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

Boston University, Boston, MA, USA.
Assessment (Impact Factor: 3.29). 10/2007; 14(3):223-30. DOI: 10.1177/1073191106298876
Source: PubMed


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.

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Available from: Sophia Banu, Aug 13, 2015
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    • "HSCL-25 has 15 questions measured by a 4-point response scale (1 = 'Not at all', 2 = 'A little', 3 = 'Quite a bit', and 4 = 'Extremely') to identify depressive symptoms (Parloff et al., 1954). According to a study by Lhewa et al. (2007) and Silove et al. (2007), HSCL-25 has been widely used and previously verified as reliable when used with Asian populations (such as Cambodian, Chinese, and Vietnamese), with a coefficient alpha of .89 for the Anxiety subscale and .92 "
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    • "In general, this literature supports the conclusion that differing response patterns and, therefore, a lack of scalar invariance are problematic for comparing scores from psychological assessments across culturally defined populations. Findings from the clinical literature suggesting that similar issues may pose particular problems in the clinical assessment of PTSD include widely varying PTSD scores across postconflict settings (de Jong et al., 2001), extremely low scores among Tibetan refugees (Lhewa, Banu, Rosenfeld, & Keller, 2007; Sachs et al., 2008), high scores among Latino combat veterans within the United States (Pole, Best, Metzler, & Marmar, 2005), and severity differences between Mexican and U.S. hurricane survivors (Norris, Perilla, & Murphy, 2001). To date there has been no direct empirical test of scalar invariance in PTSD scores among refugees or asylum seekers. "
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    • "A number of studies find that despite a high prevalence of potentially traumatizing events (imprisonment, torture, religious and cultural persecution, mass displacement), rates of psychological distress are extremely low and that coping activities (primarily religious) appeared to mediate the psychological effects of trauma exposure (Holtz 1998; Ketzer and Crescenzi 2002; Lhewa et al. 2007; Ruwanpura et al. 2006; Sachs et al. 2008). Despite the robustness of these findings, some question whether these Tibetan respondents are truly " resilient " or if they simply avoid identifying symptoms of mental distress. "
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