Development and validation of the Clinical Aspects of Historical Trauma Questionnaire in Rwandan genocide survivors

Abstract

Historical trauma is a relatively new concept in the literature, and investigations are needed to clarify its clinical aspects and develop instruments to measure its sequelae. The purpose of this study was to develop the Clinical Aspects of Historical Trauma Questionnaire (CAHTQ), which is meant to capture trauma sequelae in different contexts, and provide initial psychometric information. Participants were survivors of the genocide against the Tutsi in Rwanda (N = 261) aged 32–87 years (M = 46.30 years, SD = 11.95) who completed a preliminary version of the CAHTQ, constructed based on theoretical and content‐related consideration, as well as the International Trauma Questionnaire, Fatalism Scale, Public Health Depression Questionnaire, Brief Coping Inventory, Forgiveness Questionnaire, and Sentiment of Reconciliation Questionnaire to test the discriminant and convergent validity of the CAHTQ. Exploratory factor analysis was conducted to reduce the number of items and extract factors; confirmatory factor analysis (CFA) was conducted to confirm the measure's dimensionality. The final questionnaire includes 20 items and five subscales. The items demonstrated good internal consistency, Cronbach's α = .91, and the CFA demonstrated a very good fit of the model to the data, χ2(60, N = 261) = 271, CFI = .963 = , TLI = .956, SMRR = .052, RMSEA = .052. The CAHTQ was developed to capture the clinical aspects of historical trauma sequelae. Unlike comparable previously developed instruments, this questionnaire can be used for various historical traumas globally, and its suitability for this purpose will be the focus of future studies.

Caseness and comorbidity of probable (complex) post-traumatic stress disorder and depression in survivors of genocide against Tutsi in Rwanda: the role of social determinants

“…The final checklist of traumatic events was composed of 37 dichotomous questions and 1 additional open question (“Can you think another situation that was very frightening to you?”). This instrument was chosen because its items were easy to adapt to the experience of genocide survivors and it was previously used with Rwandans (see Mutuyimana & Maercker, 2022). In this study, it shows a high reliability, as the Kuder–Richardson 20 score was .92.…”

“…Considering the traumatic experiences during the genocide and the related post-genocide adversities, it is unsurprising that many affected individuals experienced a high level of suffering and historical trauma (Mutuyimana & Maercker, 2022). This is also reflected in the prevalence of about 30% for probable post-traumatic stress disorder (PTSD) and about 40% for probable depression (e.g., Bahati et al, 2022;Mutuyimana et al, 2019Mutuyimana et al, , 2021.…”

Clinically relevant historical trauma sequelae: A systematic review

“…Based on the current state of knowledge about historical trauma and the need to also use historical trauma research for new contexts of application within the groups that have experienced collective and cumulative trauma that took place a long time ago, for example, the genocide against the Tutsi in Rwanda (Mutuyimana & Maercker, 2022), the definition of historical trauma should be further elaborated in the future.A current working definition is the following: Historical trauma is psychological and emotional injuries shared collectively across generations resulting from past collective traumatic experiences or events, manifesting in perceived discrimination and oppression, learned mistrust, exhaustion and feelings of humiliation, cultural-related syndromes and historical thoughts of loss, associated with various clinical psychological disorders and risk behaviours within a group that share a similar social, historical, and political backgrounds. This definition differs from previous ones in that it does not consider colonization a prerequisite for historical trauma (see Hartmann & Gone, 2014).…”

Cultural psychological factors in posttraumatic symptom development and expression: a study protocol

“…The chosen researchers in the different study sites possess unique expertise in trauma research. This includes scientific contributions on armed conflicts (Saxon et al, 2017 ; Stein et al, 2018 ), genocide and historical trauma (Mutuyimana & Maercker, 2022 ), traumatic grief (Song et al, 2018 ), as well as diagnostic features of stress-related disorders (Maercker & Eberle, 2022 ) and culture-dependent risk and protective factors in the face of adversity (Bachem et al, 2023 ; Levin et al, 2021 ). All the researchers are cultural experts in the language and contexts of the study sites and are trained to lead quantitative and qualitative research procedures (e.g.…”