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      The factor structures and correlates of PTSD in post-conflict Timor-Leste: an analysis of the Harvard Trauma Questionnaire

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          Abstract

          Background

          Post-traumatic stress disorder (PTSD) is the most widely assessed form of mental distress in cross-cultural studies conducted amongst populations exposed to mass conflict and displacement. Nevertheless, there have been longstanding concerns about the universality of PTSD as a diagnostic category when applied across cultures. One approach to examining this question is to assess whether the same factor structure can be identified in culturally diverse populations as has been described in populations of western societies. We examine this issue based on an analysis of the Harvard Trauma Questionnaire (HTQ) completed by a large community sample in conflict-affected Timor-Leste.

          Method

          Culturally adapted measures were applied to assess exposure to conflict-related traumatic events (TEs), ongoing adversities, symptoms of PTSD and psychological distress, and functional impairment amongst a large population sample ( n = 2964, response rate: 82.4%) in post-conflict Timor-Leste.

          Results

          Confirmatory factor analyses of the ICD-10, ICD-11, DSM-IV, four-factor Emotional Numbing and five-factor Dysphoric-Arousal PTSD structures, found considerable support for all these models. Based on these classifications, concurrent validity was indicated by logistic regression analyses which showed that being a woman, trauma exposure, ongoing adversity, severe distress, and functional impairment were all associated with PTSD.

          Conclusions

          Although symptom prevalence estimates varied widely based on different classifications, our study found a general agreement in PTSD assignments across contemporary diagnostic systems in a large conflict-affected population in Timor-Leste. Further studies are needed, however, to establish the construct and concurrent validity of PTSD in other cultures.

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          Most cited references29

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          Multivariate Data Analysis

          For over 30 years, this text has provided students with the information they need to understand and apply multivariate data analysis. This text provides an applications-oriented introduction to multivariate analysis for the non-statistician. By reducing heavy statistical research into fundamental concepts, the text explains to students how to understand and make use of the results of specific statistical techniques. In this revision, the organization of the chapters has been greatly simplified. New chapters have been added on structural equations modeling, and all sections have been updated to reflect advances in technology, capability, and mathematical techniques. :Pearson New International Edition.
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            Diagnostic and statistical manual of mental disorders

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              Sex differences in trauma and posttraumatic stress disorder: a quantitative review of 25 years of research.

              Meta-analyses of studies yielding sex-specific risk of potentially traumatic events (PTEs) and posttraumatic stress disorder (PTSD) indicated that female participants were more likely than male participants to meet criteria for PTSD, although they were less likely to experience PTEs. Female participants were more likely than male participants to experience sexual assault and child sexual abuse, but less likely to experience accidents, nonsexual assaults, witnessing death or injury, disaster or fire, and combat or war. Among victims of specific PTEs (excluding sexual assault or abuse), female participants exhibited greater PTSD. Thus, sex differences in risk of exposure to particular types of PTE can only partially account for the differential PTSD risk in male and female participants. (c) 2006 APA, All Rights Reserved.
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                Author and article information

                Contributors
                +61 2 9616 4331 , alvin.tay@unsw.edu.au
                m.mohsin@unsw.edu.au
                s.j.rees@unsw.edu.au
                z.steel@unsw.edu.au
                natalinotam@unsw.edu.au
                zeliacosta87@gmail.com
                Jessica.baker@unsw.edu.au
                d.silove@unsw.edu.au
                Journal
                BMC Psychiatry
                BMC Psychiatry
                BMC Psychiatry
                BioMed Central (London )
                1471-244X
                22 May 2017
                22 May 2017
                2017
                : 17
                : 191
                Affiliations
                [1 ]ISNI 0000 0004 4902 0432, GRID grid.1005.4, Psychiatry Research and Teaching Unit, Academic Mental Health Unit, School of Psychiatry, , University of New South Wales, ; Cnr Forbes and Campbell Streets, Liverpool, NSW 2170 Australia
                [2 ]ISNI 0000 0001 0640 7766, GRID grid.418393.4, , The Black Dog Institute, ; Sydney, Australia
                [3 ]St John of God, Richmond Hospital, Richmond, NSW Australia
                Author information
                http://orcid.org/0000-0002-9330-3929
                Article
                1340
                10.1186/s12888-017-1340-0
                5441051
                28532449
                ffa4f051-bb53-4094-94e1-e5a20c52b095
                © The Author(s). 2017

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 20 September 2016
                : 30 April 2017
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100000925, National Health and Medical Research Council;
                Award ID: RM8300
                Award Recipient :
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2017

                Clinical Psychology & Psychiatry
                harvard trauma questionnaire,ptsd,icd-10,icd-11,dsm-iv,emotional numbing,dysphoric-arousal,trauma

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