Measures Of Trauma Exposure Research Articles

Occurrence of potentially traumatic events, type, and severity in undergraduate students

ABSTRACT Background Trauma exposure can have significant mental health impacts on students that impair academic performance and engagement. It is therefore important to describe the occurrence of trauma experiences and associated symptoms among undergraduate students. Objective This study aimed to 1) assess the rates of potentially traumatic experiences, 2) examine the frequency of different trauma experience types, and 3) compare post-traumatic stress (PTS) symptom severity across experience subtypes in a large sample of undergraduate students. Methods Participants were 806 undergraduate students from three Australian universities who completed online self-report measures of trauma exposure, psychological distress, and PTS symptoms. Results Approximately two-thirds of students (64%) reported having experienced at least one potentially traumatic event. The most common experience types were the unexpected death of a loved one and accidents. Students reporting exposure to potential trauma had significantly higher general distress than non-exposed students. Events involving interpersonal violence were associated with greater PTS symptom severity. Conclusions This study provides evidence that the occurrence of potentially traumatic events is high among university students and may carry negative effects for mental health and functioning. Results highlight the need for trauma-informed educational approaches and robust counselling services to support students managing trauma histories.

Which PTSD symptom would mediate the relationship between trauma exposure and depressive symptoms? Preliminary findings from two samples of trauma-exposed middle school students

Recent studies have documented that post-traumatic stress disorder (PTSD) symptoms are robustly associated with depressive symptoms and may mediate the relationship between trauma exposure and depressive symptoms. However, no study has explored the differential mediating effects of four specific PTSD symptom clusters. This study made the first attempt to examine the mediating effects of different PTSD symptom clusters on the linkage between trauma exposure and depressive symptoms. We analyzed data from two large samples of Chinese middle school students (N = 693 and 957) who had experienced the 2013 Ya'an earthquake. Participants completed standardized measures of trauma exposure, PTSD symptoms, and depressive symptoms. The prevalence of probable PTSD was 3.4% and 3.6%, respectively, in the two samples. Mediation analyses revealed that negative alterations in cognitions and mood and alterations in arousal and reactivity were statistically significant mediators in the relationship between trauma exposure during the earthquake and depressive symptoms. The results are very consistent in both samples. The findings suggest that symptom-specific tailored management of these two specific PTSD symptom clusters might have the potential to change the trajectory of developing depressive symptoms among trauma-exposed populations.

Trauma History Questionnaire: validation with novel samples of incarcerated women and perinatal women

ABSTRACT Trauma exposure is associated with numerous negative outcomes, many of which are amplified within at-risk populations. Two under-researched and at-risk populations, incarcerated women and perinatal women, both report high rates of trauma, psychopathology, and PTSD compared to the general population. One common measure of trauma exposure in various populations, including incarcerated women and perinatal women, is the Trauma History Questionnaire (THQ). However, no known studies have validated the THQ within these two unique, understudied populations. Using data from two studies of incarcerated women and one study of perinatal women, researchers explored indices of THQ construct, predictive, and convergent validity. The study also included between-sample comparisons, highlighting differences in trauma incidence between the included samples. Analyses supported statistically significant relations between THQ scores and Severity of Violence Against Women Scale (SVAWS), depressive symptoms, PTSD, and psychological distress. Prenatal women’s THQ scores were also predictive of later postpartum depressive symptoms. Significantly higher THQ scores were found within the incarcerated samples compared to the perinatal sample. The study results provide further information about trauma within incarcerated and perinatal populations, as well as increase understanding of the utility of trauma assessments within these vulnerable groups.

