Psychometric Properties of the Syrian Arabic Version of the Impact of Event Scale-Revised in the Context of the Syrian Refugee Crisis

The impact of events scale-revised (IES-R): Validation of the Ukrainian version

BACKGROUND

The aftermath of warfare in Ukraine has witnessed traumatic experiences emerge as a significant concern. This highlights the need for strengthened secondary prevention strategies targeting trauma and stress-related disorders. Providing mental health professionals with tools to support refugees is crucial. The Impact of Events Scale - Revised (IES-R) stands out as the prevalent early diagnostic and clinical assessment tool for measuring the traumatic stress symptoms. However, this questionnaire has yet to be psychometrically adapted to the Ukrainian linguistic and cultural context.

OBJECTIVE

This study sought to verify the reliability and validity of the Ukrainian version of the Impact of Events Scale - Revised for adult Ukrainian refugees.

METHOD

A psychometric evaluation was conducted within broader longitudinal research on refugee mental health. The study incorporated a convenience sample of 584 Ukrainian refugees located in Germany. The Ukrainian IES-R's factorial structure underwent validation using CFA with the DWLS estimator. Internal consistency was ascertained using both Cronbach's α and MacDonald's ω. The convergent and divergent validity of the questionnaire were established through Pearson's correlation coefficient. The DIF analysis evaluated diagnostic disparities between groups of respondents identifying as women and men. The ICC, derived from a two-way mixed ANOVA model, and Pearson's correlation coefficients were employed to gauge the test-retest reliability of the IES-R over an 8-month interval between the two data collection waves.

RESULTS

The Ukrainian version of the IES-R retains a three-factor, classification-free structure, with a modification of item No. 12 being shifted to the Hyperarousal subscale. Confirmatory metrics (CMIN/DF = 2.874, RMSEA = 0.049, SRMR = 0.065, CFI = 0.977, TLI = 0.974) bolster the model's fit. Consistency coefficients (α, ω) for each subscale ranged from 0.75 to 0.84, with the IES-R's overall values being ω = 0.92 and α = 0.91. The IES-R total score and individual factor values displayed significant (moderate to high) correlations with PSS-10 and either weak or inverse correlations with SWLS, TIPI, and ZTPI-S, aligning with expectations. The test-retest measures showed low temporal stability with an ICC of 0.206 for the total score and a moderate correlation (r = 0.412, p < 0.01), indicating the questionnaire assesses trauma and stressor-related symptoms rather than underlying traits.

CONCLUSION

The data reveal the IES-R as an efficacious diagnostic tool to discern trauma-induced distress in adult Ukrainian refugees. Given its robust psychometric properties, the IES-R is relevant for screening wartime impact.

The Impact of War Trauma and Housing Environment on Mental Wellbeing of Syrian Refugees in Jordan: A Comparison between In-Camp and Urban Populations

The aim of this study is to compare mental wellbeing and levels of post-trauma distress between Syrian refugees who live inside camps and those who live outside camps in Jordan through a survey-based cross-sectional design, where data were collected from 240 adult Syrian refugees in Jordan. The Arabic versions of the Mental Health Continuum Short Form (MHC-SF), and the Impact of Event Scale-Revised (IES-R) were used to quantitatively measure variables through descriptive statistics and multiple comparative analysis tests. Despite having no significant correlation with residence, findings of the MHC-SF showed significance for mental wellbeing with employment status and income. Whereas IES-R showed that camp refugees fared significantly better in terms of trauma effect than urban refugees. It can be concluded that Syrian refugees living inside camps were disadvantaged in terms of mental wellbeing but slightly less affected by war in comparison to those living in urban areas. Improved programs and policies are needed to uplift the mental wellbeing of Syrian refugees in Jordan and to minimize the destructive traumatic effects of the Syrian war on their wellness.

