The HTQ-5: revision of the Harvard Trauma Questionnaire for measuring torture, trauma and DSM-5 PTSD symptoms in refugee populations
The HTQ-5: revision of the Harvard Trauma Questionnaire for measuring torture, trauma and DSM-5 PTSD symptoms in refugee populations
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DOI：
10.1093/eurpub/cky256
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发表时间：
2019-06-01
影响因子：
4.4
通讯作者：
Lindert, Jutta
中科院分区：
文献类型：
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作者：
Berthold, S. Megan;Mollica, Richard F.;Lindert, Jutta
背景：哈佛创伤问卷(HTQ)是25年前开发的一种跨文化筛查工具，用于记录难民的创伤暴露、头部创伤和创伤相关症状。本文旨在：(1)概述HTQ第四部分的修订过程，以(A)纳入创伤后应激障碍的新的DSM-5诊断标准，并(B)分离并更充分地发展难民特有的功能项目；以及(2)促进对HTQ-5在适应于其他文化和语言群体时的验证采取一致的方法。方法：我们的过程包括项目规划；专家咨询；根据新的DSM-5标准生成项目；起草、完善和最后确定修订后的措施，密切关注含义问题、未来翻译成多种语言的问题以及低识字率和很少或根本不接触西方创伤概念的群体的理解问题。新的HTQ-5的效度和信度测试正在进行中。结果：HTQ症状自评量表修改后符合当前的DSM-5诊断标准，以识别那些存在精神健康风险的难民，以及与创伤性生活事件、残疾和功能障碍相关的其他症状。结论：准确筛查创伤后窘迫和功能障碍使难民工作人员能够更有效地将他们分流到稀缺的健康和精神卫生资源。在制定为公共卫生政策和实践提供信息的筛查措施时，至关重要的是，这些措施能够弥合西方(原住民)对创伤应激的认识和理解(原住民)之间的差距。
Background: The Harvard Trauma Questionnaire (HTQ) was developed 25 years ago as a cross-cultural screening instrument to document trauma exposure, head trauma and trauma-related symptoms in refugees. This article aims to: (i) outline the process of revision of Part IV of the HTQ to (a) include the new DSM-5 diagnostic criteria for PTSD, and (b) separate out and more fully develop the refugee-specific functioning items; and (ii) promote a consistent approach to the validation of the HTQ-5 when adapted for use in other cultures and language groups. Methods: Our process involved item mapping; expert consultations; generating items according to the new DSM-5 criteria; and drafting, refinement and finalization of the revised measure focusing closely on issues of meaning, future translation into multiple languages and comprehension amongst groups with low literacy and little or no exposure to Western trauma concepts. Validity and reliability testing of the new HTQ-5 is underway. Results: The HTQ symptom checklist was modified consistent with current DSM-5 diagnostic criteria to identify those refugees at risk for mental health and other symptoms associated with traumatic life events, disability and dysfunction. Conclusions: Accurate screening of post-traumatic distress and dysfunction enables those working with refugees to triage them more effectively to scarce health and mental health resources. When developing screening measures to inform public health policy and practice, it is vital that these measures can bridge the gap between western (etic) nosologies and indigenous (emic) understandings of traumatic stress.