Is gaming disorder related to psychological trauma? A scoping review

IntroductionGaming disorder has become a global concern and it could have a variety of health and social consequences. The trauma model has been applied to the understanding of different types of addictions as behavioral addictions can sometimes be conceptualized as self-soothing strategies to avoid trauma-related stressors or triggers. However, much less is known about the relationship between trauma exposure and gaming disorder.ObjectivesTo inform prevention and intervention strategies and to facilitate further research, we conducted the first scoping review to explore and summarize the literature on the relationship between trauma and gaming disorder.MethodsA systematic search was conducted on the Web of Science, Scopus and ProQuest. We looked for original studies published in English that included a measure of trauma exposure and a measure of gaming disorder symptoms, as well as quantitative data regarding the relationship between trauma exposure and gaming disorder.ResultsThe initial search generated 412 articles, of which 15 met the inclusion criteria. All of them were cross-sectional studies, recruiting participants from both clinical and non-clinical populations. Twelve of them (80%) reported significant correlations between trauma exposure and the severity of gaming disorder symptoms (r = 0.18 to 0.46, p < 0.010). Several potential mediators, including depressive symptoms and dissociative experiences, have been identified. One study found that parental monitoring moderated the relationship between trauma and gaming disorder symptoms. No studies reported the prevalence of trauma or trauma-related symptoms among people with gaming disorder.ConclusionsThere is some evidence supporting the association between trauma and gaming disorder, at small to medium effect sizes. Future studies should investigate the mediators and moderators underlying the relationship between trauma and gaming disorder. The longitudinal relationship between trauma exposure and the development of gaming disorder should be clarified. A trauma-informed approach may be a helpful strategy to alleviate gaming disorder symptoms.Disclosure of InterestNone Declared

Complex PTSD in asylum-seekers living in a humanitarian setting in Africa: A latent class analysis.

Participants were 126 asylum-seekers hosted in a large, isolated reception camp in the desert surroundings of Agadez (humanitarian site) or in a number of small urban hosting facilities (cases de passages) who completed measures of trauma exposure and PTSD/CPTSD symptoms. Latent class analysis (LCA) was used to identify symptom profiles, and predictors of class membership were identified via multinomial logistic regression. More asylum seekers met the criteria for CPTSD (74.6%) than PTSD (19.8%) and no gender differences were observed. LCA results identified two distinct groups: (a) a CPTSD class (69.0%); and (b) a PTSD class (31.0%). Membership in the CPTSD class was significantly predicted by the early age of the first traumatic event, levels of functional impairment and reception conditions. Specifically, those in the CPTSD class were more likely to live in the humanitarian site compared with those in the PTSD class. This study supported the validity of the ICD-11 construct of CPTSD in an asylum-seeker sample living in a low-income country. Moreover, the findings suggest that not only premigration factors (i.e., the early age of the first trauma) but also postmigration stressors (i.e., precarious reception conditions in large, isolated facilities) are important predictors of CPTSD symptoms with important implications regarding reception policies and the prevention of trauma-related mental disorders in asylum seekers and refugees. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Correction to Barbieri et al. (2022).

This study investigated ICD-11 posttraumatic stress disorder (PTSD) and complex PTSD (CPTSD) symptom profiles and their premigration, postmigration, and demographic predictors in a treatment-seeking sample of asylum-seekers in Agadez (Niger). Participants were 126 asylum-seekers hosted in a large, isolated reception camp in the desert surroundings of Agadez (humanitarian site) or in a number of small urban hosting facilities (cases de passages) who completed measures of trauma exposure and PTSD/CPTSD symptoms. Latent class analysis (LCA) was used to identify symptom profiles, and predictors of class membership were identified via multinomial logistic regression. More asylum seekers met the criteria for CPTSD (74.6%) than PTSD (19.8%) and no gender differences were observed. LCA results identified two distinct groups: (a) a CPTSD class (69.0%); and (b) a PTSD class (31.0%). Membership in the CPTSD class was significantly predicted by the early age of the first traumatic event, levels of functional impairment and reception conditions. Specifically, those in the CPTSD class were more likely to live in the humanitarian site compared with those in the PTSD class. This study supported the validity of the ICD-11 construct of CPTSD in an asylum-seeker sample living in a low-income country. Moreover, the findings suggest that not only premigration factors (i.e., the early age of the first trauma) but also postmigration stressors (i.e., precarious reception conditions in large, isolated facilities) are important predictors of CPTSD symptoms with important implications regarding reception policies and the prevention of trauma-related mental disorders in asylum seekers and refugees. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

A Longitudinal Investigation of the Buffering Effects of Resilience on Body Mass Index in Trauma-Exposed College Students.

