Harvard War Trauma - Short Screening/General Version (HKTKS/HKTGES)

Measurement object / dimensions
The Harvard War Trauma Tool is based on the Harvard Trauma Questionnaire (HTQ; Mollica et al., 1992) and measures both traumatic events and symptoms contained in the questionnaire. In the first section, stressors that refugees have experienced, such as torture, rape, murder and lack of food or water, are recorded. This is followed by the symptom section, which also corresponds to the ICD-10 criteria, as well as questions about other aspects of stress.
It provides a rich scientific and ethnographic model and tools for the care of traumatized persons in different cultural settings worldwide.
Accurate identification of post-traumatic stress and dysfunction enables those working with refugees to allocate them more effectively to scarce health and mental health resources.
The degree of any existing post-traumatic stress disorder (PTSD, ICD 10 code: F43.1) is calculated and a corresponding traffic light system including interpretation text is displayed.
ICD 10 definition: "PTSD arises as a delayed reaction to a stressful event (trauma) or situation of short or long duration, of exceptional threat or catastrophic magnitude, which would cause deep distress in almost anyone.
Typical characteristics are the repeated experience of the trauma in intrusive memories (aftermath memories, flashbacks), dreams or nightmares, which occur against a background of a persistent feeling of numbness and emotional dullness. There is also indifference towards other people, apathy towards the environment, joylessness and avoidance of activities and situations that could evoke memories of the trauma.
A state of vegetative overexcitement with increased concentration, excessive startle and sleep disturbance usually occurs. Anxiety and depression are often associated with the symptoms and characteristics mentioned and suicidal thoughts are not uncommon. The onset follows the trauma with a latency (delay) that can last from a few weeks to months.
The course is variable, but in the majority of cases a cure can be expected if treatment is started early. In some (usually untreated) cases, the disorder takes a chronic course over many years and then turns into a permanent personality change."

Brief description of the procedure

Jörg A. Prieler

Area(s) of application
Clinical psychology, refugee work

The procedure consists of 45 items (screening) or approx. 100 items (context-dependent) and can be carried out online or in paper-pencil form.

Execution time
Approx. 10 or 30 minutes (short screening/total version)

Cronbach's alpha and retest reliabilities:
In a study of 183 people, the reliability coefficient for the total score was determined to be 0.73 (Cronbach's alpha).
To determine stability, 52 people were tested a second time at three-month intervals. The retest reliability is 0.66.

The validity of the HKTKS/HKTGES is given because there is a high degree of agreement with similar test procedures (HTK), some of which measure similar dimensions, and because there is little or no agreement with test procedures that measure something else (convergent and discriminant validity).
The factor structure was replicated several times, which speaks for the stability and consistency of the method.
In a validation study with war vs. economic refugees (N=35 KF and 34 WF), the HKTGES was given and the score was checked for differences, which were significant at the 5% level. These data were also used to optimize the cut-off value.

Evaluation / Standards
Standardization of such a procedure does not prove to be useful. However, a specific cut-off value is specified, which is generally valid.

Execution methods
Possible on PCs/laptops/touchpads without restriction. On mobile phones only to a limited extent, as input with a finger is somewhat cumbersome (but possible in principle).

German, English, Ukrainian, Arabic

Security and data protection
The IR&C system meets the latest IT requirements ("banking standard"). As an additional security measure, personal codes can also be assigned instead of the specific names of the persons tested. Customers only need to provide sufficient PCs/laptops/touchpads with or without an Internet connection (on/off-line capable, also intranet-capable).