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The Harvard Trauma Questionnaire: Validating a Cross-Cultural Instrument for Measuring Torture, Trauma, and Posttraumatic Stress Disorder in Indochinese Refugees
Abstract
There are no valid and reliable cross-cultural instruments capable of measuring torture, trauma, and trauma-related symptoms associated with the DSM-III-R diagnosis of posttraumatic stress disorder (PTSD). Generating such standardized instruments for patients from non-Western cultures involves particular methodological challenges. This study describes the development and validation of three Indochinese versions of the Harvard Trauma Questionnaire (HTQ), a simple and reliable screening instrument that is well received by refugee patients and bicultural staff. It identifies for the first time trauma symptoms related to the Indochinese refugee experience that are associated with PTSD criteria. The HTQ's cultural sensitivity may make it useful for assessing other highly traumatized non-Western populations.
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“Functional impairment was based on the degree of difficulty in performing important tasks of daily living that were identified on the basis of qualitative data from the study villages, with the use of methods described elsewhere.16,26”
From Controlled trial of psychotherapy for Congolese survivors of sexual violence (2013) · cites this paper as [16]
In the citing paper
“The Harvard Trauma Questionnaire is a validated cross-cultural screening instrument designed to assess torture, trauma exposure, and trauma-related symptoms in refugees.”
From Identifying resilience-promoting factors for refugee survivors of torture (2022) · cites this paper as Mollica et al., 1992
In the citing paper
“The HTQ has been reported to have high test-retest reliability ( α = .89) internal consistency ( α = .90; Mollica et al., 1992)”
From Identifying resilience-promoting factors for refugee survivors of torture (2022) · cites this paper as Mollica et al., 1992
In the citing paper
“The primary outcome measure was self-reported PTSD symptoms assessed using part IV of the Harvard Trauma Questionnaire (HTQ), which has been developed primarily for trauma-affected refugees and validated in several languages and settings [26, 27].”
From Treatment of trauma-affected refugees with venlafaxine versus sertraline combined with psychotherapy - a randomised study (2016) · cites this paper as [26]
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Items 101–200 of 1,005
Nickerson, A., Bryant, R. A., Schnyder, U., Schick, M., Mueller, J., & Morina, N. (2015) · Journal of Affective Disorders · doi:10.1016/j.jad.2014.10.043 · Cited by 141
“Exposure to traumatic events was indexed using a measure derived from combining the trauma event lists of two standardized questionnaires, namely the Harvard Trauma Questionnaire (HTQ; Mollica et al., 1992) and the Posttraumatic Diagnostic Scale (PDS; Foa, 1996; Foa et al.”
MethodKun, P., Tong, X., Liu, Y., Pei, X., & Luo, H. (2013) · Public Health · doi:10.1016/j.puhe.2013.04.018 · Cited by 141
Kun, P., Han, S., Chen, X., & Yao, L. (2009) · Depression and Anxiety · doi:10.1002/da.20612 · Cited by 137
“In addition, given the limitations of the HTQ in that it only assesses only some posttraumatic stress symptoms and is not designed to arrive as a diagnostic tool, a psychiatrists we used diagnostic algorithms that were based on DSM-IV criteria and have been employed in others to obtain an independent diagnosis.([24,25…”
MethodO’Connor, M., Lasgaard, M., Shevlin, M. E., & Guldin, M. (2010) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2010.04.009 · Cited by 135
“ratings according to the DSM-III-R diagnostic criteria of PTSD showed an 88% concordance with interview-based estimates of PTSD (Mollica et al. 1992).”
MethodInfluentialKeller, A. S., Lhewa, D., Rosenfeld, B. D., Sachs, E., Aladjem, A. D., Cohen, I., Smith, H. E., & Porterfield, K. (2006) · The Journal of Nervous and Mental Disease · doi:10.1097/01.nmd.0000202494.75723.83 · Cited by 138
“In addition, all subjects completed two selfreport questionnaires measuring psychological symptoms, the Hopkins Symptom Checklist (Derogatis et al., 1974) and the Harvard Trauma Questionnaire (Mollica et al., 1992), both of which are described below.”
BackgroundMethodInfluentialCorrea‐Velez, I., Barnett, A. G., & Gifford, S. M. (2013) · International Migration · doi:10.1111/imig.12099 · Cited by 135
Keller, A. S., Joscelyne, A., Granski, M., & Rosenfeld, B. D. (2017) · PLoS ONE · doi:10.1371/journal.pone.0168692 · Cited by 133
Exposure to violence and its relationship to psychopathology in adolescents
Ward, C. L., Flisher, A. J., Zissis, C., Muller, M., & Lombard, C. J. (2001) · Injury Prevention · doi:10.1136/ip.7.4.297 · Cited by 133
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Pedersen, D., Tremblay, J., Errázuriz, C., & Gamarra, J. (2008) · Social Science & Medicine · doi:10.1016/j.socscimed.2008.03.040 · Cited by 130
Smit, J., Myer, L., Middelkoop, K., Seedat, S., Wood, R., Bekker, L., & Stein, D. J. (2006) · Public Health · doi:10.1016/j.puhe.2006.01.009 · Cited by 133
Parental PTSD, adverse parenting and child attachment in a refugee sample
van Ee, E., Kleber, R. J., Jongmans, M. J., Mooren, T. T. M., & Out, D. (2016) · Attachment & Human Development · doi:10.1080/14616734.2016.1148748 · Cited by 130
“A cutoff score of 2.5 was used in several studies to identify clinically significant PTSD (Mollica et al., 1992).”
