Canadian Psychiatric Association

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Editorial
2002—Defining the 21st Century II
Quentin Rae-Grant
(PDF)


Guest Editorial
Twinning Research and Practice Guidelines in the Management of Addictions
Nady el-Guebaly
(PDF)


In Review
Substance Use Disorders: Sex Differences and Psychiatric Comorbidities
Monica L Zilberman, Hermano Tavares, Sheila B Blume, Nady el-Guebaly

(PDF)

Clinical Aspects of Substance Abuse in Persons With Schizophrenia
Juan C Negrete

(PDF)

Are There Cognitive and Behavioural Approaches Specific to the Treatment of Pathological Gambling?
Hermano Tavares, Monica L Zilberman, Nady el-Guebaly

(PDF)


Review Paper
The Relation Between Memory of the Traumatic Event and PTSD: Evidence From Studies of Traumatic Brain Injury
Ehud Klein, Yael Caspi, Sharon Gil

(PDF)

Evolutionary Perspectives on Schizophrenia
Joseph Polimeni, Jeffrey P Reiss

(PDF)


Original Research
Effect of a New Casino on Problem Gambling in Treatment-Seeking Substance Abusers

Tony Toneatto, Donna Ferguson, Judy Brennan

(PDF)

The Thought Disorder Questionnaire
Edward M Waring, RWJ Neufeld, B Schaefer

(PDF)


Brief Communication
The Index Manic Episode in Juvenile-Onset Bipolar Disorder: The Pattern of Recovery

J Rajeev, Shoba Srinath, YCJ Reddy, MG Shashikiran, Satish Chandra Girimaji, Shekhar P Seshadri, DK Subbakrishna

(PDF)

Validation of a French Version of the Impact of Event Scale-Revised
Alain Brunet, Annie St-Hilaire, Louis Jehel, Suzanne King

(PDF)


Book Reviews
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Psychothérapie individuelle
Reviewed by
Jean-François de la Sablonnière, MD, FRCPC

Psychotherapy
Reviewed by
Paul Ian Steinberg, MD, FRCPC

General Psychiatry
Revue par
David S Goldbloom, MD, FRCPC

Ressources
Revue par
Pierre Doucet


Letters to the Editor
(PDF)

Re: Atypical Antipsychotics Mechanisms of Action

Reply: Atypical Antipsychotics Mechanisms of Action

Re: “Cades Disease” and Beyond

Reply: Cade’s Disease and Beyond

Quetiapine-Induced Leucopenia: Possible Dosage-Related Phenomenon

Atypical Neuroleptic Malignant Syndrome With Clozapine and Subsequent Haloperidol Treatment

Brief Communication

Validation of a French Version of the Impact of Event Scale-Revised

Alain Brunet, PhD1, Annie St-Hilaire, MA2, Louis Jehel, MD3, Suzanne King, PhD4

 

Objective: This report presents a French translation and validation of the Impact of Event Scale-Revised (IES-R) in a population of women exposed to a natural disaster during or preceding pregnancy.

Method: A total of 223 francophone women who were either pregnant at the time of the 1998 ice storm or who became pregnant shortly thereafter completed the IES-R and other questionnaires 6 months after the disaster.

Results: The French IES-R has good internal consistency, with alpha coefficients ranging from 0.81 to 0.93 for its 3 subscales and total score. The test–retest reliability of the scale, although examined with another sample, proved to be satisfactory, with correlation coefficients ranging from 0.71 to 0.76 for its 3 subscales and total score. Its convergent validity with perceived life threat and general psychiatric symptoms was judged to be marginally acceptable. Finally, a principal components analysis was conducted and a 3-factor solution, which explained 56% of the variance, was retained: a hyperarousal factor (7 items), an avoidance factor (6 items), and an intrusion factor (6 items).

Conclusions: The French version of the IES-R has satisfactory internal validity and test–retest reliability. Further, the factor structure of the translation was similar to the proposed theoretical structure of the IES-R.

