The significant others’ responses to trauma scale (SORTS) : applying factor analysis and item response theory to a measure of PTSD symptom accommodation

Background: Symptom accommodation by family members (FMs) of individuals with posttraumatic stress disorder (PTSD) includes FMs’ participation in patients’ avoidance/safety behaviours and constraining self-expression to minimise conflict, potentially maintaining patients’ symptoms. The Significant Others’ Responses to Trauma Scale (SORTS) is the only existing measure of accommodation in PTSD but has not been rigorously psychometrically tested.

Objective: We aimed to conduct further psychometric analyses to determine the factor structure and overall performance of the SORTS. Method: We conducted exploratory and confirmatory factor analyses using a sample of N = 715 FMs (85.7% female, 62.1% White, 86.7% romantic partners of individuals with elevated PTSD symptoms).

Results: After dropping cross-loading items, results indicated good fit for a higher-order model of accommodation with two factors: an anger-related accommodation factor encompassed items related largely to minimising conflict, and an anxiety-related accommodation factor encompassed items related primarily to changes to the FM’s activities. Accommodation was positively related to PTSD severity and negatively related to relationship satisfaction, although the factors showed somewhat distinct associations. Item Response Theory analyses indicated that the scale provided good information and robust coverage of different accommodation levels.

Conclusions: SORTS data should be analysed as both a single score as well as two factors to explore the factors’ potential differential performance across treatment and relationship outcomes.

HIGHLIGHTS

• We examined the Significant Others’ Responses to Trauma Scale (SORTS), a measure of symptom accommodation in PTSD, among a large sample of family members.
• As measured by the SORTS, accommodation in PTSD could be broken down into two aspects: anger-related accommodation and anxiety-related accommodation.
• Accommodation was positively related to PTSD severity and negatively related to relationship satisfaction.