Screening for Posttraumatic Stress Disorder among Somali ex-combatants : a validation study

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2007
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Conflict and Health ; 1 (2007), 10
Abstract
Background: In Somalia, a large number of active and former combatants are affected by psychological problems such as Posttraumatic Stress Disorder (PTSD). This disorder impairs their ability to re-integrate into civilian life. However, many screening instruments for Posttraumatic Stress Disorder used in post-conflict settings have limited validity. Here we report on development and validation of a screening tool for PTSD in Somali language with a sample of x-combatants.
Methods: We adapted the Posttraumatic Diagnostic Scale (PDS) to reflect linguistic and cultural differences within the Somali community so that local interviewers could be trained to administer the scale. For validation purposes, a randomly selected group of 135 Somali ex-combatants was screened by trained local interviewers; 64 of them were then re-assessed by trained clinical psychologists using the Composite International Diagnostic Interview (CIDI) and the Self-Report Questionnaire (SRQ-20).
Results: The screening instrument showed good internal consistency (Cronbach's ? = .86), convergent validity with the CIDI (sensitivity = .90; specificity = .90) as well as concurrent validity: positive cases showed higher SRQ-20 scores, higher prevalence of psychotic symptoms, and higher levels of intake of the local stimulant drug khat. Compared to a single cut-off score, the multicriteria scoring, in keeping with the DSM-IV, produced more diagnostic specificity.
Conclusion: The results provide evidence that our screening instrument is a reliable and valid method to detect PTSD among Somali ex-combatants. A future Disarmament, Demobilization and Reintegration Program in Somalia is recommended to screen for PTSD in order to identify excombatants with special psycho-social needs.
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150 Psychology
Keywords
Postraumatische Belastungsstörung,PTSD,Veteranen,Exkombattanten,PTBS,psychologisches Instrument,PTSD,Somalia,Validation,Ex-combattants,instrument development
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ISO 690ODENWALD, Michael, Birke LINGENFELDER, Maggie SCHAUER, Frank NEUNER, Brigitte ROCKSTROH, Harald HINKEL, Thomas ELBERT, 2007. Screening for Posttraumatic Stress Disorder among Somali ex-combatants : a validation study. In: Conflict and Health. 1(10). Available under: doi: 10.1186/1752-1505-1-10
BibTex
@article{Odenwald2007Scree-11377,
  year={2007},
  doi={10.1186/1752-1505-1-10},
  title={Screening for Posttraumatic Stress Disorder among Somali ex-combatants : a validation study},
  number={10},
  volume={1},
  journal={Conflict and Health},
  author={Odenwald, Michael and Lingenfelder, Birke and Schauer, Maggie and Neuner, Frank and Rockstroh, Brigitte and Hinkel, Harald and Elbert, Thomas}
}
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    <dcterms:abstract xml:lang="eng">Background: In Somalia, a large number of active and former combatants are affected by psychological problems such as Posttraumatic Stress Disorder (PTSD). This disorder impairs their ability to re-integrate into civilian life. However, many screening instruments for Posttraumatic Stress Disorder used in post-conflict settings have limited validity. Here we report on development and validation of a screening tool for PTSD in Somali language with a sample of x-combatants.&lt;br /&gt;Methods: We adapted the Posttraumatic Diagnostic Scale (PDS) to reflect linguistic and cultural differences within the Somali community so that local interviewers could be trained to administer the scale. For validation purposes, a randomly selected group of 135 Somali ex-combatants was screened by trained local interviewers; 64 of them were then re-assessed by trained clinical psychologists using the Composite International Diagnostic Interview (CIDI) and the Self-Report Questionnaire (SRQ-20).&lt;br /&gt;Results: The screening instrument showed good internal consistency (Cronbach's ? = .86), convergent validity with the CIDI (sensitivity = .90; specificity = .90) as well as concurrent validity: positive cases showed higher SRQ-20 scores, higher prevalence of psychotic symptoms, and higher levels of intake of the local stimulant drug khat. Compared to a single cut-off score, the multicriteria scoring, in keeping with the DSM-IV, produced more diagnostic specificity.&lt;br /&gt;Conclusion: The results provide evidence that our screening instrument is a reliable and valid method to detect PTSD among Somali ex-combatants. A future Disarmament, Demobilization and Reintegration Program in Somalia is recommended to screen for PTSD in order to identify excombatants with special psycho-social needs.</dcterms:abstract>
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