Denna studie har prövat den svenska översättningen av CATS för att komplettera tidigare forskning på de översättningar som hittills genomförts. Dock bör instrumentet fortsatt översättas till ytterligare språk och fortsatt valideras för att ge möjlighet till bedömning av PTSD hos barn och unga i Sverige som inte har svenska som förstaspråk och skapa tillgång till ett internationellt anpassat och beprövat screeningsinstrument.
CATS bör även testas och utvärderas på klinisk svensk population för att möjliggöra jämförelser mot i denna studie redan erhållen data för utforskande av cutoff-värde för screening av PTSD som är gångbar med den svenska översättningen. Detta är av hög klinisk relevans och datan från föreliggande studie avses användas för detta syfte när klinisk data samlats in.
CATS bör även fortsatt prövas och utvärderas mot såväl DSM-5s kriterier för PTSD som kriterierna i ICD-11 och andra inom fältet dominerande modeller. Att se över hur passformsindex kan förbättras vid exempelvis eliminering av item 8 bör också vidare utforskas. Fyrfaktormodellen bör även prövas i programvara som tillåter andra hävdat mer robusta estimeringsmetoder än ML för att i högre grad säkerhetsställa korrekta parameterestimat, något som det till följd av vald programvara ej fanns möjlighet till i föreliggande studie.
För att säkerställa de psykometriska egenskaperna på den svenska versionen av CATS och för att utöka instrumentets användningsområden bör även mer evidens för validitet inhämtas, en process som aldrig kan ses som fulländad (AERA et al., 2014).
Slutsatser
Denna studie visar att den svenska översättningen av CATS uppvisar goda psykometriska egenskaper för normpopulation och bidrar därför till att vara det första svenska validerade självsvarsformuläret för screening, monitorering och forskning av såväl traumahändelser som traumasymtom hos barn och unga.
CATS uppvisar optimal intern konsistens och moderat till god temporal stabilitet. Dock bör den temporala stabiliteten fortsatt undersöka för att utröna om erhållna moderata och enligt konfidensintervall riskerat bristfälliga resultat är avhängigt faktiska mätfel eller naturligt förekommande förändring i symtombild.
CATS kunde valideras mot psykometriskt undersökta instrument på PTSD och således bekräfta evidens för konvergent validitet. Viss evidens för kriterievaliditet har erhållits genom denna studie då antal traumahändelser tycks predicera antal traumasymtom men även då föreliggande normpopulation skiljer sig signifikant i symtomuttryck jämfört med kliniska populationer från USA, Tyskland och Norge. Dock kunde evidens för diskriminant validitet inte bekräftas vilket betraktas som en konsekvens av valda bedömningsinstrument.
Fyrfaktormodellen för PTSD i enlighet med DSM-5 bekräftades vilket därmed gör instrumentet användbart som hjälpmedel för screening i enlighet med aktuellt diagnossystem DSM- 5 samt ger evidens för intern struktur. Då andra modeller av PTSD i föreliggande studie inte har jämförts mot fyrfaktormodellen, kan dock inte fastställas att andra modeller lika väl eller bättre skulle förklara data.
Slutligen kan således konstateras att denna studie har bidragit till validering av det enda förekommande screeninginstrumentet för PTSD på svensk population som inkluderar såväl
traumahistorik som traumasymtom i enlighet med DSM-5. Därmed har denna studie påbörjat processen att fylla ett stort tomrum inom forskningsfältet.
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