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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 401–500 of 1,005
Christofides, N. J., Hatcher, A. M., Pino, A., Rebombo, D., McBride, R., Anderson, A. D., & Peacock, D. (2018) · BMJ Open · doi:10.1136/bmjopen-2017-017579 · Cited by 45
“The Harvard Trauma Questionnaire is a cross-cultural instrument for measuring symptoms associated with post-traumatic stress disorder.(37)”
Moscardino, U. M. M., Musso, P., Inguglia, C., Ceccon, C., Miconi, D., & Rousseau, C. (2022) · Vaccine · doi:10.1016/j.vaccine.2022.03.018 · Cited by 52
“The psychometric properties of the measure have been well-established in different nations and cultural groups [29], and the questionnaire is available in Italian language [30].”
Group Therapy With Male Asylum Seekers and Refugees With Posttraumatic Stress Disorder
Drožđek, B., Kamperman, A. M., Bolwerk, N., Tol, W. A., & Kleber, R. J. (2012) · The Journal of Nervous and Mental Disease · doi:10.1097/nmd.0b013e318266f860 · Cited by 48
“The HTQ (Mollica et al., 1992, 1996a) is a widely used, culturally sensitive checklist that inquires about a variety of trauma events, as well as PTSD symptoms according to DSM-III-R (APA, 1987).”
MethodInfluentialTraumatic Events Exposure and Psychological Trauma in Children Victims of War in the Gaza Strip
Manzanero, A. L., Crespo, M., Barón, S., Scott, T., El‐Astal, S., & Hemaid, F. (2017) · Journal of Interpersonal Violence · doi:10.1177/0886260517742911 · Cited by 47
“The assessment is based on the application of the Harvard Trauma Questionnaire (HTQ), developed by the Harvard Program in Refugee Trauma (Mollica et al., 1992) in its Iraqi Version–Arabic (Shoeb, Weinstein, & Mollica, 2007).”
Cooper, S., Enticott, J., Shawyer, F., & Meadows, G. N. (2018) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2019.00545 · Cited by 47
“It is derived from the Harvard Trauma Questionnaire, which has shown good performance in cross-cultural populations (25).”
MethodA meta-analytic review of the emotional symptoms associated with mild traumatic brain injury
Panayiotou, A., Jackson, M., & Crowe, S. F. (2009) · Journal of Clinical and Experimental Neuropsychology · doi:10.1080/13803390903164371 · Cited by 45
Post-traumatic stress disorder and emotional distress in persons with spinal cord lesion
Nielsen, M. S. (2003) · Spinal Cord · doi:10.1038/sj.sc.3101427 · Cited by 45
Mental health screening in immigration detention: A fresh look at Australian government data
Young, P., & Gordon, M. S. (2016) · Australasian Psychiatry · doi:10.1177/1039856215624247 · Cited by 45
Attachment style and interpersonal trauma in refugees
Morina, N., Schnyder, U., Schick, M., Nickerson, A., & Bryant, R. A. (2016) · Australian & New Zealand Journal of Psychiatry · doi:10.1177/0004867416631432 · Cited by 45
“Potentially traumatic events (PTEs) were measured by combining the trauma event lists of two standardized questionnaires, the Harvard Trauma Questionnaire (HTQ) (Mollica et al., 1992) and the first part of the Posttraumatic Diagnostic Scale (PDS) (Foa, 1996; Foa et al., 1997).”
MethodDoolan, E. L., Bryant, R. A., Liddell, B. J., & Nickerson, A. (2017) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2017.04.005 · Cited by 47
Hengst, S. M. C., Smid, G. E., & Laban, C. J. (2017) · The Journal of Nervous and Mental Disease · doi:10.1097/nmd.0000000000000750 · Cited by 47
“All rights reserved. horized reproduction of this article is prohibited. well-validated instrument, widely used in research among refugees (Mollica et al., 1992), exploring various trauma such as sexual abuse, starvation, forced isolation, separation of family, and witnessing or experiencing…”
BackgroundInterpreter-mediated psychotherapy with trauma-affected refugees – A retrospective cohort study
Sander, R., Laugesen, H., Skammeritz, S., Mortensen, E. L., & Carlsson, J. (2019) · Psychiatry Research · doi:10.1016/j.psychres.2018.12.058 · Cited by 46
A latent profile analysis of moral injury appraisals in refugees
Hoffman, J., Liddell, B. J., Bryant, R. A., & Nickerson, A. (2019) · European Journal of Psychotraumatology · doi:10.1080/20008198.2019.1686805 · Cited by 47
“The measure has shown validity and reliability across cultural groups (Mollica et al., 1992), and has been used with refugee populations (Steel et al., 2009).”
