Dimensional Structure and Cultural Invariance of DSM V Post-traumatic Stress Disorder Among Iraqi and Syrian Displaced People

Abstract

While the factor structure of post-traumatic stress disorder (PTSD) symptoms has been investigated among various traumatized populations in Western and high-income countries, knowledge regarding the validity of factor structure of PTSD among culturally diverse populations in low-and-middle-income countries is limited. The current study examined the factor structure and cultural invariance of PTSD in 521 Iraqi and 993 Syrian war-affected displaced people who were living in the Kurdistan Region of Iraq. Results from confirmatory factor analyses demonstrated that alternative factor models for PTSD, including a new model derived from this population (anhedonia and affect model) resulted in a better fit than the current DSM V models. Taken together, the results showed that a good fit, as well as the measurement invariance of PTSD factors, could be obtained by applying the anhedonia and hybrid model. This study provides further support for the anhedonia and hybrid model of PTSD and fills an important gap in knowledge about the validity of PTSD symptom clusters among Arab and Kurdish populations.

Sex differences in PTSD risk: evidence from post-conflict populations challenges the general assumption of increased vulnerability in females

“…A detailed description of the data collection procedure is described in detail elsewhere (e.g. Ibrahim, Catani, Ismail, & Neuner, 2019 ; Ibrahim, Ertl, Catani, Ismail, & Neuner, 2018a ). Participants with no trauma exposure history and who were under the age of 18 were excluded from analyses, leading to a sample of N = 974 participants included in the analyses (N = 494 males and N = 480 females).…”

“…Adverse and traumatic life events were evaluated by applying the War and Adversity Exposure Checklist (Ibrahim et al, 2018a ) comprising 25 potential traumatic events. Current PTSD symptoms were assessed by valid and reliable Arabic and Kurdish versions of the PTSD Checklist for DSM-5 (PCL-5) (Ibrahim et al, 2019 ). To determine probable PTSD diagnosis, the cut-off score of 23 or higher of the PCL-5 was used as suggested in a recent validation study in the same cultural context (Ibrahim, Ertl, Catani, Ismail, & Neuner, 2018b ).…”

Association of War-Related and Gender-Based Violence With Mental Health States of Yazidi Women

“…40 The instrument had been translated, culturally adapted, and validated among Iraqi and Syrian displaced people, including Yazidis. 41,42 Scores on the PCL-5 scores range from 0 to 80.…”

Does cumulative exposure to traumatic stressors predict treatment outcome of community-implemented exposure-based therapy for PTSD?

“…Surveys conducted in other war-affected and low-income regions found that prevalence rates of DSM-IV PTSD were, e.g. 37% in Algeria in a sample of survivors of armed conflict, 28% in Cambodia in samples from three selective areas surveying refugee camp returnees, poor population facing continues civil strife and a sample from the capital with a relatively higher living-standard, 18% in refugee camps, cities, and resettlement areas of Gaza, and 16% in Ethiopia in a sample of registered refugees and up to 64% in a sample of Iraqi displaced individuals (de Jong et al, 2001 ; Ibrahim, Catani, Ismail, & Neuner, 2019 ). Both the individual well-being and functioning as well as the development of a peaceful post-war society require effective treatments for individuals with multiple traumatization suffering from PTSD.…”