MethodInfluentialDo not forget culture when studying mental health
Bass, J. K., Bolton, P. A., & Murray, L. K. (2007) · The Lancet · doi:10.1016/s0140-6736(07)61426-3 · Cited by 131
Guilaran, J., de Terte, I., Kaniasty, K. Z., & Stephens, C. V. (2018) · International Journal of Disaster Risk Science · doi:10.1007/s13753-018-0184-7 · Cited by 151
Predictors of mental health and quality of life in male tortured refugees
Carlsson, J. M., Mortensen, E. L., & Kastrup, M. C. (2006) · Nordic Journal of Psychiatry · doi:10.1080/08039480500504982 · Cited by 129
“When comparing the level of emotional distress in this study with studies of traumatized or tortured refugees in clinical settings, results are similar or show slightly lower distress scores (26, 32, 42).”
ResultPrevalence of Psychiatric Disorders Among Unaccompanied Asylum-Seeking Adolescents in Norway
Jakobsen, M., Demott, M. A. M., & Heir, T. (2014) · Clinical Practice and Epidemiology in Mental Health · doi:10.2174/1745017901410010053 · Cited by 128
“The Harvard Trauma Questionnaire [20] was developed to assess potentially traumatic experiences, and a rich variety of post-traumatic symptoms in different cultural settings.”
BackgroundMethodTraumatic Experiences and the Mental Health of Senegalese Refugees
Tang, S. S. S., & Fox, S. H. (2001) · The Journal of Nervous and Mental Disease · doi:10.1097/00005053-200108000-00003 · Cited by 128
“It was developed by Mollica et al. (1992) to identify trauma symptoms associated with the Indochinese refugee experience.”
BackgroundInfluentialGrowing from experience: an exploratory study of posttraumatic growth in adolescent refugees
Sleijpen, M., Haagen, J. F. G., Mooren, T. T. M., & Kleber, R. J. (2016) · European Journal of Psychotraumatology · doi:10.3402/ejpt.v7.28698 · Cited by 141
“PTEs were measured by a 26-item questionnaire based on the UCLA PTSD Reaction Index DSM-IV (the part to screen for exposure to PTEs; Pynoos, Rodriguez, Steinberg, Stuber, & Frederick, 1998) and part I (trauma events) of the Harvard Trauma Questionnaire (HTQ; Mollica et al., 1992).”
Sachs, E., Rosenfeld, B. D., Lhewa, D., Rasmussen, A., & Keller, A. S. (2008) · Journal of Traumatic Stress · doi:10.1002/jts.20324 · Cited by 129
Gender, Social Support, and Posttraumatic Stress in Postwar Kosovo
Ahern, J., Galea, S., Fernandez, W. G., Koci, B., Waldman, R. J., & Vlahov, D. (2004) · The Journal of Nervous and Mental Disease · doi:10.1097/01.nmd.0000144695.02982.41 · Cited by 122
“Traumatic events experienced were measured with the Harvard Trauma Questionnaire (HTQ; Mollica et al., 1992).”
BackgroundMethodInfluentialChanges in Post-migration Living Difficulties Predict Treatment Outcome in Traumatized Refugees
Schick, M., Morina, N., Mistridis, P., Schnyder, U., Bryant, R. A., & Nickerson, A. (2018) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2018.00476 · Cited by 123
“Trauma Questionnaire [HTQ, (22)] and the Posttraumatic Diagnostic Scale [PDS, (23, 24)].”
