Latent structure and validity of the Secondary Traumatic Stress Scale

Abstract

Secondary traumatization is a condition that mimics symptoms of post-traumatic stress disorder (PTSD) which results from being engaged in helping professions especially working with traumatized individuals. Practitioners providing services to refugees are on a daily bases faced with persons who have suffered multiple traumas and postmigration stressors, and as such are highly exposed to risks of secondary traumatization. The current study aimed to examine the latent structure and validity of the Secondary Traumatic Stress Scale (STSS). 270 practitioners (43% males) working with refugees passing through the Balkan route, from 18 to 67 years old (M = 33.66, SD = 9.58) completed STSS, assessing symptoms of secondary trauma (19 items), Hopkins Symptom Checklist-25 (HSCL-25) assessing symptoms of anxiety (10 items) and depression (15 items), and Manchester Short Assessment of Quality of Life (MANSA), assessing satisfaction with various life domains (12 items). STSS showed to have good psychometric properties, with satisfactory values of sampling adequacy (KMO intrusions = .91, KMO avoidance = 92, KMO arousal = .93, KMO stss = .98), internal consistency (α intrusions = .77, α avoidance = .81, α arousal = .82, α stss = .92), and homogeneity for the three subscales and the total score (average inter-item correlations of .41, .38, .48, .39 for intrusion, avoidance, arousal subscales, and STSS total score, respectively). A series of confirmatory factor analysis conducted following prominent PTSD conceptualizations showed that the model of three relatively distinct but highly correlated factors had the best fit: intrusions, avoidance, and the blend of negative alterations in cognition, mood, and reactivity (NACMR) [χ2(116) = 270.60, p < .001; TLI = .91; CFI = .92; RMSEA = .070]. All three factors – NACMR, intrusions, avoidance, and STSS total score showed high positive correlations with symptoms of anxiety (r = .718, p < .001; r = .551, p < .001; r = .468, p < .001; r = .706. p < .001, respectively) and depression (r = .753, p < .001; r = .490, p < .001; r = .471, p < .001; r = .711, p < .001, respectively), and moderate negative correlations with the quality of life (r = -.456, p < .001; r = -.302, p < .001; r = -.326, p < .001; r = -.438, p < .001, respectively). Results provide evidence on the latent structure of the STS which partially deviate from the prominent models of PTSD questioning isomorphism of the two constructs on the empirical level. Evidence on the relationship between secondary traumatic stress and depression, anxiety, and quality of life point to the broader impact of STS-specific symptomatology on the mental health and well-being of practitioners working with refugees. Results, together with practical implications will be discussed.