This is a cross-sectional community epidemiological study of Kurdish and Vietnamese refugees in Dallas and Albuquerque to determine: 1) the prevalence of a history of torture and war-related trauma, 2) the prevalence of psychiatric disorders and symptoms, and level of impairment and treatment seeking, and 3) to test the hypotheses that there is an association between trauma type as the independent variable, shame, guilt and cultural variables as moderators, and psychiatric diagnoses, symptoms, impairment and treatment seeking as outcome measures. During the development period the research team will translate all and modify 3 existing instruments for measuring torture and related trauma, symptoms, and emotions of shame and guilt from the perspective of Kurdish and Vietnamese survivors. This research will focus on the 3 defined trauma type groups of """"""""torture,"""""""" """"""""non torture war-related trauma,"""""""" and """"""""no war-related trauma,"""""""" and the participants will be classified into trauma groups both by """"""""objective"""""""" criteria and by themselves (""""""""subjective""""""""). The development work will include: 1) in-depth interviews of representatives from the three trauma type groups to define the full range of trauma events and symptoms and to understand culturally appropriate constructs of shame and guilt which will allow for, 2) modification of 4 existing instruments measuring trauma events, symptoms, and shame and guilt, and 3) forward and back translation of all instruments by bi-lingual research assistants. The epidemiological work will begin with random sampling from existing and updated rosters of the 2,500 adult Kurds and 5,000 adult Vietnamese in Dallas and Albuquerque. Power analyses suggest sample sizes of 600 and 1,200 respectively. Data will be collected over three contacts with the administration of standard instruments which have been translated and modified to be culturally appropriate. Test-retest reliability of trauma type classification will be tested with a smaller random sample. Descriptive statistics and inferential quantitative analyses which are linked to each hypothesis are described in the proposal.
| Hollifield, Michael; Warner, Teddy D; Lian, Nityamo et al. (2002) Measuring trauma and health status in refugees: a critical review. JAMA 288:611-21 |