(Can J Psychiatry 2003;48:56–61)

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Clinical Implications

  • A validated French version of the Impact of Event Scale-Revised (IES-R) is now available to researchers and clinicians.

  • Future studies should investigate the psychometric properties of the French IES-R in other populations exposed to different traumatic events.

Limitations

  • The study had a low response rate.

  • The level of symptoms was moderate.


Key Words
: Impact of Event Scale-Revised (IES-R), French validation, 1998 ice storm, natural disaster, women, pregnancy

Résumé : Validation d’une version française de l’échelle de l’effet des événements révisée

Natural disasters are unexpected environmental events that affect entire communities and are likely to endanger life and property (1). In addition to causing casualties and economic losses, exposure to natural disasters can precipitate transient and more enduring somatic and psychological symptoms that relate to depression and posttraumatic stress disorder (PTSD) (1).

Over the past 20 years, several instruments have been developed to measure posttraumatic stress symptoms following exposure to potentially traumatic events such as natural disasters. The Impact of Event Scale (IES) (2) was the first instrument developed for this purpose and remains the most widely used self-report scale of trauma-related symptoms (3). However, because the original IES did not measure symptoms of arousal, one of the core features of PTSD (4), Weiss and Marmar (5) recently proposed a revised version of the IES, which includes 7 new items. The Impact of Event Scale-Revised (IES-R) has been shown to have good psychometric properties, and its use has increased over the last few years.

Further, the scale has already been translated and validated in the German language (6). The instrument, however, has not yet been translated into French and awaits validation. Therefore, the purpose of this paper is to present the translation and validation of a French version of the IES-R.

Method

The Event

Between January 5 and 9, 1998, the southern regions of the provinces of Quebec and Ontario, as well as the northeastern regions of the US, were hit by a series of freezing rainstorms. The 1998 ice storm was the worst natural disaster ever to hit Quebec. It resulted in the death of 27 people and left over 1.4 million households in more than 700 municipalities without power. Power failures ranged from a few hours to more than 4 weeks.

Sample and Procedure

Project Ice Storm is a longitudinal study of the effects of prenatal maternal stress on perinatal and infant outcomes (7). On June 1, 1998, 50 randomly chosen family doctors and obstetricians working in hospitals in the Montérégie (one of the areas most affected) sent out survey packets to 1435 women. These women were either pregnant at the time of the ice storm or became pregnant between January 9 and April 9, 1998. A total of 224 French-speaking women (15.6% response rate) completed the survey. Although low, this response rate is not unusual for studies using mailed questionnaires (8). The physicians obtained written informed consent from all participants.

Table 1 Principal components analysis (varimax rotation) of the French translation of the Impact of Event Scale

Original factors and items

Hyperarousal

Avoidance

Intrusion

Hyperarousal

     

       4

0.65a

0.30

0.25

      10

0.66a

0.16

0.32

      15

0.71a

0.09

0.03

      18

0.65a

0.21

0.23

      19

0.47

0.43

–0.06

      21

0.74a

0.13

0.20

Avoidance

     

       5

0.06

0.43

0.53a

       7

0.14

0.15

0.18

       8

0.17

0.78a

0.27

      11

0.28

0.64a

0.32

      12

0.38

0.70a

0.27

      13

0.34

0.65a

0.18

      17

0.02

0.83a

0.18

      22

0.04

0.78a

0.12

Intrusion

     

       1

0.10

0.27

0.77a

       2

0.64a

–0.04

0.29

       3

0.22

0.15

0.79a

       6

0.39

0.13

0.68a

       9

0.29

0.13

0.74a

      14

0.62a

0.19

0.31

      16

0.43

0.34

0.61a

      20

0.25

0.18

0.22

Eigenvalue

8.6

2.1

1.5

Total variance explained (%)