BackgroundDemir, Z., Böge, K., Fan, Y., Hartling, C., Harb, M. R., Hahn, E. W., Seybold, J., & Bajbouj, M. (2020) · Translational Psychiatry · doi:10.1038/s41398-020-01062-3 · Cited by 60
Peterman, J. N., Toof, R. A., Liang, S., & Grigg-Saito, D. C. (2015) · Health Education & Behavior · doi:10.1177/1090198115590779 · Cited by 45
“An average score of ≥1.75 was classified as “depressed” (Harvard Program in Refugee Trauma cutoff; Mollica et al., 1992).”
BackgroundInfluentialMueller, J., Schmidt, M., Staeheli, A., & Maier, T. (2010) · European Journal of Public Health · doi:10.1093/eurpub/ckq016 · Cited by 44
“Traumatic events were assessed using part one of the Harvard Trauma Questionnaire,27 a common instrument assessing 17 types of traumatic life events known to affect refugee populations (range = 0–17).”
MethodEkblad, S., Prochazka, H., & Roth, G. (2002) · Acta Psychiatrica Scandinavica · doi:10.1034/j.1600-0447.106.s412.7.x · Cited by 45
Annan, J. R., Falb, K., Kpebo, D. O., Hossain, M., & Gupta, J. (2017) · Cambridge Prisms Global Mental Health · doi:10.1017/gmh.2017.19 · Cited by 44
“Women reporting an average of 2 points or higher were coded as probable PTSD in accordance with measurement guidelines (Mollica et al. 1992).”
MethodA controlled trial of problem-solving counseling for war-affected adults in Aceh, Indonesia
Bass, J., Poudyal, B., Tol, W. A., Murray, L. K., Nadison, M., & Bolton, P. A. (2011) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-011-0339-y · Cited by 44
“Mollica et al. [ 32 ] used a cutoff of 1.75 to identify the presence of psychiatric illness among an Indochinese population, and Ventevogel et al. [33] identified cutoffs of 2.25 (women) and 1.50 (men) among a primary care sample in Afghanistan.”
InfluentialMeffert, S. M., & Marmar, C. R. (2008) · Journal of Interpersonal Violence · doi:10.1177/0886260508325491 · Cited by 46
“Although mental illness is defined by many biological, universal features, emotional expression is also informed by cultural context (Kleinman, 1977; Mollica et al., 1992).”
BackgroundKazlauskas, E., Gailienė, D., Vaskelienė, I., & Skerytė-Kazlauskienė, M. (2017) · Frontiers in Psychology · doi:10.3389/fpsyg.2017.01677 · Cited by 44
“Life-time trauma exposure was measured with the Harvard Trauma Questionnaire (HTQ) (Mollica et al., 1992).”
BackgroundMethodInfluentialSex differences in trauma exposure and symptomatology in trauma-affected refugees
Mundy, S. S., Foss, S. L. W., Poulsen, S., Hjorthøj, C., & Carlsson, J. (2020) · Psychiatry Research · doi:10.1016/j.psychres.2020.113445 · Cited by 43
Ayano, G., Duko, B., & Bedaso, A. (2020) · Psychiatric Quarterly · doi:10.1007/s11126-020-09849-9 · Cited by 44
Victimization and PTSD-like states in an Icelandic youth probability sample
Bödvarsdóttir, Í., & Elklit, A. (2007) · BMC Psychiatry · doi:10.1186/1471-244x-7-51 · Cited by 44
“When filling in the HTQ, pupils were asked to write down the event most distressing to them and to keep that in mind when answering.”