Carlsson, J. M., Mortensen, E. L., & Kastrup, M. C. (2005) · The Journal of Nervous and Mental Disease · doi:10.1097/01.nmd.0000180739.79884.10 · Cited by 123
“…of 16 PTSD symptoms (DSM-III-R) covering re-experiencing, avoidance/numbing, and physiological arousal, and 14 other traumarelated symptoms (Mollica et al., 1992, 1996); the Hopkins Symptoms Checklist-25 (HSCL-25), including 10 items from the anxiety scale and 15 items from the depression…”
BackgroundMoral Injury in Traumatized Refugees
Nickerson, A., Schnyder, U., Bryant, R. A., Schick, M., Mueller, J., & Morina, N. (2015) · Psychotherapy and Psychosomatics · doi:10.1159/000369353 · Cited by 126
Bolton, P. A., Bass, J., Zangana, G. A. S., Kamal, T., Murray, S. M., Kaysen, D. L., Lejuez, C. W., Lindgren, K. P., Pagoto, S., Murray, L. K., et al. (2014) · BMC Psychiatry · doi:10.1186/s12888-014-0360-2 · Cited by 122
“Qualitative study data were used to adapt the Hopkins Symptom Checklist for Depression and Anxiety (HSCL-25) [18,19], the Harvard Trauma Questionnaire (HTQ) [20], and the Inventory of Traumatic Grief [21,22] to measure symptoms of depression, anxiety, posttraumatic stress and traumatic grief.”
MethodAcartürk, C., Uygun, E., İlkkurşun, Z., Carswell, K., Tedeschi, F., Batu, M., Eskici, S., Kurt, G., Anttila, M., Au, T. M., et al. (2022) · World Psychiatry · doi:10.1002/wps.20939 · Cited by 129
Mental health of asylum seekers: a cross-sectional study of psychiatric disorders
Heeren, M., Mueller, J., Ehlert, U., Schnyder, U., Copiery, N., & Maier, T. (2012) · BMC Psychiatry · doi:10.1186/1471-244x-12-114 · Cited by 118
van Duijl, M., Nijenhuis, E. R. S., Komproe, I. H., Gernaat, H. B. P. E., & de Jong, J. T. V. M. (2010) · Culture Medicine and Psychiatry · doi:10.1007/s11013-010-9171-1 · Cited by 127
“The Harvard Trauma Questionnaire (HTQ; Mollica et al. 1992), part 1, covers potentially traumatizing events such as lack of food and water, lack of shelter and medical access, being close to death, forced separation, war experiences, torture, serious injury, being lost or kidnapped, being…”
BackgroundThe role of guilt in the development of post-traumatic stress disorder: A systematic review
Pugh, L., Taylor, P. J., & Berry, K. (2015) · Journal of Affective Disorders · doi:10.1016/j.jad.2015.04.026 · Cited by 119
Prevalence of anxiety, depression and post-traumatic stress disorder in the Kashmir Valley
Housen, T., Lenglet, A., Ariti, C. A., Shah, S., Shah, H., Ara, S., Viney, K. A., Janes, S., & Pintaldi, G. (2017) · BMJ Global Health · doi:10.1136/bmjgh-2017-000419 · Cited by 122
“27 The HTQ-16, 27 28 is the fourth section of a larger instrument which addresses 30 trauma symptoms derived from the DSM-IV criteria for PTSD.”
Lindauer, R. J. L., Booij, J., Habraken, J. B. A., Uylings, H. B. M., Olff, M., Carlier, I. V. E., den Heeten, G. J., van Eck-Smit, B. L. F., & Gersons, B. P. R. (2004) · Biological Psychiatry · doi:10.1016/j.biopsych.2004.08.003 · Cited by 119
Lhewa, D., Banu, S., Rosenfeld, B. D., & Keller, A. S. (2007) · Assessment · doi:10.1177/1073191106298876 · Cited by 115
“The HTQ was developed specifically for an Indochinese refugee population, with validated translations in Vietnamese, Cambodian, and Laotian (Mollica et al., 1992).”
MethodTrauma, PTSD and the longer-term mental health burden amongst Vietnamese refugees
Silove, D. M., Steel, Z., Bauman, A. E., Chey, T., & McFARLANE, A. C. (2007) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-007-0194-z · Cited by 117
“The CIDI trauma events schedule was expanded, therefore, to include 14 additional experiences derived from the Harvard Trauma Questionnaire [ 22 ] designed specifically for use amongst Southeast Asian refugees.”
MethodSchock, K., Böttche, M., Rosner, R., Wenk-Ansohn, M., & Knaevelsrud, C. (2016) · European Journal of Psychotraumatology · doi:10.3402/ejpt.v7.32106 · Cited by 124
“Participants identified the respective traumatic event from a trauma list comprising items derived from the PDS Part I (Foa, 1995) and the Harvard Trauma Questionnaire event list (Mollica et al., 1992).”
MethodNickerson, A., Byrow, Y., O'Donnell, M. L., Mau, V., McMahon, T., Pajak, R., Li, S., Hamilton, A., Minihan, S., Liu, C., et al. (2019) · European Journal of Psychotraumatology · doi:10.1080/20008198.2019.1688129 · Cited by 111
Farhood, L., Dimassi, H. I., & Lehtinen, T. (2006) · Journal of Transcultural Nursing · doi:10.1177/1043659606291549 · Cited by 113
“Cronbach’s alpha for internal consistency is .90 for traumatic events and .96 for traumatic symptoms (Mollica et al., 1992).”
