Developing a measure of adaptive stress arising from the psychosocial disruptions experienced by refugees based on a sample of displaced persons from West Papua

Abstract

We report the testing and refinement of the Adaptive Stress Index (ASI), a psychosocial assessment tool designed to measure the longer terms stressors of adapting to the psychosocial disruptions experienced by refugees. The ASI is based on a theoretical model, the Adaptation and Development After Persecution and Trauma (ADAPT), which postulates that five psychosocial domains are disrupted by conflict and displacement, namely, safety and security, attachment, access to justice, roles and identities, and existential meaning. We used confirmatory factor analysis (CFA) and item response theory (IRT) to shorten and refine the measure based on data obtained from 487 refugees participating in a household survey in Papua New Guinea (response rate: 85.8%). CFA allowed the exclusion of low loading items (<0.5) and locally dependent items. A good fit was found for single models representing each of the five ASI domains. A graded response IRT model identified items with the highest discrimination and information content in each of the five derived scales. The analysis produced a shortened and refined ASI for use amongst refugee populations. The study offers a guide to adapting measures of stress for application to diverse populations exposed to mass conflict and refugee displacement.