Research Appraisals
Evidence-based critical appraisals of the latest medical research, systematically evaluated using Oxford CEBM methodology.
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European journal of psychotraumatology
Assessment of functional impairment related to post-traumatic stress in children and adolescents: a systematic review
Background: Post-traumatic stress disorder (PTSD) often impairs children's and adolescents' functioning across different life domains. Significant functional impairment is a diagnostic criterion for PTSD in both the DSM-5 and the ICD-11, but the methods in terms of domains covered and scoring rules to assess functional impairments are quite inconsistent.Objective: This systematic review evaluates instruments specifically designed to assess post-traumatic stress symptoms (PTSS), PTSS modules within diagnostic interviews, and generic functional impairment measures used to capture PTSS-related functional impairment in children and adolescents.Method: A systematic search was conducted across six databases for studies published between January 2010 and November 2025. Eligible papers included the development or psychometric evaluation of PTSS-specific measures, PTSS modules in diagnostic interview, and generic functional impairment measures validated in samples exposed to trauma or adverse childhood experiences. Data were extracted and categorized based on assessed content domains, scoring methods, and psychometric properties, with results stratified by age group (6 years and younger versus 7 years and older).Results: From 3519 records, 30 papers met the inclusion criteria. Thirteen PTSS-specific instruments, one diagnostic interview module, and one generic functional impairment measure were identified. Together, these instruments assessed 11 different life domains, although considerable variation existed in the domains covered across tools. Scoring methods also varied, with approximately half using dichotomous response formats and the remainder using multi-categorical scales. Psychometric properties of the functional impairment scales were reported in only 20.7% of publications.Conclusion: Current tools for assessing PTSS-related functional impairment in youth lack standardization. There is a critical need for well-validated instruments that comprehensively capture the presence and severity of PTSS-related functional impairment. This systematic review identified and evaluated 15 instruments, comprising PTSS-specific measures, diagnostic interview modules, and generic functional impairment tools, used to assess PTSS-related functional impairment in children and adolescents.The instruments collectively assessed 11 different life domains; however, substantial variability existed in the domains covered, and scoring methods ranged from dichotomous formats to Likert-type scales.Only 20.7% of papers reported psychometric properties for functional impairment items, highlighting the critical need for standardized, developmentally appropriate tools with robust validation in children and adolescents with potentially traumatic experiences.
8 July 2026
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Cross-cultural adaptation and psychometric evaluation of the artificial intelligence learning intention scale (AILIS) among medical sciences students: a methodological study
BACKGROUND: This study aimed to adapt and psychometrically evaluate the Artificial Intelligence Learning Intention Scale (AILIS) among Iranian medical sciences students. METHODS: This methodological psychometric study was conducted among 800 medical sciences students at Babol University of Medical Sciences, Iran. The AILIS was translated and culturally adapted into Persian using a standardized cross-cultural adaptation process. Construct validity was examined through exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). Reliability was assessed using Cronbach's alpha, McDonald's omega, and the intraclass correlation coefficient (ICC). Convergent and discriminant validity were evaluated using composite reliability (CR) and average variance extracted (AVE). Measurement invariance across gender and structural stability were assessed using multi-group confirmatory factor analysis and exploratory graph analysis (EGA). RESULTS: EFA supported a four-factor structure consisting of Epistemic Capacity, Psychological Attitudes, Facilitating Environments, and Psychological and Behavioral Outcomes, explaining 44.55% of the total variance, with factor loadings greater than 0.40. Confirmatory factor analysis indicated an acceptable model fit, supporting the proposed factor structure (χ²/df = 3.42, RMSEA = 0.078, CFI = 0.932). Internal consistency and test-retest reliability were satisfactory, with Cronbach's alpha ranging from 0.854 to 0.904, McDonald's omega from 0.854 to 0.899, and ICC from 0.750 to 0.860. Composite reliability values were adequate, while AVE values indicated acceptable but partially limited evidence of convergent validity. Discriminant validity was generally supported. In addition, multi-group analysis demonstrated measurement invariance across gender, and exploratory graph analysis confirmed the structural stability of the four-factor model. CONCLUSION: The Persian AILIS is a valid and reliable instrument for assessing AI learning intention among medical sciences students. Beyond its psychometric robustness, the instrument may support curriculum planning, evaluation of AI-related educational interventions, and evidence-based decision-making in medical sciences education by providing a standardized measure of students' intentions to engage with AI learning.
20 June 2026
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