RELIABILITY AND VALIDITY OF THE UCLA PTSD …

1 Nigerian Psychological Research, Volume 1, September 2013, 25 - 33. Copyright Nigerian Psychological Association, Abuja _____. RELIABILITY AND VALIDITY OF THE UCLA PTSD REACTION IN- DEX FOR DSM-IV IN THE NIGERIAN CONTEXT. Katrina A. Korb Department of General and Applied Psychology University of Jos E-Mail: _____. ABSTRACT. The purpose of this study was to determine the RELIABILITY and VALIDITY of the UCLA. PTSD Reaction Index in the Nigerian context. To this end, two samples were drawn: 243 students from UniJos and 80 students from JETS Seminary. All partici- pants completed the UCLA PTSD Reaction Index and a measure of traumatic events that participants had experienced in ethno-religious violence. The internal consistency of the UCLA PTSD Reaction Index was excellent, around.

2 90. A signif- icant positive correlation was also found between scores on the UCLA PTSD Reac- tion Index and number of traumatic events experienced, providing VALIDITY evidence for the instrument. A high rate of PTSD was found amongst the participants. The UCLA PTSD Reaction Index was judged an adequate instrument for clinical and research purposes in Nigeria. INTRODUCTION are extremely violent in their attempts to steal oil and in kidnap both for political In recent years, Nigeria has been and financial purposes (Paden, 2013). plagued by violence: kidnapping in the south, terrorist attacks in the north, and The negative consequences of the- ethno-religious violence in the middle belt. se violent conflicts are not just limited to Human Rights Watch (2013) estimates the physical loss of lives or destruction of that about 3,000 individuals have lost their property.

3 Survivors of violent conflicts are lives since 2009 as a result of the Boko typically mentally affected by the violence Harm conflict in the North. Boko Haram that they experience or witness. This emo- has carried out gun attacks, bomb attacks, tional cost of violent conflict can be just as and suicide bombings as well as burnt distressing to survivors as the physical schools, bombed newspaper offices, and costs. targeted politicians (Human Rights Watch, Post-traumatic stress disorder 2012). In Plateau State, more than 3,800. (PTSD) is a mental health condition that a lives have been lost from over ten years of person can develop after experiencing a ethno-religious violence (Human Rights horrifying event such as violent crisis, Watch, 2011). These crises have resulted armed robbery, bombing, rape, or a severe in lost lives as well as destruction of automobile accident.

4 Formally, PTSD. countless houses, churches, mosques, and consists of a protracted response to an ex- businesses (Ostien, 2009). The Niger Del- tremely stressful or threatening event ta has many protest groups, some of which Nigerian Psychological Research Katrina A. Korb 26. (World Health Organization, 2010). A per- ally has difficulty concentrating, which son can also develop PTSD after witness- can hurt work and relationships with ing something frightening, such as seeing friends and family. another person being tortured, raped, or The University of California at killed. After suffering a traumatic event, Los Angeles Post-traumatic Stress Disor- individuals typically experience anxiety der Reaction Index for DSM-IV (hereafter and distorted thoughts. After a few weeks, called UCLA PTSD Reaction Index) is a though, the emotional pain typically dis- paper and pencil questionnaire that assess- appears gradually.

5 However, for some es both exposure to traumatic events and people, these feelings can get worse or last post-traumatic stress symptoms amongst for many months. children and adolescents (Steinberg, There are three different types of Brymer, Decker, & Pynoos, 2004). The symptoms that constitute PTSD (Mash & goal of instrument design was to develop Wolfe, 2002). The first type is re- items that were clear and easy for young experiencing symptoms, such as having respondents to understand. Because this flashbacks or bad dreams about the trau- particular study is interested in the as- ma. These flashback symptoms are often- sessment of PTSD, the scales that assess times triggered by something related to the exposure to traumatic events (Parts I and II. traumatic experience. The second type is of the UCLA PTSD Reaction Index) were called hyper-arousal symptoms.

6 These not used. The focus of this study was on symptoms include being easily frightened, Part III of the UCLA PTSD Reaction In- continuously feeling tense, having diffi- dex that evaluates the frequency of PTSD. culty sleeping, or having angry outbursts. symptoms during the past month. This The final type is avoidance symptoms. section directly assesses the DSM-IV cri- This means that a person will try to avoid terion for PTSD: intrusion (called re- situations or emotions that might cause experiencing on the UCLA PTSD Reac- anxiety or fear. These symptoms include tion Index), avoidance, and arousal. The avoiding places, events, or objects that are instrument was developed primarily for reminders of the frightening experience; research purposes, not as a diagnostic tool feeling emotionally numb; feeling guilt, for clinicians.

7 However, the authors report depression, or worry; losing interest in that the instrument can provide prelimi- activities that were previously enjoyable; nary diagnostic information for PTSD. or having difficulty remembering the The UCLA PTSD Reaction Index traumatic event. has been the most widely used assessment PTSD is diagnosed when all three tool for PTSD in clinical and research pur- types of symptoms re-experiencing, hy- poses amongst children (Steinberg et al., per-arousal, and avoidance are still man- 2004). According to the authors (Steinberg ifest after one month has passed from the et al., 2004), the instrument has primarily date of the traumatic event (Mash & been used after natural disasters such as Wolfe, 2002). Having PTSD can disrupt a earthquakes in Armenia, Turkey, Greece, person's life because they generally have a Taiwan, and the United States.

8 It has also hard time doing tasks necessary for daily been used after large-scale political vio- living, such as sleeping or eating. This can lence in Bosnia and Herzegovina, cause physical health to decline. Further- Mozambique, Kuwait, Israel, Palestine, more, a person experiencing PTSD gener- and Lebanon. The VALIDITY of the UCLA. Nigerian Psychological Research RELIABILITY and VALIDITY of the UCLA PTSD Reaction Index for DSM-IV 27. PTSD Reaction Index has been supported What is the VALIDITY of the UCLA. by studies that have found higher scores PTSD Reaction Index? To an- among individuals exposed to traumatic swer this question, scores on the events as compared to those who have not UCLA PTSD Reaction Index been exposed to traumatic events ( , were correlated with the number Goenjian et al.)

9 , 2001). Strong RELIABILITY has been found with internal consistency of traumatic experiences that par- around ( , Roussos et al., 2005). ticipants had suffered as a result The test-retest RELIABILITY has also been of ethno-religious violence. This strong, around (Steinberg et al., will give an index of construct 2004). In conclusion, the UCLA PTSD VALIDITY because the more trau- Reaction Index has been found to be a use- matic experiences a person has ful tool for conducting needs assessment, experienced, the more likely they screening, clinical evaluation, and treat- are to develop PTSD (Mash &. ment outcome evaluation after a range of Wolfe, 2002). traumatic events and in a range of cultures According to the UCLA PTSD. (Steinberg et al., 2004). Reaction Index, what is the rate However, the RELIABILITY and valid- of PTSD amongst participants?

10 Ity of the UCLA PTSD Reaction Index for use in the Nigerian context has not been To strengthen the results of this established. With the increase in ethno- study, two samples were drawn. The first religious and community violence sample consisted of 200-level students at throughout Nigeria, the possibility of high the University of Jos (UniJos). The two rates of PTSD presents a very real mental campuses of UniJos are located in border health threat. Therefore, research needs to areas of Jos that are oftentimes directly be conducted to determine whether the affected when violent conflict erupts. The UCLA PTSD Reaction Index could be a second sample consisted of 300-level stu- valid and reliable instrument to use in the dents at Jos ECWA Theological Seminary Nigerian context, particularly amongst Jos (JETS).