BackgroundThe structure of PTSD symptoms: A test of alternative models using confirmatory factor analysis
Elklit, A., & Shevlin, M. E. (2006) · British Journal of Clinical Psychology · doi:10.1348/014466506x171540 · Cited by 130
“The Harvard Trauma Questionnaire Part IV (HTQ: Mollica et al., 1992) The HTQ assess both DSM-IV symptoms and culture-specific symptoms associated with PTSD.”
BackgroundMethodThe Illustrated History of Surgery
(1996) · The Medical Journal of Australia · doi:10.5694/j.1326-5377.1996.tb138672.x · Cited by 110
Machisa, M., Christofides, N. J., & Jewkes, R. K. (2018) · Global Health Action · doi:10.1080/16549716.2018.1491114 · Cited by 132
Factor structure of PTSD symptoms among west and central African refugees
Rasmussen, A., Smith, H. E., & Keller, A. S. (2007) · Journal of Traumatic Stress · doi:10.1002/jts.20208 · Cited by 109
The factor structure of complex posttraumatic stress disorder in traumatized refugees
Nickerson, A., Cloître, M., Bryant, R. A., Schnyder, U., Morina, N., & Schick, M. (2016) · European Journal of Psychotraumatology · doi:10.3402/ejpt.v7.33253 · Cited by 108
“This scale represented the compilation of trauma event lists from two standardized questionnaires, namely the Harvard Trauma Questionnaire (HTQ) (Mollica et al., 1992) and the Posttraumatic Diagnostic Scale (PDS) (Foa, 1996; Foa, Cashman, Jaycox, & Perry, 1997).”
MethodInfluentialBonilla-Escobar, F. J., Losada, A. F., Martínez-Buitrago, D. M., Santaella-Tenorio, J., Tobón-García, D., Muñoz-Morales, E. J., Escobar-Roldán, I. D., Babcock, L., Duarte-Davidson, E., Bass, J., et al. (2018) · PLoS ONE · doi:10.1371/journal.pone.0208483 · Cited by 120
Nickerson, A., Steel, Z., Bryant, R. A., Brooks, R., & Silove, D. M. (2011) · Psychiatry Research · doi:10.1016/j.psychres.2010.12.015 · Cited by 110
“The PTSD subscale of the Harvard Trauma Questionnaire was implemented to provide a continuous measure of PTSD symptoms (HTQ; Mollica et al., 1992).”
BackgroundMethodLabour Exploitation and Health: A Case Series of Men and Women Seeking Post-Trafficking Services
Turner-Moss, E., Zimmerman, C., Howard, L. M., & Oram, S. (2013) · Journal of Immigrant and Minority Health · doi:10.1007/s10903-013-9832-6 · Cited by 107
“We collected data from a consecutive series of people trafficked for labor exploitation and used standardized measures of physical and mental health validated in traumatized and culturally diverse populations [37, 38].”
MethodClinical Correlates of HIV-Associated Neurocognitive Disorders in South Africa
Joska, J. A., Fincham, D. S., Stein, D. J., Paul, R. H., & Seedat, S. (2009) · AIDS and Behavior · doi:10.1007/s10461-009-9538-x · Cited by 106
“Symptoms of post-traumatic stress disorder (PTSD) were assessed using the Harvard trauma scale (HTS; Mollica et al. 1992 ).”
MethodImpact of asylum interviews on the mental health of traumatized asylum seekers
Schock, K., Rosner, R., & Knaevelsrud, C. (2015) · European Journal of Psychotraumatology · doi:10.3402/ejpt.v6.26286 · Cited by 110
“The measures on psychopathology were all translated from the German and then retranslated in advance of the study in order to ensure the accuracy and content validity of the scale items.”
MethodQuantifying the Reliability and Replicability of Psychopathology Network Characteristics
Forbes, M. K., Wright, A. G. C., Markon, K. E., & Krueger, R. F. (2019) · Multivariate Behavioral Research · doi:10.1080/00273171.2019.1616526 · Cited by 108
“The symptom networks in Fried et al. (2018) were based on PTSD symptoms assessed by the 16-item Harvard Trauma Questionnaire (HTQ; Mollica et al., 1992), the 17-item Posttraumatic Stress Symptom Scale Self-report (PSS-SR; Foa, Cashman, Jaycox, & Perry, 1997), and the 17-item Civilian version of the…”
MethodFawzi, M. C. S., Murphy, E., Pham, T., Lin, L., Poole, C., & Mollica, R. F. (1997) · Acta Psychiatrica Scandinavica · doi:10.1111/j.1600-0447.1997.tb00379.x · Cited by 104
Self-citationSangalang, C. C., Jager, J., & Harachi, T. W. (2017) · Social Science & Medicine · doi:10.1016/j.socscimed.2017.04.032 · Cited by 106
“Maternal traumatic distress was measured with 30 items from the Harvard Trauma Questionnaire (HTQ), developed to assess DSM-based PTSD symptoms in Southeast Asian refugees (Mollica et al., 1992).”
