTSD symptoms measured by the Korean version of PCL-5 at time 1 properly predicted PTSD, depression, anxiety, and somatization symptoms at time 2. Fifth, discrimination power of PCL-5 for screening PTSD group and best cut-off score were confirmed by ROC anlaysis. As a result of the longitudinal validation of Korean version of PCL-5, it was found that this scale is a reliable and valid measure for Korean adults. This study differs from previous validation studies in that the Korean version of PCL-5 can predict not only PTSD symptoms but also PTSD-related symptoms such as depression, anxiety, and somatization, and that the best cut-off score for distinguising PTSD symptom group was confirmed.
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