College students are at an increased risk for trauma exposure (TE), as well as weight gain and subsequent obesity. Notably, existing research has demonstrated that TE is associated with subsequent obesity. However, there is a dearth of literature looking at this relationship in college students who are at increased risk. Given this increased risk, there is a need to identify protective factors in the wake of TE that may buffer against the adverse impacts of TE on physical health outcomes. As such, the aim of the present study was to examine the relationship between college onset TE on subsequent BMI, and to examine psychological resilience as a buffer in this relationship. Trauma exposed college students (N= 2,281, Mage=18.5, 61.6% female, 50.3% identifying as racial/ethnic minorities) completed measures of TE, weight, height, and resilience. Individuals completed measures at baseline and at spring follow-up time points each year after. Resilience was assessed using the Connor-Davidson Resilience Scale (CD-RISC), and both new onset TE and BMI were assessed at Y2, Y3, and Y4. There was no significant main effect of new onset TE on BMI, nor an interaction between resilience and new onset TE. There was a main effect of resilience on later BMI, whereby those with higher levels of reported resilience reported higher BMI in subsequent years (Y2: B=.36, p<.05; Y3: B= .37= p<.01). The positive association between resilience and BMI is not consistent with our hypotheses. Findings suggest that resilience does not buffer against physical health outcomes.

Intergenerational transmission of trauma and its association with attitudes toward reconciliation.

We aimed to investigate the link between mothers' posttraumatic stress disorder (PTSD) symptoms and their adult offspring's attitudes toward reconciliation and psychopathology among survivors of the 1994 genocide perpetrated against the Tutsi in Rwanda. We also sought to examine whether parenting styles mediate the relationship between mothers' PTSD symptoms and their adult offspring's psychopathology, if any. Mother-child dyads (N = 181) were recruited in Rwanda and completed measures of trauma exposure, PTSD, depression, attitudes toward reconciliation, and parenting styles. Adult offspring of mothers who suffered from more severe PTSD symptoms had less favorable attitudes toward reconciliation, even after controlling for their own PTSD symptoms. Mothers' PTSD symptoms were not associated with their adult offspring's PTSD or depression symptoms. In addition, mothers' PTSD symptoms did not predict their parenting styles. These results suggest that the mental health of survivors of mass violence has repercussions on the intergroup attitudes of the following generation. This study has practical implications for sustainable peacebuilding in postconflict societies. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Posttraumatic stress symptom profiles of aid workers: Identifying risk and protective factors.

Researchers have documented elevated rates of posttraumatic stress disorder (PTSD) in aid workers. Yet, few have investigated the heterogeneity of PTSD presentations in this population. This study examined clinically relevant patterns of PTSD symptomatology in aid workers and examined whether factors such as the degree of trauma exposure (e.g., morally injurious events), social support, and sociodemographic and work characteristics predict symptom profiles. Participants were 243 aid workers who had completed 8.2 assignments on average. They completed measures of trauma exposure, PTSD symptoms, and various types of social support. Latent profile analysis was used to identify PTSD symptom profiles using PCL-5 subscale scores. Next, profiles were compared on 15 potential risk and protective factors. Five profiles were identified: a no PTSD profile (49.4%), a low subclinical PTSD profile (21.8%), a dysphoric subclinical PTSD profile (5.8%), an intermediate clinical PTSD profile (14.8%), and a severe clinical PTSD profile (8.2%). Profiles differed in terms of witnessed traumatic events, morally injurious exposure, social support adequacy, age, number of assignments, types of assignments, and organizational support. This study is the first to identify distinct patterns of PTSD symptomatology in aid workers and to investigate novel psychological risk factors such as potentially morally injurious events. Overall, these findings provide further insight into the risk and protective factors for the psychological well-being of aid workers as well as avenues for improving the psychological assessment and support. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Contributions of Trauma and Economic Insecurity to Psychological Distress in Response to the COVID-19 Pandemic.