InfluentialPatterns of somatic distress among conflict-affected persons in the Republic of Georgia
Comellas, R. M., Makhashvili, N., Chikovani, I., Patel, V., McKee, M., Bisson, J. I., & Roberts, B. (2015) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2015.01.015 · Cited by 43
Risk Factors for Posttraumatic Stress Disorder in Female Help-Seeking Victims of Sexual Assault
Elklit, A., & Christiansen, D. M. (2013) · Violence and Victims · doi:10.1891/0886-6708.09-135 · Cited by 44
“The Harvard Trauma Questionnaire Part IV (HTQ; Mollica et al., 1992), which was filled out by participants at T2, consists of 31 items, 16 of which correspond to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) diagnostic criteria for PTSD…”
BackgroundMethodInfluentialZaninotto, A. L., Vicentini, J. E., Fregni, F., Rodrigues, P. A., Botelho, C., de Lúcia, M. C. S., & Paiva, W. S. (2016) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2016.00095 · Cited by 47
“Harvard Trauma Questionnaire (127) HTQ Interview schedule”
Bass, J., Murray, S. M., Mohammed, T. A., Bunn, M., Gorman, W., Ahmed, A. M. A., Murray, L. K., & Bolton, P. A. (2016) · Global Health Science and Practice · doi:10.9745/ghsp-d-16-00017 · Cited by 47
“In a progressive treatment model, this type of work is characterized as setting the stage for later, more in-depth narrative work that focuses on addressing underlying trauma experiences and associated PTSD symptoms, which the HAI intervention did not include.(8,29,30) Similar to other randomized controlled trials of…”
MethodKoch, T., Ehring, T. W., & Liedl, A. (2020) · Behaviour Research and Therapy · doi:10.1016/j.brat.2020.103689 · Cited by 43
Assessing war trauma in refugees: Properties of the Comprehensive Trauma Inventory-104
Hollifield, M. A., Warner, T. D., JENKINS, J. H., Sinclair-Lian, N., Krakow, B. J., Eckert, V., Karadaghi, P., & Westermeyer, J. J. (2006) · Journal of Traumatic Stress · doi:10.1002/jts.20137 · Cited by 43
Intrusive Traumatic Recollections and Comorbid Posttraumatic Stress Disorder in Depressed Patients
Carlier, I. V. E., Voerman, B. E., & Gersons, B. P. R. (2000) · Psychosomatic Medicine · doi:10.1097/00006842-200001000-00004 · Cited by 43
“matic Events, adapted version; see also Table 1) (21, 22).”
BackgroundYasui, M., Pottick, K. J., & Chen, Y. (2017) · Clinical Child and Family Psychology Review · doi:10.1007/s10567-017-0229-2 · Cited by 45
How can Story Completion be Used in Culturally Safe Ways?
Lenette, C., Vaughan, P., & Boydell, K. (2022) · International Journal of Qualitative Methods · doi:10.1177/16094069221077764 · Cited by 42
Soosay, I., Silove, D. M., Bateman-Steel, C. R., Steel, Z., Bebbington, P., Jones, P. B., Chey, T., Ivancic, L., & Marnane, C. L. (2012) · BMC Psychiatry · doi:10.1186/1471-244x-12-229 · Cited by 42
“PTSD symptoms based on DSM-IV criteria were measured by the Harvard Trauma Questionnaire (HTQ) [23], the most widely applied instrument in the postconflict and refugee field [24].”
MethodInfluentialBeck, B. D., Lund, S. T., Søgaard, U., Simonsen, E. H., Tellier, T. C., Cordtz, T. O., Laier, G. H., & Moe, T. (2018) · Trials · doi:10.1186/s13063-018-2662-z · Cited by 46
“Procedure of obtaining informed consent Following the regulations of the regional Ethical Scientific Committee, patients eligible to participate in the trial are invited to an information meeting with one of the music therapists or the senior staff specialist, where they are informed orally as well as provided with a…”
BackgroundInfluentialProfiles of exposure to potentially traumatic events in refugees living in Australia
Nickerson, A., Byrow, Y., Rasmussen, A., O'Donnell, M. L., Bryant, R. A., Murphy, S., Mau, V., McMahon, T., Benson, G., & Liddell, B. J. (2021) · Epidemiology and Psychiatric Sciences · doi:10.1017/s2045796021000068 · Cited by 43
“Exposure to PTEs was measured using the 16-item Harvard Trauma Questionnaire (Mollica et al ., 1992).”
