Abstract
BackgroundPerception of entrapment can emerge when someone feels trapped in an aversive situation and incapable of escape. Depression is closely related to the construct of entrapment. In China, men who have sex with men (MSM) have a high prevalence of depression; therefore, a tool to evaluate entrapment in this population is needed. We evaluated the validity and reliability of the Chinese version of the entrapment scale (ES) and the relationship to depression among MSM in Shanghai, China.MethodsWe recruited 304 MSM from four districts in Shanghai, China. Participants completed health behavior questionnaires that included baseline information and psychological measurements such as the ES and Patient Health Questionnaire (PHQ-9). The sample was randomly divided into two groups for exploratory factor analysis (n = 143) and confirmatory factor analysis (n = 161). Criterion validity was tested to explore the correlation between the ES and PHQ-9 scores. The reliability of the ES was evaluated with internal consistency reliability (Cronbach’s α coefficient) and split-half reliability (Spearman-Brown coefficient). We performed hierarchical regression analysis to determine the variance explained of entrapment to predicting depressive symptoms after adjusting for sociodemographic factors. Finally, receiver operator characteristic curve analysis was performed to measure the optimal ES cut-off value for predicting depression.ResultsFactor analysis showed the ES had one principal component, and one-dimensional scale had more acceptable model fit indices than two-dimensional model. The correlation coefficient between the ES and PHQ-9 scores was 0.756 (P < 0.01). The Cronbach’s α coefficient was 0.970 and the Spearman-Brown coefficient was 0.976. ES scores significantly predicted an additional 45.1% of depressive symptoms after controlling for sociodemographic characteristics in the MSM population (β = 0.689, P < 0.001). The optimum cut-off value was 23, which had a sensitivity of 70% and a specificity of 85.4%.ConclusionsThe Chinese version of the ES has good validity and reliability in the MSM population in Shanghai, and can be used to evaluate perception of entrapment among MSM. The findings confirmed an association between entrapment and depression.
Highlights
Perception of entrapment can emerge when someone feels trapped in an aversive situation and incapable of escape
The findings confirmed an association between entrapment and depression
A previous systematic review reported that self-perceived defeat and entrapment played key roles in depression, anxiety, suicide ideation, and posttraumatic stress disorder, and emphasized that entrapment played a decisive role in depression [8]
Summary
Perception of entrapment can emerge when someone feels trapped in an aversive situation and incapable of escape. Feeling defeated and trapped (called arrested flight) may lead individuals to perceive entrapment, which is considered more serious than being defeated but able to escape [2]. Gilbert and Allan defined entrapment as a personal feeling in which an individual is in an adverse state or environment and has a strong motive to take flight or get rid of the stressor, but is incapable of escape. A previous systematic review reported that self-perceived defeat and entrapment played key roles in depression, anxiety, suicide ideation, and posttraumatic stress disorder, and emphasized that entrapment played a decisive role in depression [8]
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