Racially minoritized women with limited socioeconomic resources are at increased risk for adverse psychological outcomes in response to the COVID-19 pandemic. Disproportionate rates of trauma exposure and economic insecurity likely heighten risk for these outcomes among socioeconomically vulnerable individuals, but the unique contributions of these factors are poorly understood. As such, we examined trauma and economic factors as predictors of pandemic-related psychological distress and symptoms. Ninety-six women recruited for a trauma research study (91.7% Black, Mage=38.3 years, SDage=11.8 years) completed measures of trauma exposure, economic insecurity, and several items assessing psychological distress and symptoms related to the COVID-19 pandemic. We examined concern for mental and physical health impacts of COVID-19 as well as changes in self-reported levels of anxiety and anhedonia from the three months prior to the pandemic to the past two weeks. Linear regression analyses were used to assess contributions of trauma exposure and economic insecurity to COVID-19-related distress. Childhood maltreatment and lifetime trauma exposure did not predict COVID-19-related distress; however, financial concern significantly contributed to concern for the physical health impact of COVID-19 (B = .30, p < .05). Food insecurity emerged as the only significant predictor of concern for mental health impact of COVID-19 (B=.91, p < .01). Housing instability was the only significant predictor of COVID-19-related increases in anhedonia (B = -.30, p < .05). Economic insecurity, namely self-reported financial concern, food insecurity, and housing instability, was related to COVID-19-related psychological distress in a sample of predominately Black American women living in under-resourced communities. Findings may help identify populations at risk for COVID-19-related psychological distress and symptoms and develop effective interventions, such as expanding access to nutritious food sources and housing support, for minoritized community members.

Measures of trauma exposure and trauma response: A scoping review.

In contrast to the vast clinical, theoretical, and empirical literature on the impact of trauma, relatively few studies have reviewed the trauma measures that researchers and clinicians can choose to use in their work. This scoping review aimed to catalog all trauma measures (trauma exposure and its subjective responses) that have been published in the peer-reviewed literature, developed for use with adult populations. Through a systematic search of the literature and the screening of 19,631 abstracts, a total of 363 unique trauma measures were identified. Most of these measures were developed for assessment purposes rather than for clinical screening or diagnostic purposes. Most of these measures are patient-self-report measures that assess trauma exposure in the patients' lifetime, or subsequent symptoms, particularly cognitive impairments. Complications in the trauma literature are highlighted, including the use of very similar abbreviations of measures, substantial discrepancies regarding the definition of trauma, and the general assumption that a potentially traumatic event inevitably leads to traumatic distress rather than a path of resilience.

The longitudinal impact of war exposure on psychopathology in Syrian and Iraqi refugee youth.

War and natural disasters lead to forced migration - and increased risk of adverse psychological outcomes - in approximately 1% of the global population. Though recent years have brought a greater understanding of the consequences of war exposure on mental health outcomes for refugee children, little is known about the longitudinal and developmental impact of these experiences on youth. The aim of this study was to assess the effect of direct exposure to war and/or combat on trajectories of symptoms related to anxiety and post-traumatic stress disorder (PTSD) in Syrian and Iraqi refugee youth following resettlement. Prevalence of possible anxiety disorders and PTSD was also assessed. Participants included accompanied refugee youth resettled in the state of Michigan in the U.S. (n = 74). Youth filled out self-report measures of trauma exposure, anxiety symptoms, and PTSD symptoms upon arrival and 2 years later. Linear mixed-effects modeling was used to assess the effect of war exposure over time. Upon arrival, 38% screened positive for an anxiety disorder and 4.1% met diagnostic thresholds for PTSD. While war exposure did not predict changes to PTSD symptom trajectories (p = .481), anxiety symptoms increased over time among children reporting war exposure (B = 10.13, SE = 4.22, t = 2.40, p = .019). Our findings suggest that without appropriate interventions, anxiety- and trauma-related symptoms often do not decrease. Further, exposure to war trauma may lead to progressive worsening of symptoms. These findings suggest that assessing for type of trauma exposure, rather than focusing solely on migration status, may inform focused attention and interventions among trauma-exposed children resettling as refugees.