BackgroundMethodThe familial influence of loss and trauma on refugee mental health: A multilevel path analysis
Nickerson, A., Bryant, R. A., Brooks, R., Steel, Z., Silove, D. M., & Chen, J. (2011) · Journal of Traumatic Stress · doi:10.1002/jts.20608 · Cited by 103
Andersen, T. E., Karstoft, K., Brink, O., & Elklit, A. (2016) · European Journal of Pain · doi:10.1002/ejp.848 · Cited by 104
“To measure the severity of PTSS, we used the Harvard Trauma Questionnaire part IV (HTQ-IV; Mollica et al., 1992).”
MethodKnipscheer, J. W., Sleijpen, M., Mooren, T. T. M., ter Heide, F. J. J., & van der Aa, N. (2015) · BJPsych Bulletin · doi:10.1192/pb.bp.114.047951 · Cited by 104
“8 The HTQ consists of three parts, the first two of which were used in this study.”
Hagaman, A. K., Sivilli, T. I., Ao, T. T.-H., Blanton, C., Ellis, H., Cardozo, B. L., & Shetty, S. (2016) · Journal of Immigrant and Minority Health · doi:10.1007/s10903-015-0326-6 · Cited by 103
“During the 1980s, a period of cultural and religious oppression of the Lhotshampas (an ethnically and linguistically Nepali minority in Bhutan) resulted in the relocation of over 100,000 refugees to neighboring Nepal [1].”
InfluentialMorgan, G., Melluish, S., & Welham, A. (2017) · Transcultural Psychiatry · doi:10.1177/1363461517737188 · Cited by 106
“The Harvard Trauma Questionnaire-Posttraumatic Stress Subscale (HTQ- PTSD; Mollica et al., 1992) and the Hopkins Symptom Checklist (HSCL-25; Hesbacher, 1980; Winokur, Winokur, Rickels, & Cox, 1984) were used to measure distress.”
MethodNikopoulou, V. A., Holeva, V., Parlapani, E., Karamouzi, P., Voitsidis, P., Porfyri, G.-N., Blekas, A., Papigkioti, K., Patsiala, S., & Diakogiannis, I. (2020) · International Journal of Mental Health and Addiction · doi:10.1007/s11469-020-00414-w · Cited by 114
Effects of Post-migration Factors on PTSD Outcomes Among Immigrant Survivors of Political Violence
Chu, T., Keller, A. S., & Rasmussen, A. (2012) · Journal of Immigrant and Minority Health · doi:10.1007/s10903-012-9696-1 · Cited by 105
Machisa, M., Christofides, N. J., & Jewkes, R. K. (2016) · PLoS ONE · doi:10.1371/journal.pone.0150986 · Cited by 115
Psychological Assessment of Children in Disasters and Emergencies
Balaban, V. (2006) · Disasters · doi:10.1111/j.0361-3666.2006.00314.x · Cited by 107
Confirmatory factor analysis of posttraumatic stress symptoms in cambodian refugees
Palmieri, P. A., Marshall, G. N., & Schell, T. L. (2007) · Journal of Traumatic Stress · doi:10.1002/jts.20196 · Cited by 102
Trauma and Disasters in Social and Cultural Context
Kirmayer, L. J., Kienzler, H., Afana, A. H., & Pedersen, D. (2010) · Wiley eBooks · doi:10.1002/9780470684214.ch13 · Cited by 102
“These include the Harvard Trauma Questionnaire (HTQ) and measures for assessing anxiety and depression [141].”
MethodMental health among torture survivors: cultural background, refugee status and gender
Schubert, C. C., & Punamäki, R. (2010) · Nordic Journal of Psychiatry · doi:10.3109/08039488.2010.514943 · Cited by 100
Nickerson, A., Byrow, Y., Pajak, R., McMahon, T., Bryant, R. A., Christensen, H., & Liddell, B. J. (2020) · Psychological Medicine · doi:10.1017/s0033291719000606 · Cited by 98
“The 16-item Harvard Trauma Questionnaire (HTQ; Mollica et al., 1992) was used to index potentially traumatic events commonly experienced by refugees in this study.”
MethodLess is more? Assessing the validity of the ICD-11 model of PTSD across multiple trauma samples
Hansen, M., Hyland, P., Armour, C., Shevlin, M. E., & Elklit, A. (2015) · European Journal of Psychotraumatology · doi:10.3402/ejpt.v6.28766 · Cited by 105
“The Harvard Trauma Questionnaire Part IV (HTQ; Mollica et al., 1992) includes 31 items designed to assess DSM-IV PTSD symptoms and more general posttraumatic stress symptoms.”