Psychiatric effects of traumatic brain injury events in Cambodian survivors of mass violence
Mollica, R. F., Henderson, D. C., & Tor, S. (2002) · The British Journal of Psychiatry · doi:10.1192/bjp.181.4.339 · Cited by 42
Self-citationBoehnlein, J. K., & Kinzie, J. D. (1995) · Transcultural Psychiatric Research Review · doi:10.1177/136346159503200301 · Cited by 42
Profiles of post-migration stressors and mental health in refugees: A latent class analysis
Byrow, Y., Liddell, B. J., O'Donnell, M. L., Mau, V., McMahon, T., Bryant, R. A., Benson, G., & Nickerson, A. (2022) · Psychiatry Research · doi:10.1016/j.psychres.2022.114494 · Cited by 42
Marshall, G. N., Schell, T. L., & Miles, J. N. V. (2012) · Clinical Psychology Review · doi:10.1016/j.cpr.2012.10.004 · Cited by 57
“…PTSD Scale (Blake et al., 1995), the PTSD Symptom Checklist (Weathers, Litz, Herman, Huska, & Keane, 1993), the Harvard Trauma Questionnaire (Mollica et al., 1992)5, the Posttraumatic Diagnostic Scale (PDS; Foa, Cashman, Jaycox, & Perry, 1997), the Posttraumatic Stress Disorder…”
MethodInfluentialSteinert, C., Bumke, P. J., Hollekamp, R. L., Larisch, A., Leichsenring, F., Mattheß, H., Sisokhom, S., Sodemann, U., Stingl, M., Ret, T., et al. (2016) · Psychological Medicine · doi:10.1017/s0033291716002592 · Cited by 41
“The power analysis was based on the primary outcome (HTQ mean scores) (Steinert et al. 2016).”
MethodInfluentialJongedijk, R. A., Eising, D. D., van der Aa, N., Kleber, R. J., & Boelen, P. A. (2020) · Journal of Affective Disorders · doi:10.1016/j.jad.2020.01.077 · Cited by 42
Mechanisms underlying the mental health impact of family separation on resettled refugees
Liddell, B. J., Byrow, Y., O'Donnell, M. L., Mau, V., Batch, N., McMahon, T., Bryant, R. A., & Nickerson, A. (2020) · Australian & New Zealand Journal of Psychiatry · doi:10.1177/0004867420967427 · Cited by 40
“The path analysis findings highlight the direct association between PTE exposure and increasing risk for mental health symptoms in both separated and non-separated refugees, although these pathways were stronger in the separated group, thus supporting the majority of findings in the literature of such a dose–response…”
BackgroundMethodResultStrømme, E. M., Igland, J., Haj-Younes, J., Kumar, B. N., Fadnes, L. T., Hasha, W., & Díaz, E. (2021) · BMJ Open · doi:10.1136/bmjopen-2020-046454 · Cited by 37
Schieß-Jokanovic, J., Knefel, M., Kantor, V., Weindl, D., Schäfer, I., & Lueger‐Schuster, B. (2021) · European Journal of Psychotraumatology · doi:10.1080/20008198.2021.2001190 · Cited by 43
“German and Dari versions of the International Trauma Questionnaire (ITQ), Post-Migration Living Difficulties Checklist (PMLDC) and Harvard Trauma Questionnaire (HTQ) were provided.”
MethodGupta, J., Falb, K., Carliner, H., Hossain, M., Kpebo, D. O., & Annan, J. R. (2014) · PLoS ONE · doi:10.1371/journal.pone.0096300 · Cited by 45
“A 16-item post-traumatic symptom subscale of the Harvard Trauma Questionnaire (HTQ) was utilized to assess past-week post-traumatic stress disorder, as defined by the Diagnostic and Statistical Manual of Mental Disorders, 3 edition, revised (DSMIII-R) criteria [23].”
MethodAragona, M., Catino, E., Pucci, D., Carrer, S., Colosimo, F., Lafuente, M., Mazzetti, M., Maisano, B., & Geraci, S. (2010) · Journal of Traumatic Stress · doi:10.1002/jts.20571 · Cited by 41
Self-Reported Head Injury Among Refugee Survivors of Torture
Keatley, E. S., Ashman, T. A., Im, B., & Rasmussen, A. (2013) · Journal of Head Trauma Rehabilitation · doi:10.1097/htr.0b013e3182776a70 · Cited by 41
Sheikh, T. L., Abdulaziz, M., Agunbiade, S., Ike, J., Ebiti, B., & Adekeye, O. B. (2014) · Journal of Affective Disorders · doi:10.1016/j.jad.2014.08.050 · Cited by 41
“Finally we used the Harvard Trauma Questionnaire (HTQ) (Mollica et al., 1992) designed by Harvard Program in Refugee Trauma, Massachusetts General Hospital for the diagnosis of symptomatic PTSD.”