Posttraumatic stress disorder symptoms and dissociation as serial mediators of the relationship between cumulative victimization and adjustment problems among poly-victimized at-risk youth.

Poly-victimization (PV) has a greater adverse impact on adolescents' lives than any single victimization type, even when repeatedly experienced. Adolescents who experience PV tend to present with an array of adjustment problems, and research has begun to identify mechanisms linking PV to adjustment problems. Both posttraumatic stress disorder (PTSD) and dissociation are linked to PV and adjustment problems; however, it is unclear how these variables play a role in the pathways from PV to adjustment problems. This study assessed PTSD and dissociation as serial mediators in the PV-adjustment problems link. Two hundred eighteen Portuguese youth identified as poly-victims (56% girls) and aged between 12 and 17 years old (M = 15.63; SD = 1.26) were recruited from three at-risk contexts' cohorts. Participants completed self-report measures of trauma exposure, posttraumatic symptoms, dissociative symptoms, and emotional and social adjustment problems. The study results suggest that, among poly-victim adolescents, PTSD and dissociation may be mediators of the relationship between the cumulative extent of victimization and adjustment problems. The current study's findings highlight the importance of careful assessment of both PTSD and dissociative symptoms and indicate that targeted interventions are essential when working with poly-victimized youth with the highest scores of cumulative victimization. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Feeling pressured to talk about trauma: How pressure to disclose alters the association between trauma disclosure and posttraumatic growth.

Talking with others about traumatic experiences (i.e., trauma disclosure) has been associated with increased posttraumatic growth (PTG). Although this association indicates the value of disclosing, there is evidence that external pressure to disclose can hinder the benefits of trauma disclosure. The aim of the current study was to examine the influence of pressure to disclose on the association between trauma disclosure and PTG. People who had experienced a traumatic event and disclosed their trauma to a close other were recruited using Amazon's Mechanical Turk (N = 208). Participants completed measures of trauma exposure, trauma disclosure, pressure to disclose, PTG, posttraumatic stress symptoms, and response to disclosure. The results indicated that the linear association between trauma disclosure and PTG was quadratically moderated by pressure to disclose, ηp 2 = .025. Pressure to disclose strengthened the positive association between trauma disclosure and PTG from low, B = 0.818 (SE = 0.267), to moderate levels of pressure, B = 2.109 (SE = 0.471). However, when pressure was high, the association between disclosure and PTG was not significant, B = -1.19 (SE = 1.327). These findings indicate that a moderate amount of pressure to disclose may facilitate the positive impact of disclosure on PTG, yet a high amount of pressure may impede the positive association between disclosure and PTG. This research furthers understanding of the nuances of trauma disclosure and how close others' involvement in disclosure can impact the process of PTG for trauma survivors.

