Screening for Posttraumatic Stress Symptoms in Young Refugees: Comparison of Questionnaire Data with and without Involvement of an Interpreter

Abstract

Background: The substantial number of young refugees who have arrived in Europe since 2015 requires rapid screening to identify those in need of treatment. However, translated versions of screening measures are not always available, necessitating the support of interpreters. The Child and Adolescent Trauma Screen (CATS) is a validated questionnaire for posttraumatic stress symptoms. Here, we report on the psychometric properties of the CATS in a sample of young refugees as a function of interpreter involvement. Methods: A total of N = 145 (Mage = 16.8, SD = 1.54; 93% male) were assessed with the CATS, with half of the screenings conducted with and half without interpreters. Post hoc analyses included calculating internal consistency using Cronbach’s α. We used confirmative factor analysis to investigate the factor structure. Results: The CATS total scale showed good reliability (α = 0.84). Differences in psychometric properties between the interpreter vs. the no interpreter group were minor and tended to be in favor of the interpreter group. Results of a confirmatory factor analysis were acceptable after the exclusion of items with low item-scale correlations. Conclusions: The sample and the administration of the assessment represent the situation of young refugees in Germany, where resources are low and translated versions not always available. The CATS may be a helpful screening tool for clinicians working with young refugees, even when administered with an interpreter. Limitations include the post hoc design of the analysis without randomization of participants and the lack of a third comparison group using translated questionnaire versions.

Psychometric properties of the Perceived Stress Scale (PSS-10) in silica-exposed workers from diverse cultural and linguistic backgrounds

“…Another study involving a different PTSD instrument, the Child and Adolescent Trauma Screen (CATS), assessed the prevalence of post-traumatic stress disorder amongst refugees to Germany, and reported on psychometric properties amongst those who used an interpreter to complete the questionnaire compared to those who used a validated translation of the questionnaire [ 47 ]. Although Cronbach α scores for the overall CATS score did not differ significantly between the two groups, the authors cautioned against using interpreters due to the challenges of a clinical setting compared to the ‘elaborate’ and ‘iterative’ process of a validated translation.…”

Prevalence, comorbidities, and factors associated with prolonged grief disorder, posttraumatic stress disorder and complex posttraumatic stress disorder in refugees: A systematic review

“…Clinician ratings that follow ICD-11 guidelines for PGD, PTSD, and cPTSD are now available (105)(106)(107) and should be applied in future studies. Although there is some evidence for comparable psychometric properties for assessments with and without interpreters (108), future studies also need to focus more on the potential influence of the language of the assessment and the use of interpreters. This is especially important because some terms (e.g.…”