Abstract
Secondary traumatic stress (STS) is a syndrome including intrusion, avoidance, and arousal due to indirect trauma exposure (e.g., by caring for traumatized patients in a professional context or transgenerational transmission of trauma in familial or cultural systems). Bride et al. (1) developed the Secondary Traumatic Stress Scale (STSS), designed to measure these reactions of helping professionals who have experienced traumatic stress through their work with their traumatized clients. This study aimed to validate the French version of the STSS (STSS-F) by evaluating factorial and criterion validity. Furthermore, its reliability and other psychometric properties were evaluated. Two-hundred-and-twenty midwives at two university hospitals in the French-speaking part of Switzerland completed an anonymous online survey. Midwives were chosen as study population because STS represents a serious professional risk in this population. In a series of confirmatory factor analyses and exploratory structural equation modeling (ESEM), a model with two correlated ESEM factors (i.e., intrusion, avoidance-arousal) provided the best model fit, thus establishing factorial validity. Differential associations of the STSS-F total score to general distress and posttraumatic stress and the utility of the STSS-F total score to account for variance in core dimensions of burnout beyond general distress, posttraumatic stress, perceived stress, occupational reward, and efforts supported the criterion validity of the STSS-F. The full STSS-F and its subscales showed acceptable to good levels of reliability. Limitations include the relatively small and homogeneous sample and the lack of tests of factorial invariance of the STSS-F and the original STSS. In conclusion, the present study provides evidence for the reliability and validity of the STSS-F. It makes the SSTS accessible to French speaking research contexts.
Highlights
Secondary traumatic stress (STS) or STS disorder (STSD) is a syndrome including intrusion, avoidance, and arousal (2)
The current study aimed to validate the French version of Bride et al.’s (1) Secondary Traumatic Stress Scale in a sample of N = 220 Swiss midwives by evaluating its factorial and criterion validity
Using the independent cluster model of confirmatory factor analysis (ICM-CFA) approach (22), a series of five models was tested, of which the King et al (26) numbing model, and the Simms et al (28) dysphoria model were tested for the first time in the context of the Stress Scale (STSS)
Summary
Secondary traumatic stress (STS) or STS disorder (STSD) is a syndrome including intrusion, avoidance, and arousal (2). The DSM-5 disregards the helping and empathic quality of the relationship between primary and secondary traumatized victims. This reveals an important gap in the definitions of STSD in the DSM-5 and in the STS literature (6). Renshaw et al (7) showed that PTSD inventories likely provide an ambiguous measure of STS that may tap into traumatic events experienced in respondents’ own lives. A recent publication setting out a research agenda for STSD highlighted that many previous studies have not made the important distinction between primary and secondary exposure to traumatic events and have called for the validation of screening tools for STS (8). The authors have called for research that can provide evidence for the operationalization of STS and compassion fatigue that allow the development and validation of measures sensitive to the underlying concept (8)
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