Screening for posttraumatic stress disorder among Somali ex-combatants: a validation study

• Published in: Conflict and health 2007-09, Vol.1 (1), p.10-10, Article 10
• Main Authors: Odenwald, Michael, Lingenfelder, Birke, Schauer, Maggie, Neuner, Frank, Rockstroh, Brigitte, Hinkel, Harald, Elbert, Thomas
• Format: Article
• Language: English
• Subjects: Causes of; Health aspects; Political aspects; Post-traumatic stress disorder; Somalis
• ISSN: 1752-1505; 1752-1505
• DOI: 10.1186/1752-1505-1-10

In Somalia, a large number of active and former combatants are affected by psychological problems such as Posttraumatic Stress Disorder (PTSD). This disorder impairs their ability to re-integrate into civilian life. However, many screening instruments for Posttraumatic Stress Disorder used in post-conflict settings have limited validity. Here we report on development and validation of a screening tool for PTSD in Somali language with a sample of ex-combatants. We adapted the Posttraumatic Diagnostic Scale (PDS) to reflect linguistic and cultural differences within the Somali community so that local interviewers could be trained to administer the scale. For validation purposes, a randomly selected group of 135 Somali ex-combatants was screened by trained local interviewers; 64 of them were then re-assessed by trained clinical psychologists using the Composite International Diagnostic Interview (CIDI) and the Self-Report Questionnaire (SRQ-20). The screening instrument showed good internal consistency (Cronbach's alpha = .86), convergent validity with the CIDI (sensitivity = .90; specificity = .90) as well as concurrent validity: positive cases showed higher SRQ-20 scores, higher prevalence of psychotic symptoms, and higher levels of intake of the local stimulant drug khat. Compared to a single cut-off score, the multi-criteria scoring, in keeping with the DSM-IV, produced more diagnostic specificity. The results provide evidence that our screening instrument is a reliable and valid method to detect PTSD among Somali ex-combatants. A future Disarmament, Demobilization and Reintegration Program in Somalia is recommended to screen for PTSD in order to identify ex-combatants with special psycho-social needs.