MethodFather‐Involvement in a Refugee Sample: Relations between Posttraumatic Stress and Caregiving
van Ee, E., Sleijpen, M., Kleber, R. J., & Jongmans, M. J. (2013) · Family Process · doi:10.1111/famp.12045 · Cited by 104
Burmese political dissidents in Thailand: trauma and survival among young adults in exile.
Allden, K., Poole, C., Chantavanich, S., Ohmar, K., Aung, N. N., & Mollica, R. F. (1996) · American Journal of Public Health · doi:10.2105/ajph.86.11.1561 · Cited by 99
Self-citationAraya, M., Chotai, J., Komproe, I. H., & de Jong, J. T. V. M. (2007) · Quality of Life Research · doi:10.1007/s11136-007-9201-9 · Cited by 97
“Traumatic childhood life events were evaluated by the total number of affirmative responses among 16 questions derived from Harvard Trauma Questionnaire, Section I [11, 12], and were posed regarding the life period before 12 years of age.”
MethodElklit, A., & Christiansen, D. M. (2010) · Journal of Interpersonal Violence · doi:10.1177/0886260509354587 · Cited by 98
“The HTQ measures the intensity of the three core symptom groups of PTSD (intrusion, avoidance, and arousal) and consists of 30 items, 16 of which correspond to the DSM-IV.”
MethodInfluentialOruč, L., Kapetanovic, A., Pojskić, N., Miley, K., Forstbauer, S., Mollica, R. F., & Henderson, D. C. (2008) · International Journal of Culture and Mental Health · doi:10.1080/17542860802456620 · Cited by 93
“The Harvard Trauma Questionnaire (HTQ) and the Hopkins Check List-25 (HSCL25) are screening instruments widely used for assessment of PTSD and MDD in various populations and cultural settings (Mollica et al., 1992; Mollica, Wyshak, de Marneffe, Khuon, & Lavelle, 1987; Smith et al., 1997).”
BackgroundMethodInfluentialSelf-citationHondius, A. J. K., van Willigen, L. H. M., Kleijn, W. C., & van der Ploeg, H. M. (2000) · Journal of Traumatic Stress · doi:10.1023/a:1007858116390 · Cited by 97
“psychiatric patients (Kinzie et al., 1990; Mollica et al., 1992; Mollica et al., 1987), but more intriguing is the variance in PTSD prevalence found in nonclinical groups of refugees, varying from a 9% low (Hauff & Vaglum, 1993) to an almost 100% high (Bernstein-Carlson & Rosser-Hogan, 1991).”
BackgroundInclusive victim consciousness predicts minority group members’ support for refugees and immigrants
Vollhardt, J. R., Nair, R., & Tropp, L. R. (2016) · Journal of Applied Social Psychology · doi:10.1111/jasp.12368 · Cited by 94
McColl, H., & Johnson, S. (2006) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-006-0102-y · Cited by 94
Crea, T. M., López, A., Taylor, T., & Underwood, D. (2016) · Children and Youth Services Review · doi:10.1016/j.childyouth.2016.12.009 · Cited by 96
Screening for Depression and PTSD in a Cambodian Population Unaffected by War
Silove, D. M., Manicavasagar, V. L., Mollica, R. F., Thai, M., Khiek, D., Lavelle, J., & Tor, S. (2007) · The Journal of Nervous and Mental Disease · doi:10.1097/01.nmd.0000254747.03333.70 · Cited by 94
“, 1987) and the Harvard Trauma Questionnaire (HTQ; Mollica et al., 1992), have been used internationally across multiple sites (Kleijn et al.”
MethodInfluentialSelf-citationToar, M., O’Brien, K. K., & Fahey, T. P. (2009) · BMC Public Health · doi:10.1186/1471-2458-9-214 · Cited by 92
“lack of food and water, being close to death) with three possible responses (experienced, witnessed, no) [9].”
BackgroundMethodMental health problems associated with female genital mutilation
Knipscheer, J. W., Vloeberghs, E., van der Kwaak, A., & van den Muijsenbergh, M. E. T. C. (2015) · BJPsych Bulletin · doi:10.1192/pb.bp.114.047944 · Cited by 95
Mental ill health in structural pathways to women’s experiences of intimate partner violence
Machisa, M., Christofides, N. J., & Jewkes, R. K. (2017) · PLoS ONE · doi:10.1371/journal.pone.0175240 · Cited by 100
The Mental Health of Expatriate and Kosovar Albanian Humanitarian Aid Workers
Cardozo, B. L., Holtz, T. H., Kaiser, R., Gotway, C. A., Ghitis, F., Toomey, E., & Salama, P. (2005) · Disasters · doi:10.1111/j.0361-3666.2005.00278.x · Cited by 93
Nexhmedin Morina, B., Rudari, V., Bleichhardt, G. M., & Prigerson, H. G. (2009) · International Journal of Social Psychiatry · doi:10.1177/0020764008101638 · Cited by 96
“Traumatic events were measured using an adjusted checklist for war-related events that is based on the fi rst part of the Harvard Trauma Questionnaire (Mollica et al., 1992).”
