The factor structure of posttraumatic stress disorder symptoms among Rwandans exposed to the 1994 genocide: A confirmatory factor analytic study using the PCL-C

Fodor, Kinga Edit; Pozen, Joanna; Ntaganira, Joseph; Sezibera, Vincent; Neugebauer, Richard

doi:10.1016/j.janxdis.2015.03.001

Cited by 28 publications

(30 citation statements)

References 57 publications

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“…Thus, in contrast to our results, most studies provided evidence for the recently proposed DSM-5 PTSD model (e.g. Fodor et al, 2015; Vindbjerg, Carlsson, Mortensen, Elklit, & Makransky, 2016). …”

Section: Discussioncontrasting

confidence: 99%

“…Fodor et al, 2015), providing evidence for conceptual similarity of mental health concepts are. We conclude, in line with these previous findings, that depression, anxiety, and posttraumatic stress are conceptually similar across our groups under study.…”

Section: Discussionmentioning

confidence: 99%

“…Within this selection process, clinicians also need to bear in mind whether an instrument is valid across different linguistic groups (see Fodor, Pozen, Ntaganira, Sezibera, & Neugebauer, 2015). Health professionals are using assessment tools in linguistic groups for whom these instruments were not originally developed (Miller, Kulkarni, & Kushner, 2007; Rasmussen et al, 2015).…”

Section: Introductionmentioning

confidence: 99%

“…Only when MI holds for a mental health questionnaire, cross-group differences in scores on mental health constructs are meaningful (Meredith, 1993; Steenkamp & Baumgartner, 1998; Van De Schoot et al, 2012). Methodologically, scholars have examined MI of mental health questionnaires using confirmatory factor analyses (CFA; Charak et al, 2014; Contractor et al, 2015; Fodor et al, 2015; Schnyder et al, 2015). CFA is a widely-used technique for testing MI of mental health questionnaires.…”

Section: Introductionmentioning

confidence: 99%

“…Studies from non-Euro-American samples are exceedingly sparse. Fodor et al (2015) examined the factor structure of PTSD within a group of Rwandan adults who experienced trauma during the 1994 genocide using the PTSD-Checklist – Civilian Version (PCL-C). Their results suggest that the latent structure of PTSD found in this sample was comparable to Euro-American samples.…”

Section: Introductionmentioning

confidence: 99%

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The assessment of psychopathology among traumatized refugees: measurement invariance of the Harvard Trauma Questionnaire and the Hopkins Symptom Checklist-25 across five linguistic groups

Wind

Rie

et al. 2017

European Journal of Psychotraumatology

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Background: Questionnaires are widely used to assess the mental health status of refugees, whereas their construct validity largely remains unexplored. Objective: This study examined the construct validity of two widely-used instruments for the assessment of PTSD symptoms (Harvard Trauma Questionnaire [HTQ]; 16 items) and symptoms of anxiety and depression (Hopkins Symptom Check list-25 [HSCL-25]; 25 items) among Dutch and refugee patients with different linguistic backgrounds. Method: We applied exploratory factor analyses and measurement invariance analyses to test construct validity.Participants (n =1 256) were divided into five linguistic groups defined by language family, including four non-western linguistic groups (Indo-Iranian [n = 262], Niger-Congo [n = 134], Semitic [n = 288], and South Slavic languages [n = 199]) and one western linguistic group (Germanic languages; Dutch [n = 373]). Results: Exploratory factor analysis yielded a 3-factor structure of the HTQ and a 2-factor structure of the HSCL-25. Measurement invariance 20 analyses on the HTQ showed strong measurement invariance across the groups of refugee patients. However, Dutch patients reported milder symptom severity on most items of the HTQ. Measurement invariance analyses on the HSCL-25 (not conducted in Dutch patients) indicated partial strong measurement invariance across refugee patients. Conclusion: We conclude that mental health constructs measured by the HTQ and the HSCL25 25 are to a large extent interpreted in a similar way by refugee patients. This indicates that these instruments can be applied in non-western refugee patient populations, and that local idioms of distress and inherent response patterns may not play a major role when applying the HTQ and the HSCL-25 in these populations. Yet, whereas meaningful comparisons of observed PTSD and depression scores between groups of refugee patients with different non30 western linguistic background are feasible, comparisons between patients with a western and non-western linguistic background, as well as comparisons of anxiety scores, are likely to be biased. Future studies need to establish whether the commonly used cut-off scores of both questionnaires apply for refugee patients with non-western linguistic backgrounds.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The assessment of psychopathology among traumatized refugees: measurement invariance of the Harvard Trauma Questionnaire and the Hopkins Symptom Checklist-25 across five linguistic groups