38.9

9.5

6.7

aItems that have a factor loading ³ 0.50

Instruments

French Version of the Impact of Event Scale-Revised (IES-R). The IES-R comprises 22 items that measure symptoms of intrusion (dreams about the event), avoidance and numbing (effort to avoid reminders of the event), and hyperarousal (feeling watchful and on guard) with respect to a particular life-threatening event. Participants rate on a 5-point Likert scale the extent to which each item applies to their experiences during the preceding 7 days. Total score on the IES-R ranges between 0 and 88. Selected items were totalled to create the 3 subscales (Table 1). For the purposes of this study, participants were asked to complete the French translation of the IES-R with respect to the 1998 ice storm. The IES-R was first translated into French, then back-translated into English, and was finally reviewed and approved by Daniel Weiss. Table 2 provides a copy of the French version of the IES-R.

Storm Questionnaire. The Project Ice Storm research group designed the “storm” questionnaire to collect information about the degree of exposure to the ice storm. Likewise, the questionnaire includes several items related to perceived threat; specifically, injury to self and feeling in danger owing to cold, electricity, CO2, falling ice, contaminated water, and food poisoning. The scale comprises 8 items, and scores range from 0 to 8.

General Health Questionnaire. The 28-item General Health Questionnaire (GHQ-28) is a self-report measure used to screen for somatization, anxiety, depression, and social maladjustment symptoms (9). For each item on the 4-point Likert scale, subjects circled the answer that corresponded best to how they had felt in the previous 2 weeks. The scale has been shown to have satisfactory psychometric properties (9,10), and numerous studies have reported significant correlations between the scale and the intrusion and avoidance subscales of the IES (11,12).

Table 2 IES-R en français

Instructions.  Voici une liste de difficultés que les gens éprouvent parfois à la suite d’un événement stressant.  Veuillez lire chaque item et indiquer à quel point vous avez été boulversé(e) par chacune de ces difficultés au cours des 7 derniers jours en ce qui concerne________.
Dans quelle mesure avez-vous été affecté(e) ou bouleversé(e) par ces difficultés.

Pas du tout

Un peu

Moyennement

Passablement

Extrêmement

1. Tout rappel de l’événement ravivait mes sentiments face à l’événement

0

1

2

3

4

2. Je me réveillais la nuit

0

1

2

3

4

3. Différentes choses m’y faisait penser

0

1

2

3

4

4. Je me sentais irritable et en colère

0

1

2

3

4

5. Quand j’y repensais ou qu’on me le rappelait, j’évitais de me laisser bouleverser

0

1

2

3

4

6. Sans le vouloir, j’y repensais

0

1

2

3

4

7. J’ai eu l’impression que l’événement n’était jamais arrivé ou n’était pas réel

0

1

2

3

4

8. Je me suis tenu loin de ce qui m’y faisait penser

0

1

2

3

4

9. Des images de l’événement surgissaient dans ma tête

0

1

2

3

4

10. J’étais nerveux (nerveuse) et je sursautais facilement

0

1

2

3

4

11. J’essayais de ne pas y penser

0

1

2

3

4

12. J’étais conscient(e) d’avoir encore beaucoup d’émotions à propos de l’événement, mais je n’y ai pas fait face

0

1

2

3

4

13. Mes sentiments à propos de l’événement étaient comme figés

0

1

2

3

4

14. Je me sentais et je réagissais comme si j’étais encore dans l’événement

0

1

2

3

4

15. J’avais du mal à m’endormir

0

1

2

3

4

16. J’ai ressenti des vagues de sentiments intenses à propos de l’événement

0

1

2

3

4

17. J’ai essayé de l’effacer de ma mémoire

0

1

2

3

4

18. J’avais du mal à me concentrer

0

1

2

3

4

19. Ce qui me rappelait l’événement me causait des réactions physiques telles que des sueurs, des difficultés à respirer, des nausées ou des palpitations

0

1

2

3

4

20. J’ai rêvé à l’événement

0

1

2

3

4

21. J’étais aux aguets et sur mes gardes

0

1

2

3

4

22. J’ai essayé de ne pas en parler

0

1

2

3

4


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