Validation of a Tibetan Translation of the Hopkins Symptom Checklist–25 and the Harvard Trauma Questionnaire

Abstract

This study sought to translate and validate the Hopkins Symptom Checklist-25 (HSCL) and the Harvard Trauma Questionnaire (HTQ) in a Tibetan population. Translated questionnaires were administered to 57 Tibetan survivors of torture/human rights abuses living in the United States and receiving services in a torture treatment program. Participants were evaluated to determine if they met criteria for major depressive episode, generalized anxiety disorder, or posttraumatic stress disorder (PTSD). Coefficient alpha for the HSCL Anxiety subscale (.89), Depression subscale (.92), and the HTQ (.89) were high. Diagnostic accuracy using receiver operating characteristic curve analysis generated good classification accuracy for anxiety (.89), depression (.92), and PTSD (.83). However, although sensitivity and specificity for HSCL subscales were quite high, the HTQ generated low sensitivity (.33), partly because of a low rate of PTSD. Results support the reliability and validity of the HSCL but suggest further study of the HTQ with this population is required.

Entering exile: Trauma, mental health, and coping among Tibetan refugees arriving in Dharamsala, India

“…As observed by many cross-cultural researchers (Crescenzi et al, 2002;Hollifield et al, 2002;Kagee & Naidoo, 2004), the validity of Western mental health constructs and standardized instruments is often unknown when applied to non-Western populations. Researchers have specifically questioned the construct of PTSD, and the HTQ as a measure of PTSD, in the Tibetan population (Holtz, 1998;Lhewa et al, 2007Terheggen et al, 2001. As in prior research, this study did not elicit or employ indigenous conceptualizations of mental illness.…”

“…Lhewa et al (2007) observed high internal consistency for both the anxiety and depression subscales (α = .89, .92, respectively), and strong diagnostic accuracy (compared to an independent psychiatric diagnosis) using the 1.75 cutoff score (sensitivity = .91, specificity = .88 for the anxiety subscale, and sensitivity = .89 and specificity = .87 for the depression subscale). Symptoms of PTSD were assessed with a Tibetan version of the Harvard Trauma Questionnaire (HTQ; Mollica et al, 1992), also developed by Lhewa et al (2007). The HTQ has demonstrated excellent statistical properties in a number of refugee studies (Hollifield et al, 2002;Renner, Salem, & Ottomeyer, 2006) and is considered the best-supported measure of PTSD for refugee populations (Hollifield et al, 2002).…”

“…Anxiety and depression were measured with a Tibetan version of the Hopkins Symptom Checklist (HSC; Derogatis, 1974) developed by Lhewa, Banu, Rosenfeld, and Keller (2007). Lhewa et al (2007) observed high internal consistency for both the anxiety and depression subscales (α = .89, .92, respectively), and strong diagnostic accuracy (compared to an independent psychiatric diagnosis) using the 1.75 cutoff score (sensitivity = .91, specificity = .88 for the anxiety subscale, and sensitivity = .89 and specificity = .87 for the depression subscale). Symptoms of PTSD were assessed with a Tibetan version of the Harvard Trauma Questionnaire (HTQ; Mollica et al, 1992), also developed by Lhewa et al (2007).…”

Translation and Cultural Adaptation of the Hopkins Symptom Checklist-25 (HSCL-25) into Nepalese for Use with Bhutanese Refugees

“…In another translation study of the HSCL-25 into the Dinka language for use with South Sudanese refugees, the authors found item 14 to be offensive to both men and women and recommended removal in order to be culturally sensitive to this population (Baird & Skariah, 2015). In a translation of the HSCL-25 into Tibetan, the authors discovered that sexual matters are not typically discussed in this culture; even when item 14 was removed, the depression subscale maintained consistency (Lhewa, Banu, Rosenfeld, & Keller, 2007).…”

Association of Anxiety and Teacher Expectation among High School Students in Jakarta

“…Coefficient alpha of 10 first items HSCL-25 is 0.84 (Derogatis et al, 1974). HSCL-25 has high and accurate predictive level for both anxiety and depression symptoms or as psychological distress as general (Lhewa et al, 2007). Procedure.…”