title: Screening for posttraumatic stress disorder among Somali ex-combatants: a validation study.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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).
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: University of Konstanz, Department of Psychology, Fach D25, 78457 Konstanz, Germany. michael.odenwald@uni-konstanz.de
authors.forename: Michael
authors.initials: M
authors.lastname: Odenwald
authors.forename: Birke
authors.initials: B
authors.lastname: Lingenfelder
authors.forename: Maggie
authors.initials: M
authors.lastname: Schauer
authors.forename: Frank
authors.initials: F
authors.lastname: Neuner
authors.forename: Brigitte
authors.initials: B
authors.lastname: Rockstroh
authors.forename: Harald
authors.initials: H
authors.lastname: Hinkel
authors.forename: Thomas
authors.initials: T
authors.lastname: Elbert