Traumatic Stress, Mental Health Stigma, and Treatment-Seeking Attitudes among Chinese College Students

ABSTRACT To date, research on traumatic stress and treatment-seeking behavior has primarily focused on Western populations. Despite experiencing similar levels of symptomatology, mental health service utilization appears lower among East Asian populations. Stigma toward mental health services may be one barrier to treatment-seeking, especially among individuals who have experienced potentially traumatic events; however, previous research has been primarily conducted in the United States. Less is known about predictors of treatment-seeking attitudes among populations residing in East Asia, particularly college students. The present study examined the relationship between trauma, mental health services stigma, and treatment-seeking attitudes among undergraduate students in Southwestern China. Self-report measures of trauma exposure, posttraumatic stress disorder symptomatology, mental health services stigma, and treatment-seeking attitudes were administered. We hypothesized that students with greater severity of traumatic symptoms would endorse more positive attitudes toward treatment-seeking if they reported lower levels of mental health services stigma. Mental health services stigma was a strong predictor of negative attitudes toward treatment-seeking, whereas neither trauma exposure nor traumatic symptomatology were associated with treatment-seeking attitudes. The significant association between mental health services stigma and treatment-seeking attitudes underscores the importance of destigmatizing mental health to encourage treatment-seeking among the Chinese college student population.

Associations between the misinformation effect, trauma exposure and symptoms of posttraumatic stress disorder and depression

ABSTRACT This research aimed to conduct an initial investigation into the relationships between the “misinformation effect” and trauma exposure, posttraumatic stress disorder (PTSD) and depression. Study 1 was a pilot study developing an online misinformation paradigm that could assess the influence of emotion and arousal on memory distortions. Participants (n = 162, Mage = 39.90; SD = 10.90) were recruited through TurkPrime. In Study 2 community members (n = 116, Mage = 28.96; SD = 10.33) completed this misinformation paradigm and measures of trauma exposure, PTSD, and depression. Study 1 found memory for central details was better for high-arousal than low-arousal and neutral-arousal images. Peripheral memory appeared worse for negative and neutral images than positive images. Study 2 found trauma exposure and PTSD symptoms predicted the misinformation effect; greater trauma exposure was associated with a greater proportion of errors, while PTSD was associated with a lower proportion of errors. Valence and arousal did not influence these associations. These findings have important implications in clinical and legal contexts where individuals with a history of trauma, or who are experiencing symptoms of PTSD or depression, are often required to recall emotionally-laden events. There is a surprising dearth of research into the misinformation effect in clinical populations and further research is required.

What we talk about when we talk about trauma: Content overlap and heterogeneity in the assessment of trauma exposure.

The accurate definition and assessment of trauma exposure is the foundation for replicable studies of mental health problems following trauma exposure. However, scales developed to assess trauma exposure might vary widely in terms of item content; overlap; and specifications of trauma intensity, frequency, duration, and timing. We compared eight frequently used self-report measures of trauma exposure to address content overlap and measurement heterogeneity. Combined, these measures assess 44 disparate exposures. Mean overlap across scales was moderate (M = 0.41, range: 0.25-0.48 across scales). Pairwise overlap between scales ranged from .19 to .59. We found 18 exposures (40.9%) that were included in one scale and three exposures (6.8%) that were included in all eight scales. Four of the included scales assess trauma frequency, five assess intensity or perceived danger, two assess duration, and four assess timing. The implications of measurement heterogeneity for clinical research as well as for comparability and replication of trauma-related research are discussed.

Drinking to cope as a mechanism between sleep problems and heavy episodic drinking among trauma survivors.

Objective: Women who have experienced trauma report high rates of heavy episodic drinking (HED) and sleep problems. Prior work suggests that poor sleep exacerbates heavy alcohol use; however, potential mechanisms for this association are unclear. Consistent with the self-medication model, one possibility may be that women with a history of trauma are drinking at increased rates in order to cope with the affective consequences of poor sleep. To examine this possibility, the current study tested the role of drinking to cope motives as a mediator of prospective associations between sleep problems and HED among women who have experienced trauma. Method: Community women reporting a history of trauma (N = 414, Mage = 21.8, 59.9% White, 36.2% Black) completed self-report measures at baseline and 4 month and 8 month follow-ups. Measures of trauma exposure (Life Events Checklist [LEC]) and sleep problems (Cohen-Hoberman Inventory of Physical Symptoms-Revised [CHIPS-R]) were taken from baseline, drinking motives (Revised Drinking Motives Questionnaire) at 4 months, and HED at 8 months. Results: Findings supported an indirect association between sleep problems and later HED through increased drinking to cope motives (b = .05, 95% CI [.018, .108], β = .05). Conclusion: As hypothesized, drinking to cope accounted for associations between sleep problems and later HED. Findings underscore the potential value in addressing drinking to cope motives as a means of reducing HED, particularly among women with a history of trauma who are sleeping poorly. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