MethodInfluentialThe narrative epidemiology of L'Aquila 2009 earthquake
CASACCHIA, M., Pollice, R., & Roncone, R. (2012) · Epidemiology and Psychiatric Sciences · doi:10.1017/s2045796011000801 · Cited by 40
“…introduced to us the adaptation of the Harvard Battery in Italian, including the Harvard Trauma Questionnaire – Revised (HTQ-R) in its three parts (Mollica et al. 1992; Smith Fawzi et al. 1997) and the Hopkins Symptom Checklist-25 (HSCL-25), a screening tool designed to detect symptoms of…”
MethodPallitto, C., Garcia‐Moreno, C., Stöckl, H., Hatcher, A. M., MacPhail, C. L., Mokoatle, K., & Woollett, N. (2016) · BMC Health Services Research · doi:10.1186/s12913-016-1872-x · Cited by 42
“include post-traumatic stress (using the Harvard Trauma Questionnaire (HTQ) [40], anxiety and depression”
MethodWong, C. W. S., & Schweitzer, R. (2017) · Transcultural Psychiatry · doi:10.1177/1363461517737015 · Cited by 48
“GPA – Grade Point Average; CTBS – Comprehensive Test of Basic Skills; HTQ – Harvard Trauma Questionnaire (Mollica et al., 1992); SCECVSurvey of Children’s Exposure to Community Violence (Richters & Saltzman, 1990); LA PTSD Index – Los Angeles Posttrraumatic Stress Index (King, King, Leskin, & Foy, 1995); CED-DC – Cent…”
BackgroundA Longitudinal Investigation of Moral Injury Appraisals Amongst Treatment-Seeking Refugees
Nickerson, A., Hoffman, J., Schick, M., Schnyder, U., Bryant, R. A., & Morina, N. (2018) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2018.00667 · Cited by 39
“The trauma event lists of two standardized questionnaires, the Harvard Trauma Questionnaire (29) and the Posttraumatic Diagnostic Scale (30) were amalgamated, and the final scale comprised 23 items which indexed exposure to PTEs typically experienced by refugees.”
MethodDisability, violence, and mental health among Somali refugee women in a humanitarian setting
Hossain, M., Pearson, R. J., McAlpine, A., Bacchus, L., Muuo, S., Muthuri, S. K., Spangaro, J., Kuper, H., Franchi, G., Cordero, R. P., et al. (2020) · Cambridge Prisms Global Mental Health · doi:10.1017/gmh.2020.23 · Cited by 39
Boris, N. W., Thurman, T. R., Snider, L., SPENCER, E., & Brown, L. F. (2006) · Infant Mental Health Journal · doi:10.1002/imhj.20116 · Cited by 40
Bentley, J. A., Thoburn, J. W., Stewart, D. G., & Boynton, L. D. (2012) · Journal of Loss and Trauma · doi:10.1080/15325024.2012.665008 · Cited by 40
“The Harvard Trauma Questionnaire (HTQ; Mollica, Caspi-Yavin, Bollini, & Truong, 1992 ) is a widely used measure of PTSD symptom severity and one of the few assessments normed and validated specifically for use with refugee populations.”
MethodAndersen, T. E., Andersen, L.-A. C., & Andersen, P. G. (2014) · European Journal of Psychotraumatology · doi:10.3402/ejpt.v5.23235 · Cited by 39
Burchert, S., Stammel, N., & Knaevelsrud, C. (2017) · Psychiatry Research · doi:10.1016/j.psychres.2017.04.033 · Cited by 42
“Measuring traumatic exposure Traumatic exposure (TE) of mothers and offspring was assessed using a list of 25 different traumatic event types based on the Posttraumatic Diagnostic Scale (Foa et al., 1997) and the Harvard Trauma Questionnaire (Mollica et al., 1992).”
BackgroundMethodThomas, S., & Williams, T. A. (2013) · Drug Science Policy and Law · doi:10.1177/2050324513498332 · Cited by 39
“…political oppression, escape from war and trauma and uncertainty over their future may be more vulnerable to developing them (ACMD, 2005; Bhui et al., 2006; Cervantes et al., 1989; De Jong et al., 2001, 2003; Hondius et al., 2000; Miller et al., 2002; Mollica et al., 1992; Turner et al., 2003).”
BackgroundSengoelge, M., Johnson-Singh, C. M., Mittendorfer‐Rutz, E., Vaez, M., & Saboonchi, F. (2019) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2019.109814 · Cited by 39
Greene, M. C., Likindikoki, S. L., Rees, S. J., Bonz, A. G., Kaysen, D. L., Misinzo, L., Njau, T., Kiluwa, S., Turner, R. M., Ventevogel, P., et al. (2021) · PLoS ONE · doi:10.1371/journal.pone.0252982 · Cited by 47
“Psychological distress was measured using the Hopkins Symptom Checklist (HSCL-25) [29], which measures symptoms of anxiety and depression, and the Harvard Trauma Questionnaire (HTQ) [30], which measures symptoms of post-traumatic stress.”