MethodInternational migration to Canada: The post-birth health of mothers and infants by immigration class
Gagnon, A. J., Dougherty, G. E., Wahoush, O., Saucier, J., Dennis, C., Stanger, E., Palmer, B., Merry, L. A., & Stewart, D. E. (2012) · Social Science & Medicine · doi:10.1016/j.socscimed.2012.11.001 · Cited by 88
Buhmann, C. B., Nordentoft, M., Ekstroem, M., Carlsson, J., & Mortensen, E. L. (2016) · British Journal of Psychiatry · doi:10.1192/bjp.bp.114.150961 · Cited by 92
The epidemiology of psychiatric disorders in Africa: a scoping review
Greene, M. C., Yangchen, T., Lehner, T., Sullivan, P. F., Pato, C. N., McIntosh, A. M., Walters, J., Gouveia, L., Msefula, C. L., Fumo, W., et al. (2021) · The Lancet Psychiatry · doi:10.1016/s2215-0366(21)00009-2 · Cited by 99
“Thirteen studies used screening tools to estimate the point, period, or lifetime prevalence of probable cases of psychiatric disorder using the Hopkins Symptom Checklist in combination with a locally developed functional impairment measure;(47,60,70,71) the Center for Epidemiologic Studies Depression Scale (CES-D);(24…”
MethodHuijts, I., Kleijn, W. C., van Emmerik, A., Noordhof, A., & Smith, A. J. M. (2012) · Journal of Traumatic Stress · doi:10.1002/jts.21665 · Cited by 93
Roth, G., Ekblad, S., & Ågren, H. (2006) · European Psychiatry · doi:10.1016/j.eurpsy.2005.11.004 · Cited by 91
Silove, D. M., Liddell, B. J., Rees, S. J., Chey, T., Nickerson, A., Tam, N., Zwi, A. B., Brooks, R., Sila, L. L., & Steel, Z. (2014) · The Lancet Global Health · doi:10.1016/s2214-109x(14)70196-2 · Cited by 93
d’Abreu, A., Castro-Olivo, S. M., & Ura, S. K. (2019) · School Psychology International · doi:10.1177/0143034318822688 · Cited by 92
Sarraj, E. E., Punamäki, R., Salmi, S., & Summerfield, D. A. (1996) · Journal of Traumatic Stress · doi:10.1007/bf02103668 · Cited by 103
Trauma, Healthcare Access, and Health Outcomes Among Southeast Asian Refugees in Connecticut
Wagner, J. A., Burke, G., Kuoch, T., Scully, M. F., Armeli, S., & Rajan, T. V. (2012) · Journal of Immigrant and Minority Health · doi:10.1007/s10903-012-9715-2 · Cited by 90
“The post-traumatic stress symptom subscale of the Harvard Trauma Questionnaire (HTQ; [20]) assesses 16 of the 17 diagnostic criteria for PTSD [21] which measures symptoms of re-experiencing traumatic events, avoidance of stimuli associated with the trauma, numbing of general responsiveness and increased arousal.”
Posttraumatic Stress Disorder Among Cambodian Refugees in New Zealand
Cheung, P. (1994) · International Journal of Social Psychiatry · doi:10.1177/002076409404000102 · Cited by 90
Psychiatric Symptoms Associated with Brief Detention of Adult Asylum Seekers in Canada
Cleveland, J., & Rousseau, C. (2013) · The Canadian Journal of Psychiatry · doi:10.1177/070674371305800706 · Cited by 87
Morina, N., Kuenburg, A., Schnyder, U., Bryant, R. A., Nickerson, A., & Schick, M. (2017) · Pain Medicine · doi:10.1093/pm/pnx005 · Cited by 87
Parents bereaved by infant death: PTSD symptoms up to 18 years after the loss
Christiansen, D. M., Elklit, A., & Olff, M. (2013) · General Hospital Psychiatry · doi:10.1016/j.genhosppsych.2013.06.006 · Cited by 91
Veer, I. M., Oei, N. Y. L., van Buchem, M. A., Spinhoven, P., Elzinga, B. M., & Rombouts, S. A. R. B. (2015) · Psychiatry Research Neuroimaging · doi:10.1016/j.pscychresns.2015.07.016 · Cited by 95
“On the day of the scan session, all participants were assessed with the Harvard Trauma Questionnaire (Mollica et al., 1992), the Dutch version of the Beck Depression Inventory (Bouman et al., 1985), the Dissociative Experience Scale (Bernstein and Putnam, 1986), and the State-Trait Anxiety Inventory (Spielberger, 1983…”
MethodBerthold, S. M., Mollica, R. F., Silove, D. M., Tay, A. K., Lavelle, J., & Lindert, J. (2018) · European Journal of Public Health · doi:10.1093/eurpub/cky256 · Cited by 87
Self-citationRasmussen, A., Keatley, E., & Joscelyne, A. (2014) · Social Science & Medicine · doi:10.1016/j.socscimed.2014.03.015 · Cited by 87
“…of good emic practice because their purpose was to adapt measures of DSM constructs to particular cultural contexts (e.g., Kohrt, et al., 2011; Mollica et al., 1992; Phan et al., 2004), were not related to trauma or stress (Kohrt et al., 2004), or provided insufficient detail on specific CCDs…”
O’Connor, M., Piet, J., & Hougaard, E. (2013) · Mindfulness · doi:10.1007/s12671-013-0194-x · Cited by 86
“HTQ ratings according to the DSM-III-R diagnostic criteria of PTSD showed an 88 % concordance with interview-based estimates of PTSD (Mollica et al. 1992).”