Wind

Rie

et al. 2017

European Journal of Psychotraumatology

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Gender Differences in Traumatic Experiences and Posttraumatic Stress Symptoms After the Rwandan Genocide Against the Tutsi

Platt

Pozen

Ntaganira

et al. 2021

Journal of Traumatic Stress

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The effects of the 1994 Rwandan Genocide against the Tutsi are widespread and long‐lasting, but little is known about how posttraumatic consequences differ regarding gender. In the present study, we estimated the associations between trauma exposure and posttraumatic stress symptoms (PTSS) in a Rwandan community sample and examined whether the associations differed by gender. The sample comprised 498 adults (75.2% women) living in Rwanda's Huye District in 2011. We used a validated self‐report checklist to assess the eight most frequent traumatic experiences during the Genocide. The PTSD Checklist–Civilian version (PCL‐C) was used to assess PTSS. Associations between trauma exposure and PTSS were estimated using structural equation modeling (SEM), with additional SEMs stratified by gender. The prevalence of exposure to each traumatic event ranged from 15.1% to 64.5%, with more severe PTSS among individuals who reported personal physical injury, β = .76, 95% CI [0.54, 0.98]; witnessing sexual/physical violence against a loved one, β = .51, 95% CI [0.20, 0.81]; a close relative/friend's death, β = .54, 95% CI [0.24, 0.83]; property destruction, β = .35, 95% CI [0.048, 0.51]; or a family member's death due to illness, β = .21, 95% CI [0.00, 0.41]. Men who saw people killed and women who witnessed sexual/physical violence against a close family member reported elevated PTSS. The psychiatric impact of the Rwandan Genocide continues into the 21st century. Increased attention should be paid to the long‐term and demographic patterns of distress and disorder, especially in the absence of widespread clinical mental health services.

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Geocultural variation in correlates of psychological distress among refugees resettled in the United States

Blackwell

Lardier

Choe

et al. 2022

Journal of Traumatic Stress

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Attention to cultural variability in mental health symptoms could inform intervention targets; however, this is currently a neglected area of study. This study examined whether the associations between common mental health disorder (CMD) symptoms and predictors of CMDs varied cross‐culturally. Participants were 290 refugees from three geocultural regions (Afghanistan, Great Lakes region of Africa, and Iraq and Syria) who recently resettled in the United States and completed assessments of CMD symptoms and predictors. Multilevel generalized linear modeling was used to examine the interactions between correlates of depressive, anxiety, and posttraumatic stress disorder (PTSD) symptoms and each of the three cultural reference groups. Relative to refugees from other regions, Iraqi and Syrian participants demonstrated stronger associations between the number of reported traumatic experiences and both depressive, B = 0.01, SE = .003, p = .003, and anxiety symptoms, B = 0.01, SE = .003, p < .001; Afghan participants showed a stronger association between physical quality of life and PTSD symptoms, B = 0.02, SE = .011, p = .037; and African participants demonstrated stronger associations between gender and symptoms of all three CMDs, Bs = 0.11–.020, SEs = .04–.06, ps = .005‐.008, and weaker associations between traumatic event exposure and CMD symptoms, Bs = ‐0.01–‐0.02, SEs = .003–.006, ps = .000–.002. CMD symptoms likely present differently across cultures, with various predictors more salient depending on cultural backgrounds and differential experiences that vary based on context. These findings have implications for cross‐cultural assessment research and mental health.

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The factor structure of posttraumatic stress disorder symptoms among Rwandans exposed to the 1994 genocide: A confirmatory factor analytic study using the PCL-C

Cited by 28 publications

References 57 publications

The assessment of psychopathology among traumatized refugees: measurement invariance of the Harvard Trauma Questionnaire and the Hopkins Symptom Checklist-25 across five linguistic groups

The assessment of psychopathology among traumatized refugees: measurement invariance of the Harvard Trauma Questionnaire and the Hopkins Symptom Checklist-25 across five linguistic groups

Gender Differences in Traumatic Experiences and Posttraumatic Stress Symptoms After the Rwandan Genocide Against the Tutsi

Geocultural variation in correlates of psychological distress among refugees resettled in the United States

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