Electronic Letters to:
|
|
eLetters: Electronic letters published:
-
![[Read eLetter]](/icons/misc/sectionDOWN.gif)
Trauma Research Outside Western World
- Rafey A. Faruqui (26 October 2004)
|
|
|||
|
Rafey A. Faruqui, Specialist Registrar & Hon. Research Fellow Charing Cross Higher Training Scheme & Imperial College London
Send letter to journal:
rafey.faruqui{at}imperial.ac.uk Rafey A. Faruqui
|
Man made violence, in the form of state sponsored oppression and wars and terrorist activities by individuals and groups, stands out as a major cause of mortality as well as physical and psychiatric morbidity. Njenga et al (2004) in their article on psychological reactions following the US embassy bombing in Nairobi have attempted to capture the prevalence of post-traumatic stress disorder (PTSD) along with a study of associated risk factors. The data were collected through an unvalidated English language self-report questionnaire and the prevalence of ‘post- traumatic stress symptomatology’ (authors’ approximation to the PTSD diagnoses) was obtained on the basis of a 21 item ‘yes/no’ sub-section, closely matching the diagnostic criteria provided by DSM-1V (American Psychiatric Association, 1994). A large sample size and the timings of data collection could be considered as two major strengths of this study. However, the method of data collection including the choice of recording instrument and exclusion of the DSM-1V PTSD criterion for impairment in functioning from the diagnostic algorithm of this study do raise serious doubts over the robustness of the prevalence figure of 35% and other results obtained in this study. The information on clinical diagnosis and other clinical and socio-demographic variables was collected at the same time and hence the data could only provide statistical associations rather than true ‘risk factors’ for developing a diagnosis of PTSD. The choice of instruments for trauma research outside the western world remains a difficult issue while planning a study. Combined with an underdeveloped research potential a lack of valid and reliable instruments, developed or translated in local languages, could potentially serve as a barrier to conducting any meaningful research activity. A strategy whereby instruments could be developed directly from the diagnostic construct under study, using the diagnostic criteria, could prove useful. However, use of such a self-report instrument in a foreign language, even with bilingual responders, may not be sufficient to study a diagnostic construct such as PTSD. Ascertainment of diagnosis on the basis of self-reporting of symptoms in this context may lead to spurious estimates of prevalence. Declaration of Interest: None References: American Psychiatric Association (1994) Diagnostic and Statistical Manual of Mental Disorders (4th Edition) (DSM-1V). Washington DC: APA Njenga, F. G., Nicholls, P. J., Nyami, C. et al (2004) Post-traumatic stress after terrorist attack: psychological reactions following the US embassy bombing in Nairobi |
|||