MethodInfluentialSCIENCE-BASED POLICY FOR PSYCHOSOCIAL INTERVENTIONS IN REFUGEE CAMPS
Mollica, R. F., Cui, X., McInnes, D. K., & Massagli, M. P. (2002) · The Journal of Nervous and Mental Disease · doi:10.1097/00005053-200203000-00004 · Cited by 86
“…being depressed or having PTSD. Validation studies show that these cut-off points are highly correlated with being checklist positive for the DSM-IIIR diagnoses of major depression and PTSD in Indochinese clinic and community samples (Mollica et al., 1992; Mollica et al., 1987; Smith-Fawzi, 1997).”
MethodInfluentialSelf-citationPredictors of Depression Among Refugees from Vietnam: A Longitudinal Study of New Arrivals
Hinton, W. L., Tiêt, Q. Q., Tran, C. G., & Chesney, M. A. (1997) · The Journal of Nervous and Mental Disease · doi:10.1097/00005053-199701000-00007 · Cited by 86
Këllezi, B., Reicher, S. D., & Cassidy, C. (2008) · Applied Psychology · doi:10.1111/j.1464-0597.2008.00382.x · Cited by 101
Symptoms of posttraumatic stress disorder in a clinical sample of refugees: a network analysis
Spiller, T. R., Schick, M., Schnyder, U., Bryant, R. A., Nickerson, A., & Morina, N. (2017) · European Journal of Psychotraumatology · doi:10.1080/20008198.2017.1318032 · Cited by 87
“Trauma exposure To index trauma exposure, a combined version of the Harvard Trauma Questionnaire (HTQ; Mollica et al., 1992) and the PDS trauma checklist (Foa, Cashman,”
MethodWind, T. R., van der Aa, N., de la Rie, S. M., & Knipscheer, J. W. (2017) · European Journal of Psychotraumatology · doi:10.1080/20008198.2017.1321357 · Cited by 93
“The HTQ (Mollica et al., 1992) is a self-report questionnaire assessing traumatic experiences and PTSD symptom severity.”
BackgroundChildhood Experiences of Care and Abuse (CECA)
Kaess, M., Parzer, P., Mattern, M., Resch, F., Bifulco, A. T., & Brunner, R. M. (2011) · Zeitschrift für Kinder- und Jugendpsychiatrie und Psychotherapie · doi:10.1024/1422-4917/a000115 · Cited by 95
Metadata
- Authors
- MOLLICA, R. F., CASPI-YAVIN, Y., BOLLINI, P., TRUONG, T., TOR, S., & LAVELLE, J.
- Affiliations
- Harvard University (US)
- St. Elizabeth's Medical Center (US)
- ORCID
- MOLLICA, RICHARD F.
- Venue
- The Journal of Nervous and Mental Disease
- Published
- 1992-02
- Volume
- 180
- Issue
- 2
- Pages
- 111-116
- ISSN
- 0022-3018 (ISSN-L)
- OpenAlex
- W4292855834
- Cited by
- 1,489
- References
- 0
- Citations by year
- 2026: 56 · 2025: 92 · 2024: 66 · 2023: 92 · 2022: 100 · 2021: 98 · 2020: 103 · 2019: 73 · 2018: 90 · 2017: 86 · 2016: 71 · 2015: 59 · 2014: 63 · 2013: 50 · 2012: 54
- FWCI
- 6.74
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Nervous and Mental Disease (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Social Sciences › Psychology › Clinical Psychology › Migration, Health and Trauma
- Social Sciences › Decision Sciences › Management Science and Operations Research › Psychometric Methodologies and Testing
- Keywords
- Harvard Trauma Questionnaire, post-traumatic stress disorder, torture, trauma symptoms, Indochinese refugees, cross-cultural assessment, screening tool, cultural sensitivity, instrument validation, refugee mental health
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