MethodInfluentialAkhtar, A., Malik, A., Ghatasheh, M., Aqel, I. S., Habashneh, R., Dawson, K. S., Watts, S., Jordans, M. J. D., Brown, F. L., Sijbrandij, M., et al. (2021) · European Journal of Psychotraumatology · doi:10.1080/20008198.2021.1901408 · Cited by 38
“The items were adapted in collaboration with local mental health professionals from commonly used trauma checklists (Foa, Johnson, Feeny, & Treadwell, 2001; Mollica et al., 1992; Nickerson et al., 2015; Steinberg, Brymer, Decker, & Pynoos, 2004).”
MethodArmour, C., Elklit, A., & Shevlin, M. E. (2011) · European Journal of Psychotraumatology · doi:10.3402/ejpt.v2i0.6018 · Cited by 40
“The Harvard Trauma Questionnaire Part IV (HTQ: Mollica et al., 1992).”
MethodPredictors of psychological distress in Lebanese hostages of war
Saab, B. R., Chaaya, M., Doumit, M. A. A., & Farhood, L. (2003) · Social Science & Medicine · doi:10.1016/s0277-9536(02)00505-1 · Cited by 39
Intrusive re-experiencing of chronic strife or war
Schreuder, B. J. N., Igreja, V., van Dijk, J., & Kleijn, W. (2001) · Advances in Psychiatric Treatment · doi:10.1192/apt.7.2.102 · Cited by 37
“In this study the Harvard Trauma Questionnaire (HTQ) (Mollica et al, 1992) and the Hopkins Symptom Checklist (HSCL–25) (Mollica et al, 1996) gave an adequate indication of symptomatology.”
MethodTrauma, Burnout, and Resilience of Syrian Primary Teachers Working in a War Zone
Sharifian, M. S., Hoot, J. L., Shibly, O., & Reyhanian, A. (2022) · Journal of Research in Childhood Education · doi:10.1080/02568543.2022.2076267 · Cited by 41
“The Harvard Trauma, Questionnaire (HTQ), Indochinese Version validated by Mollica et al. (1992) is a cross-cultural instrument designed to measure torture, trauma and PTSD in Indochinese refugees, according to DSM-III-R.”
MethodKun, P., Wang, Z., Chen, X., Le, H., Gong, X., Zhang, L., & Yao, L. (2010) · Public Health · doi:10.1016/j.puhe.2010.06.001 · Cited by 38
Suarez, E. B. (2012) · Child Abuse & Neglect · doi:10.1016/j.chiabu.2012.09.011 · Cited by 39
Brooks, R., Silove, D. M., Steel, Z., Steel, C., & Rees, S. J. (2011) · Journal of Affective Disorders · doi:10.1016/j.jad.2010.12.020 · Cited by 38
Liddell, B. J., Kemp, A. H., Steel, Z., Nickerson, A., Bryant, R. A., Tam, N., Tay, A. K., & Silove, D. M. (2016) · BMC Psychiatry · doi:10.1186/s12888-016-0850-5 · Cited by 38
Kritikos, T. K., Comer, J. S., He, M., Curren, L. C., & Tompson, M. C. (2018) · Research on Child and Adolescent Psychopathology · doi:10.1007/s10802-018-0427-5 · Cited by 45
Parents’ adjustment to late abortion, stillbirth or infant death: The role of causal attributions
Jind, L. (2003) · Scandinavian Journal of Psychology · doi:10.1111/1467-9450.00358 · Cited by 38
Severe war-related trauma and personality pathology: a case-control study
Munjiza, J., Britvić, D., Radman, M., & Crawford, M. (2017) · BMC Psychiatry · doi:10.1186/s12888-017-1269-3 · Cited by 39
“Recall bias can be minimised if exposure status between cases and controls is assessed in a sufficiently similar way which in this study was done by using a standardised self-report measure to assess trauma exposure (HTQ) in cases and controls ensuring that the exposure of interest (war trauma) was equally assessed in…”
MethodInfluentialEmerson, J. A., Tol, W. A., Caulfield, L. E., & Doocy, S. (2017) · Food and Nutrition Bulletin · doi:10.1177/0379572117714385 · Cited by 37
“Depression and anxiety symptoms were assessed using the Hopkins Symptom Checklist-25 (HSCL-25) and post-traumatic stress disorder (PTSD) symptoms were assessed using the Harvard Trauma Questionnaire (HTQ).(38,39) All measures asked participants to rate frequency of symptoms in the past month on a 4-point Likert scale…”
MethodGlobal Posttrauma Symptoms: A Systematic Review of Qualitative Literature
Michalopoulos, L., Meinhart, M., Yung, J., Barton, S. M., Wang, X., Chakrabarti, U., Ritchey, M., Haroz, E. E., Joseph, N., Bass, J., et al. (2018) · Trauma Violence & Abuse · doi:10.1177/1524838018772293 · Cited by 36
“…and somatic complaints (e.g., headaches, heart palpitations, and pressure in the chest) were commonly mentioned, building on previous research conducted in non-Western settings (Hinton & Lewis-Fernández, 2011; Kaiser et al., 2015; Meyer et al., 2014; Mollica et al., 1992; Rasmussen et al., 2015).”