The psychometric properties of the adolescent dissociative experiences scale (A-DES) in a sample of Portuguese at-risk adolescents

ABSTRACT Dissociation is a process that often occurs as a sequela of psychological trauma, and it is interrelated with psychological and behavioral problems. In the at-risk adolescent population, dissociation is often underdiagnosed and undertreated. Having reliable measures to assess this phenomenon can help in identifying adolescents at-risk and improve treatment outcomes. This study assessed the psychometric properties of the Adolescent Dissociative Experiences Scale (A-DES) with a sample of 402 Portuguese adolescents recruited from three at-risk populations. Participants completed self-report measures of trauma exposure, posttraumatic symptoms, psychological and behavioral problems, and the A-DES. A subset of the sample also completed test-retest measures. Confirmatory factor analyses revealed a best-fitting 3-factor model. Analyses revealed good internal consistencies and good agreement test-retest reliability for the scale overall and the factor-based sub-scales. Construct and predictive validity was supported with results showing that A-DES discriminates between youth reporting high versus low levels of cumulative trauma exposure and youth who meet or do not meet criteria for a probable PTSD diagnosis. Study findings replicate prior research supporting a 3-factor model of dissociation and the usefulness of A-DES to identify adolescents with dissociative symptoms. Clinical and research implications are discussed.

A pilot study adapting and validating the Harvard Trauma Questionnaire (HTQ) and PTSD checklist-5 (PCL-5) with Indian women from slums reporting gender-based violence

BackgroundDespite high rates of gender-based violence (GBV) in India, culturally sensitive measures that examine universal and culturally relevant trauma reactions are lacking. Although the Harvard Trauma Questionnaire (HTQ) has been used in India, no study has adapted the measure in full for use with this population. Similarly, the PTSD checklist-5 (PCL-5) has not yet been validated in India. This study describes the adaptation, validation, and results from the adapted HTQ, and embedded PCL-5, for Indian women from slums reporting GBV.MethodThis study used the adaptation framework proposed by the HTQ measure developers. The adapted HTQ contained a (1) trauma screen relevant for stressors faced by Indian women from slums, (2) description of the index trauma, (3) description of any ongoing stressors, (4) universal trauma reactions (i.e., PTSD measured by the PCL-5), and culturally relevant trauma reactions (i.e., idioms of distress measured by a scale developed for the study). This measure was piloted on 111 women from Indian slums in face-to-face interviews. Trauma characteristics, types of ongoing stressors, and psychometric properties of the PCL-5 and idioms of distress scale were explored. These scales were validated against measures of depression (PHQ-9), anxiety (GAD-7), and somatic complaints (PHQ-15).ResultsThe majority of participants (77%) reported physical beatings, 18% reported unwanted sexual touch, and 28.8% reported infidelity as the primary emotional abuse. Further, 96.7% of GBV was perpetrated by partner or family member and over half reported ongoing stressors (e.g., poverty-related strain). The PCL-5 embedded in the HTQ yielded good internal consistency (Cronbach’s alpha = .88) as did the idioms of distress scale with deletion of one item (Cronbach’s alpha = .80). Both scales were externally valid, yielding large correlations with depression, anxiety, and somatic complaints (rs between .54 and .80, ps < .05).DiscussionThis is the first study to develop a comprehensive measure of trauma exposure with universal and culturally relevant trauma reactions in India. This study also enhances HTQ usage in India by delineating all the steps in the adaptation process. Results can inform the development of trauma-focused interventions for Indian women from slums.