Adapting the Trauma History Questionnaire for use in a population of homeless people with severe mental illness in Tamil Nadu, India: qualitative study
Background The Trauma History Questionnaire (THQ) is one of the most widely used traumatic event inventories, but its lack of validation makes it unsuitable for the millions of homeless people with severe mental illness in India, who are particularly vulnerable to trauma exposure. Aims To translate...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Cambridge University Press
2021-07-01
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| Series: | BJPsych Open |
| Subjects: | |
| Online Access: | https://www.cambridge.org/core/product/identifier/S2056472421009522/type/journal_article |
| _version_ | 1811156978850856960 |
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| author | Andrew R. Gilmoor Smriti Vallath Ruth M. H. Peters Denise van der Ben Lauren Ng |
| author_facet | Andrew R. Gilmoor Smriti Vallath Ruth M. H. Peters Denise van der Ben Lauren Ng |
| author_sort | Andrew R. Gilmoor |
| collection | DOAJ |
| description | Background
The Trauma History Questionnaire (THQ) is one of the most widely used traumatic event inventories, but its lack of validation makes it unsuitable for the millions of homeless people with severe mental illness in India, who are particularly vulnerable to trauma exposure.
Aims
To translate and culturally adapt the THQ for use in a population of homeless people with severe mental illness in Tamil Nadu, India.
Method
We used Herdman et al's model of cultural equivalence to conduct an in-depth qualitative assessment of the cultural validity of the THQ. Following several translations, conceptual, item, semantic and operational equivalence of the THQ was assessed through four focus groups with user-survivors (n = 20) and two focus groups with mental health professionals (n = 11).
Results
Several adaptations, including the addition of 18 items about relationships, homelessness and mental illness, were necessary to improve cultural validity. Three items, such as rape, were removed for reasons of irrelevance or cultural insensitivity. Items like ‘adultery’ and ‘mental illness’ were reworded to ‘extramarital affair’ and ‘mental health problem’, respectively, to capture the cultural nuances of the Tamil language. Findings revealed a divergence in views on tool acceptability between user-survivors, who felt empowered to voice their experiences, and mental health professionals, who were concerned for patient well-being. Providing a sense of pride and autonomy, user-survivors preferred self-administration, whereas mental health professionals preferred rater administration.
Conclusions
Culture significantly affects what types of events are considered traumatic, highlighting the importance of cultural validation of instruments for use in novel populations and settings.
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| first_indexed | 2024-04-10T04:59:49Z |
| format | Article |
| id | doaj.art-ff57e8b6f6f942038bc8fc05998eb1e2 |
| institution | Directory Open Access Journal |
| issn | 2056-4724 |
| language | English |
| last_indexed | 2024-04-10T04:59:49Z |
| publishDate | 2021-07-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | BJPsych Open |
| spelling | doaj.art-ff57e8b6f6f942038bc8fc05998eb1e22023-03-09T12:29:07ZengCambridge University PressBJPsych Open2056-47242021-07-01710.1192/bjo.2021.952Adapting the Trauma History Questionnaire for use in a population of homeless people with severe mental illness in Tamil Nadu, India: qualitative studyAndrew R. Gilmoor0https://orcid.org/0000-0001-6759-8375Smriti Vallath1https://orcid.org/0000-0002-6272-2848Ruth M. H. Peters2Denise van der Ben3Lauren Ng4Department of Science, Vrije Universiteit Amsterdam, The NetherlandsDepartment of Science, Vrije Universiteit Amsterdam, The Netherlands; Department of Psychology, Banyan Academy of Leadership in Mental Health, India; and The Banyan, IndiaDepartment of Science, Vrije Universiteit Amsterdam, The Netherlands; and Department of Global Health and Social Medicine, Harvard Medical School, USADepartment of Science, Vrije Universiteit Amsterdam, The NetherlandsDepartment of Psychiatry, Boston University School of Medicine, USA; and Department of Psychology, University of California Los Angeles, USABackground The Trauma History Questionnaire (THQ) is one of the most widely used traumatic event inventories, but its lack of validation makes it unsuitable for the millions of homeless people with severe mental illness in India, who are particularly vulnerable to trauma exposure. Aims To translate and culturally adapt the THQ for use in a population of homeless people with severe mental illness in Tamil Nadu, India. Method We used Herdman et al's model of cultural equivalence to conduct an in-depth qualitative assessment of the cultural validity of the THQ. Following several translations, conceptual, item, semantic and operational equivalence of the THQ was assessed through four focus groups with user-survivors (n = 20) and two focus groups with mental health professionals (n = 11). Results Several adaptations, including the addition of 18 items about relationships, homelessness and mental illness, were necessary to improve cultural validity. Three items, such as rape, were removed for reasons of irrelevance or cultural insensitivity. Items like ‘adultery’ and ‘mental illness’ were reworded to ‘extramarital affair’ and ‘mental health problem’, respectively, to capture the cultural nuances of the Tamil language. Findings revealed a divergence in views on tool acceptability between user-survivors, who felt empowered to voice their experiences, and mental health professionals, who were concerned for patient well-being. Providing a sense of pride and autonomy, user-survivors preferred self-administration, whereas mental health professionals preferred rater administration. Conclusions Culture significantly affects what types of events are considered traumatic, highlighting the importance of cultural validation of instruments for use in novel populations and settings. https://www.cambridge.org/core/product/identifier/S2056472421009522/type/journal_articleTraumapost-traumatic stress disorderqualitative researchtranscultural psychiatryrating scales |
| spellingShingle | Andrew R. Gilmoor Smriti Vallath Ruth M. H. Peters Denise van der Ben Lauren Ng Adapting the Trauma History Questionnaire for use in a population of homeless people with severe mental illness in Tamil Nadu, India: qualitative study BJPsych Open Trauma post-traumatic stress disorder qualitative research transcultural psychiatry rating scales |
| title | Adapting the Trauma History Questionnaire for use in a population of homeless people with severe mental illness in Tamil Nadu, India: qualitative study |
| title_full | Adapting the Trauma History Questionnaire for use in a population of homeless people with severe mental illness in Tamil Nadu, India: qualitative study |
| title_fullStr | Adapting the Trauma History Questionnaire for use in a population of homeless people with severe mental illness in Tamil Nadu, India: qualitative study |
| title_full_unstemmed | Adapting the Trauma History Questionnaire for use in a population of homeless people with severe mental illness in Tamil Nadu, India: qualitative study |
| title_short | Adapting the Trauma History Questionnaire for use in a population of homeless people with severe mental illness in Tamil Nadu, India: qualitative study |
| title_sort | adapting the trauma history questionnaire for use in a population of homeless people with severe mental illness in tamil nadu india qualitative study |
| topic | Trauma post-traumatic stress disorder qualitative research transcultural psychiatry rating scales |
| url | https://www.cambridge.org/core/product/identifier/S2056472421009522/type/journal_article |
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