BackgroundMethodLenferink, L. I. M., Liddell, B. J., Byrow, Y., O'Donnell, M. L., Bryant, R. A., Mau, V., McMahon, T., Benson, G., & Nickerson, A. (2021) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2021.12.009 · Cited by 39
“The Harvard Trauma Questionnaire.”
MethodAcculturation, Premigration Traumatic Experiences, and Depression Among Vietnamese Americans
Ngo, D. T., Tran, T. V., Gibbons, J. L., & Oliver, J. M. (2000) · Journal of Human Behavior in the Social Environment · doi:10.1300/j137v03n03_14 · Cited by 36
“Furthermore, although the HTQ was originally designed to capture the typical traumatic experiences of Southeast-Asian refugees who presented to the Indochinese Psychiatry Clinic (Boston, MA) (Mollica et al., 1992), its cultural validation among large community-based samples has yet to be tested.”
BackgroundDaud, A., af Klinteberg, B., & Rydelius, P. (2008) · Scandinavian Journal of Caring Sciences · doi:10.1111/j.1471-6712.2007.00532.x · Cited by 37
Amone‐P’Olak, K., Štochl, J., Ovuga, E., Abbott, R., Meiser‐Stedman, R., Croudace, T. J., & Jones, P. B. (2014) · Journal of Epidemiology & Community Health · doi:10.1136/jech-2013-203042 · Cited by 38
Silove, D. M., Manicavasagar, V. L., Beltran, R. O., Le, G. K. N., Nguyen, H., Phan, T. H., & Blaszczynski, A. P. (1997) · Psychiatric Services · doi:10.1176/ps.48.8.1064 · Cited by 37
Farhood, L., Fares, S. A., & Hamady, C. (2018) · Archives of Women s Mental Health · doi:10.1007/s00737-018-0874-6 · Cited by 37
“The cutoff that was used was 2.5 (Mollica et al. 1992).”
MethodInfluentialMurphy, S., Elklit, A., Murphy, J., Hyland, P., & Shevlin, M. (2017) · Journal of Clinical Psychology · doi:10.1002/jclp.22439 · Cited by 36
“Mollica et al. (1992) reported 88% concordance between those endorsing symptoms consistent with PTSD diagnostic criteria based on the HTQ and a diagnostic interview assessing PTSD.”
Labor Migration and Mental Health in Cambodia: A Qualitative Study
Meyer, S. R., Robinson, W. C., Chhim, S., & Bass, J. K. (2014) · Journal of Nervous & Mental Disease · doi:10.1097/nmd.0000000000000101 · Cited by 35
“Studies conducted with clinic-based samples of Cambodians resettled to the United States found extensive exposure to significant traumas during the Khmer Rouge period, including imprisonment, war injury, experiencing torture, and witnessing murder or torture (Mollica et al., 1992, 1987, 1990).”
BackgroundJewkes, R., Corboz, J., & Gibbs, A. (2018) · PLOS ONE · doi:10.1371/journal.pone.0201974 · Cited by 36
Measurement and assessment of grief in a large international sample
Killikelly, C., Kagialis, A., Henneman, S., Coronado, H., Demanarig, D. L. L., Farahani, H., Özdoğru, A. A., Yalçın, B., Yockey, R. A., Gosnell, C. L., et al. (2023) · Journal of Affective Disorders · doi:10.1016/j.jad.2023.01.095 · Cited by 37
Ali, M., Mutavi, T. N., Mburu, J. M., & Mathai, M. A. (2023) · Neuropsychiatric Disease and Treatment · doi:10.2147/ndt.s398423 · Cited by 38
Gee, G., Hulbert, C. A., Kennedy, H., & Paradies, Y. (2023) · BMC Psychiatry · doi:10.1186/s12888-023-04567-5 · Cited by 37
“Rather, based on recommendations from Mollica and colleagues [34], a mean score of 2.”
