Psychiatric Services
Volume 61, Issue 11, 2010, Pages 1132-1137

HADStress: A somatic symptom screen for posttraumatic stress among somali refugees (Article)

Westermeyer J.J. , Campbell R. , Lien R. , Spring M. , Johnson D.R. , Butcher J. , Hyland J. , Thuras P. , Jaranson J.M.
  • a Department of Psychiatry, University of Minnesota, 1935 Summit Ave., St. Paul, MN 55105, United States
  • b Department of Mental Health, Minneapolis Department of Veterans Affairs Medical Center, United States
  • c Professional Data Analysts, Inc., Minneapolis, MN, United States
  • d Department of Mental Health, Minneapolis Department of Veterans Affairs Medical Center, United States
  • e Department of State Health Services, Washington, DC, United States
  • f Department of Psychology, University of Minnesota, Minneapolis, MN, United States
  • g Department of Mental Health, Minneapolis Department of Veterans Affairs Medical Center, United States
  • h Department of Mental Health, Minneapolis Department of Veterans Affairs Medical Center, United States
  • i Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, United States

Abstract

Objective: This study assessed whether a simple, readily implemented foursymptom somatic screen would be able to effectively identify current posttraumatic stress symptoms in victimized populations. Methods: The sample consisted of 622 Somali community-dwelling refugees who fled widespread violence and trauma occurring in East Africa during 1990-1992. Data were collected during 2000-2003 and included demographic characteristics, number of types of torture and nontorture trauma experienced earlier in Africa, and current self-rated posttraumatic stress symptoms, as measured by the Posttraumatic Stress Disorder Checklist (PCL). The sample was also assessed with the HADStress screen, which was developed for this study, to determine whether the screen was effective in detecting current posttraumatic stress symptoms. The HADStress screen assessed for the presence of four somatic symptoms: Headaches, Appetite change, Dizziness, and Sleep problems. All items were given equal weight. Possible scores on the screen range from 0 to 4, with higher scores indicating more somatic symptoms. Results: Univariate analysis showed that persons who experienced more types of trauma (both torture and nontorture trauma) and persons who had higher PCL scores (indicating more current posttraumatic stress symptoms) had significantly higher HADStress scores. Negative binomial regression analysis showed that PCL scores were the most effective variable in predicting HADStress scores. On the Tukey-B post hoc analysis, a HAD-Stress score of 0 or 1 was associated with a mean PCL score of less than 30, a score of 2 was associated with a mean PCL score of 40.28, and a score of 4 was associated with a mean PCL score of 51.07 (suggesting that over 50% of this group would have active posttraumatic stress disorder). Conclusions: A score of 2 or higher on the HADStress scale among refugees warrants additional evaluation for posttraumatic stress symptoms in clinical settings. For communitywide efforts at early recognition and treatment, a cutoff score of 4 may be more practical and cost-effective.

Author Keywords

[No Keywords available]

Index Keywords

refugee regression analysis HADStress score psychological aspect demography human Refugees violence Minnesota ethnology dizziness screening United States Humans appetite disorder sleep disorder chi square distribution male Chi-Square Distribution headache female psychological rating scale Psychiatric Status Rating Scales scoring system Health Status Indicators Article major clinical study adult posttraumatic stress disorder body weight Somalia Stress Disorders, Post-Traumatic Poisson distribution Analysis of Variance Somatoform Disorders somatoform disorder Torture health survey
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85047689468&doi=10.1176%2fps.2010.61.11.1132&partnerID=40&md5=e247ac0a557ee451601538b3c69b8138
DOI: 10.1176/ps.2010.61.11.1132
ISSN: 10752730
Cited by: 8
Original Language: English