Mapping the availability of translated versions of posttraumatic stress disorder screening questionnaires for adults: A scoping review

Background: The most used questionnaires for PTSD screening in adults were developed in English. Although many of these questionnaires were translated into other languages, the procedures used to translate them and to evaluate their reliability and validity have not been consistently documented. This comprehensive scoping review aimed to compile the currently available translated and evaluated questionnaires used for PTSD screening, and highlight important gaps in the literature.Objective: This review aimed to map the availability of translated and evaluated screening questionnaires for posttraumatic stress disorder (PTSD) for adults.Methods: All peer-reviewed studies in which a PTSD screening questionnaire for adults was translated, and which reported at least one result of a qualitative and /or quantitative evaluation procedure were included. The literature was searched using Embase, MEDLINE, and APA PsycInfo, citation searches and contributions from study team members. There were no restrictions regarding the target languages of the translations. Data on the translation procedure, the qualitative evaluation, the quantitative evaluation (dimensionality of the questionnaire, reliability, and performance), and open access were extracted.Results: A total of 866 studies were screened, of which 126 were included. Collectively, 128 translations of 12 different questionnaires were found. Out of these, 105 (83.3%) studies used a forward and backward translation procedure, 120 (95.2%) assessed the reliability of the translated questionnaire, 60 (47.6%) the dimensionality, 49 (38.9%) the performance, and 42 (33.3%) used qualitative evaluation procedures. Thirty-four questionnaires (27.0%) were either freely available or accessible on request.Conclusions: The analyses conducted and the description of the methods and results varied substantially, making a quality assessment impractical. Translations into languages spoken in middle- or low-income countries were underrepresented. In addition, only a small proportion of all translated questionnaires were available. Given the need for freely accessible translations, an online repository was developed.HIGHLIGHTS We mapped the availability of translated PTSD screening questionnaires.The quality of the translation and validation processes is very heterogenous.We created a repository for translated, validated PTSD screening questionnaires.

Effect of a self-help group intervention using Teaching Recovery Techniques to improve mental health among Syrian refugees in Norway: a randomized controlled trial

Background

Mental health symptoms among refugees are common, often related to chronic pain disorders, and their management is usually challenging. Studies evaluating the effect of group therapies among adult refugees to improve mental health symptoms are scarce.

Aims

To assess the effect of Teaching Recovery Techniques (TRT) on mental health and to reduce pain disorder among adult Syrian refugees.

Method

A randomized controlled trial was designed to study the effect of a self-help group intervention using TRT. The outcomes, mental health symptoms measured by Impact of Event Scale-Revised (IES-R) and General Health Questionnaire (GHQ-12) and chronic pain measured by Brief Pain Inventory (BPI), were reported as regression coefficients (B) with 95% confidence intervals.

Results

Seventy-six adults participated: 38 in the intervention and 38 in the control groups. Intention-to-treat analyses showed a significant effect on general mental health as measured by GHQ-12 with B (95% CI) of -3.8 (-7.2, -0.4). There was no effect of TRT on mental health when assessed by IES-R (-1.3 (-8.7, 6.2)) or on pain levels assessed by BPI (-0.04 (-4.0, 3.9)).

Conclusions

This self-help group intervention significantly improved general mental health symptoms among adult refugees but had no effect on trauma symptoms or chronic pain. Higher participation rates might be necessary to achieve the full potential of TRT.

Trial registration: The trial was registered with Clinical Trials.gov at https://clinicaltrials.gov/ct2/show/NCT03951909. To include user participation in the design of the interventions, the study was retrospectively registered on 19 February 2019.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13033-022-00557-4.

Validation of the Korean Version of Impact of Event Scale-Revised (IES-R) in Korean Nurses during the COVID-19 Pandemic

Nurses working amid the COVID-19 pandemic are at increased risk of developing post-traumatic stress disorder (PTSD). This study was conducted to verify the reliability and validity of the Korean version of Impact of Event Scale-Revised (IES-R), one of the most used tools for assessing trauma. Secondary data of 249 nurses who performed face-to-face nursing tasks during the COVID-19 pandemic, collected through an online survey, were analyzed by conducting a factor analysis of the K-IES-R and testing the internal consistency and concurrent validity with the Perceived Stress Scale (PSS), Generalized Anxiety Disorder Screener (GAD-7), and Dimensions of Anger Reactions-5 (DAR-5). The result of an exploratory factor analysis of the K-IES-R supported a three-factor structure of intrusion, avoidance, and sleep disturbance, with CMIN/DF = 2.98, RMSEA = 0.09, SRMR = 0.03, CFI = 0.93, and TLI = 0.90. The Cronbach's alpha of each subscale was 0.88-0.94. The total K-IES-R score and each factor's value showed a significant correlation (moderate or higher) with the PSS, GAD-7, and DAR-5. The K-IES-R was verified as a useful tool for assessing post-traumatic stress symptoms in nurses who directly perform nursing tasks in crises such as COVID-19. This study suggests the tool be used for early assessment of post-traumatic stress symptoms in nurses and providing appropriate interventions.