BackgroundMethodDrožđek, B., Kamperman, A. M., Tol, W. A., Knipscheer, J. W., & Kleber, R. J. (2013) · BMC Psychiatry · doi:10.1186/1471-244x-13-148 · Cited by 42
“The number of traumatic events experienced, as assessed with the HTQ [27,28] ranged from 6 to 20, with a mean number of traumatic experiences of 14.7 (SD = 3.0).”
BackgroundMethodInfluentialCook, T. L., Shannon, P. J., Vinson, G. A., Letts, J., & Dwee, E. (2015) · BMC International Health and Human Rights · doi:10.1186/s12914-015-0046-y · Cited by 36
“Comparing this adapted HTQ to the 17-item used by Schweitzer and colleagues supports the importance of adapting existing instruments to fit the experiences of different groups [25].”
MethodA latent growth mixture modeling approach to PTSD symptoms in rape victims.
Armour, C., Shevlin, M. E., Elklit, A., & Mroczek, D. K. (2011) · Traumatology An International Journal · doi:10.1177/1534765610395627 · Cited by 36
“Mollica et al. (1992) reported good reliability and validity of the HTQ.”
BackgroundMethodAskovic, M., Watters, A. J., Aroche, J., & Harris, A. W. F. (2017) · Australasian Psychiatry · doi:10.1177/1039856217715988 · Cited by 34
Iglesias-Ríos, L., Harlow, S. D., Burgard, S. A., Kiss, L., & Zimmerman, C. (2018) · BMC Psychology · doi:10.1186/s40359-018-0269-5 · Cited by 37
War can harm intimacy: consequences for refugees who escaped Syria
Rizkalla, N., & Segal, S. P. (2019) · Journal of Global Health · doi:10.7189/jogh.09.020407 · Cited by 36
Trauma during humanitarian work: the effects on intimacy, wellbeing and PTSD-symptoms
Rizkalla, N., & Segal, S. P. (2019) · European Journal of Psychotraumatology · doi:10.1080/20008198.2019.1679065 · Cited by 41
“(2) The Harvard Trauma Questionnaire (HTQ) (Mollica et al., 1992), a 16 item Likert-type scale that measures PTSD-symptom severity ranging from 1 = not at all to 4 = extremely.”
MethodPosttraumatic Stress and Depression Among Syrian Refugees Living in Turkey
Kaya, E., Kılıç, C., Çaman, Ö. K., & Üner, S. (2019) · The Journal of Nervous and Mental Disease · doi:10.1097/nmd.0000000000001104 · Cited by 36
Housen, T., Lenglet, A., Shah, S., Sha, H., Ara, S., Pintaldi, G., & Richardson, A. (2019) · Conflict and Health · doi:10.1186/s13031-019-0245-6 · Cited by 38
Dokkedahl, S., Kristensen, T. R., Murphy, S., & Elklit, A. (2021) · European Journal of Psychotraumatology · doi:10.1080/20008198.2020.1863580 · Cited by 35
“The HTQ has demonstrated good cross-cultural validity and reliability (Mollica et al., 1992).”
BackgroundSymptoms of Posttraumatic Stress after Intensive Care Delirium
Svenningsen, H., Egerod, I., Christensen, D. F., Tønnesen, E. K., Frydenberg, M., & Videbech, P. (2015) · BioMed Research International · doi:10.1155/2015/876947 · Cited by 37
Methodological Issues in the Use of Survey Questionnaires to Assess the Health Effects of Torture
Willis, G., & GONZALEZ, A. (1998) · The Journal of Nervous and Mental Disease · doi:10.1097/00005053-199805000-00004 · Cited by 36
Silove, D. M., Coello, M., Tang, K., Aroche, J., Soares, M., Lingam, R., Chaussivert, M., Manicavasagar, V. L., & Steel, Z. (2002) · Transcultural Psychiatry · doi:10.1177/136346150203900404 · Cited by 36
“The Harvard Trauma Questionnaire (HTQ) (Mollica et al., 1992) is a self-report instrument specifically designed for use with trauma-affected populations from diverse cultures.”
Background
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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