Local interviewers conducted the screening interviews, and the validation interviews were conducted by expert interviewers. Between December 2016 and January 2017, we recruited six local interviewers (three men and three women). The local interviewers were fluent in Kurdish and Arabic and they had at least a Bachelor’s degree in psychology or social work. Each interviewer attended a one-week intensive theoretical and practical training course on the study instruments. Due to the absence of reliable census data from the refugee camps, we used a pragmatic sampling approach based on a random selection of individuals and households. The camp was sub-divided according to approximately equal household and population size. Local interviewers were assigned to the resulting zones and instructed to randomly select a sampling direction by spinning a pen from the zone center. The first household with one distance to another was selected and from each household, only main householder couples were interviewed.
Our study is part of a much more extensive and cross-national project, which aims to study psychosocial consequences of migration among Iraqi IDPs and Syrian refugees. In the current study, we interviewed displaced Iraqi and Syrian people. We began with a background questionnaire, followed by a war-related events checklist and Life Events Checklist for DSM-5 (LEC-5) [18 ]. Psychopathology was assessed using the PCL-5 and the depression section of the Hopkins symptom checklist [19 (link)]. Participants were fully informed about the procedures of the current study through a standardized informed consent, which included information about aims of our study, confidentiality, potential risks and discomforts, the right to withdraw without prejudice, benefits, and data protection. Verbal informed consent was given, and interviewers documented informed consent for each participant. The interviewers were matched in gender to the interviewees and they were asked about their readiness for re-interview by different interviewers. All participants (except three couples, who had moved to a new location) assented to a further interview. Two weeks later forty-nine couples between 18 and 67 years of age (48% Iraqi and 52% Syrian) were chosen randomly for re-interview by four expert clinical psychologists (two women and two men).
The expert interviewers had at least a Master’s degree in clinical psychology and more than four years clinical experience with highly vulnerable populations including survivors of war, displacement, torture, genocide, and family and gender-based violence. All clinical psychologists were university lecturers at the department of clinical psychology at Koya University in the KRI, and they partially worked as psychotherapists at Koya university’s outpatient clinic. This clinic offers psychological diagnostics as well as counseling and psychotherapy for individuals with different mental health problems in including trauma and PTSD.
About 15 days after the first interview, the expert interviewers conducted validation interviews based on the same instruments. However, the experts were instructed to ask the questions of the PCL in the form of a structured clinical interview. For every single PTSD symptom listed in the PCL5, the clinical experts asked about symptom’s presence and it’s occurrences over the past month. They were instructed to explore as much information as needed about the intensity, relevance, and frequency of each symptom to be able to judge the clinical significance of each symptom. We perceived that this procedure was the best approximation to culturally sensitive structured interviews that have been recognized as a standard gold for diagnosing PTSD.
Clinically significant symptoms were rated at least as “2 = Moderate”. Expert diagnosis of PTSD was then determined using the DSM-5 algorithm, counting all symptoms rated ‘two or more’ as a present. The clinical psychologists were fluent in Kurdish and Arabic languages, and they were blind to the results of the screening interviews. The ethical review committees of Bielefeld University in Germany and Koya University in the KRI approved all study procedures.
Our study is part of a much more extensive and cross-national project, which aims to study psychosocial consequences of migration among Iraqi IDPs and Syrian refugees. In the current study, we interviewed displaced Iraqi and Syrian people. We began with a background questionnaire, followed by a war-related events checklist and Life Events Checklist for DSM-5 (LEC-5) [18 ]. Psychopathology was assessed using the PCL-5 and the depression section of the Hopkins symptom checklist [19 (link)]. Participants were fully informed about the procedures of the current study through a standardized informed consent, which included information about aims of our study, confidentiality, potential risks and discomforts, the right to withdraw without prejudice, benefits, and data protection. Verbal informed consent was given, and interviewers documented informed consent for each participant. The interviewers were matched in gender to the interviewees and they were asked about their readiness for re-interview by different interviewers. All participants (except three couples, who had moved to a new location) assented to a further interview. Two weeks later forty-nine couples between 18 and 67 years of age (48% Iraqi and 52% Syrian) were chosen randomly for re-interview by four expert clinical psychologists (two women and two men).
The expert interviewers had at least a Master’s degree in clinical psychology and more than four years clinical experience with highly vulnerable populations including survivors of war, displacement, torture, genocide, and family and gender-based violence. All clinical psychologists were university lecturers at the department of clinical psychology at Koya University in the KRI, and they partially worked as psychotherapists at Koya university’s outpatient clinic. This clinic offers psychological diagnostics as well as counseling and psychotherapy for individuals with different mental health problems in including trauma and PTSD.
About 15 days after the first interview, the expert interviewers conducted validation interviews based on the same instruments. However, the experts were instructed to ask the questions of the PCL in the form of a structured clinical interview. For every single PTSD symptom listed in the PCL5, the clinical experts asked about symptom’s presence and it’s occurrences over the past month. They were instructed to explore as much information as needed about the intensity, relevance, and frequency of each symptom to be able to judge the clinical significance of each symptom. We perceived that this procedure was the best approximation to culturally sensitive structured interviews that have been recognized as a standard gold for diagnosing PTSD.
Clinically significant symptoms were rated at least as “2 = Moderate”. Expert diagnosis of PTSD was then determined using the DSM-5 algorithm, counting all symptoms rated ‘two or more’ as a present. The clinical psychologists were fluent in Kurdish and Arabic languages, and they were blind to the results of the screening interviews. The ethical review committees of Bielefeld University in Germany and Koya University in the KRI approved all study procedures.
Free full text: Click here
