Psychiatry Research and Teaching Unit, Academic Mental Health Unit, School of Psychiatry, University of New South Wales, Sydney NSW, Australia.
School of Public Health and Community Medicine, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia.
J Anxiety Disord. 2017 Apr;47:45-53. doi: 10.1016/j.janxdis.2017.02.001. Epub 2017 Feb 3.
The Harvard Trauma Questionnaire (HTQ) remains the most widely used screening measure for post-traumatic stress disorder (PTSD) in the refugee and post-conflict field. The present study is the first to test the factorial structure and measurement invariance of the HTQ according to DSM-5 criteria across gender and ethnic groups in the ethnically diverse society of post-conflict Sri Lanka. The survey sample included 5136 participants (86% response rate) followed up 12 months after a baseline nationally representative survey undertaken in Sri Lanka in 2014. Exposure to conflict-related traumatic experiences (TEs) generating a trauma count (TC), and symptoms of PTSD were assessed using a modified version of the HTQ adapted to the local context. The final analytic sample included 4260 participants after excluding records with missing data on key variables. We conducted Multigroup Confirmatory Factor Analysis (MG-CFA) to test the four-factor (DSM-5 consistent) and three-factor (DSM-IV-TR) models of PTSD, then assessing measurement invariance of the four factor model by gender and ethnic groups. The three-factor and four-factor DSM-5 model each produced a good fit across the sample as a whole. In addition, there was configural, metric, and scalar invariance for the four-factor model both by gender and ethnicity. The trauma count was directly associated with each of the symptom domains of the four factor model. Our findings provide support for the capacity of the modified HTQ to measure the DSM5 construct of PTSD across gender and key ethnic groupings in Sri Lanka. Confirmation of our findings in other cultures will be important.
《哈佛创伤问卷》（HTQ）仍然是难民和冲突后领域中最广泛用于创伤后应激障碍（PTSD）筛查的测量工具。本研究首次根据 DSM-5 标准，在斯里兰卡这个种族多样化的冲突后社会中，测试了 HTQ 在性别和族裔群体中的因子结构和测量不变性。该调查样本包括 5136 名参与者（86%的回复率），在 2014 年斯里兰卡进行的一项全国代表性基线调查后 12 个月进行了随访。使用经过修改的 HTQ 版本，根据当地情况评估与冲突相关的创伤经历（TEs）产生的创伤计数（TC）和 PTSD 症状。在排除关键变量数据缺失的记录后，最终分析样本包括 4260 名参与者。我们进行了多组验证性因素分析（MG-CFA），以测试 PTSD 的四因素（DSM-5 一致）和三因素（DSM-IV-TR）模型，然后评估四因素模型在性别和族裔群体中的测量不变性。三因素和四因素 DSM-5 模型在整个样本中都产生了良好的拟合。此外，四因素模型在性别和族裔群体中都具有结构、度量和标度不变性。创伤计数与四因素模型的每个症状领域都有直接关联。我们的研究结果为修改后的 HTQ 在斯里兰卡的性别和主要族群中测量 DSM5 建构的 PTSD 能力提供了支持。在其他文化中确认我们的发现将非常重要。
