The central aim of the current study is to examine structural models of posttraumatic stress symptoms, as measured by the Harvard Trauma Questionnaire-Revised (HTQ-R; Mollica et al., 1992; Mollica, McDonald, Massagli, & Silove, 2004). Participants were international torture survivors who sought psychological treatment from a torture rehabilitation center in the United States. It was hypothesized that the factor structure of posttraumatic stress reactions among this heterogeneous sample of torture survivors would be consistent with the aroused intrusion model (Rasmussen, Smith, & Keller, 2007) rather than the dysphoria model (Simms, Watson, & Doebbelling, 2002). In order to evaluate model superiority, confirmatory factor analyses (CFAs) were conducted. It was also hypothesized that avoidance and numbing are two discrete factors in the aroused intrusion model. To determine whether these two constructs are distinct, convergent and discriminant validity were examined. Lastly, it was hypothesized that there is no difference in the means of the latent variable emotional numbing across culture. A one-factor ANOVA was conducted to compare means of the numbing construct between ethnic groups. The findings indicate that the dysphoria model was marginally more preferential than the aroused intrusion model (Rasmussen, Smith, and Keller, 2007; Simms, Watson, & Doebbeling, 2002). The results of a post hoc CFA support previous research, which suggests that a four-factor structure is preferred over the previously accepted three-factor model (American Psychiatric Association, 2000). The findings also suggest that emotional numbing and avoidance are two separate factors. Lastly, the ANOVA resulted in the failure to reject the null hypothesis. Future research is needed to establish model superiority for posttraumatic stress reactions among torture survivors and the generalizability of the model across cultures.

xiv, 116 p. / This study presents the development and validation of a measure of counseling competency with refugee torture survivors. The Refugee Torture Counseling Competency Assessment (REFTOR) measure was adapted from the Multicultural Awareness Knowledge and Skills Survey - Counselor Edition (MAKSS-CE-R; Kim et al., 2003) and was theoretically developed based on the limited literature available on refugee torture survivors. The 37-item REFTOR measure was administered to a sample of 179 psychologists and trainees in clinical and counseling psychology who were actively engaged in clinical work. Results of an exploratory principal axis factor analysis with oblimin (oblique) rotation revealed a two-factor structure for the measure with 37 total items and that explained 43.64% of the total variance. The first factor included 29 items and was labeled "Efficacy," accounting for 38.90% of the variance, and the second factor included 8 items and was labeled "Awareness," accounting for 4.74% of the variance. Evidence of concurrent validity was supported by factor correlations with other scales and items, and internal consistencies for the subscales and the full scale were acceptable. Information regarding current training experiences relevant to clinical work with refugee torture survivors and attitudes towards torture among study participants was also assessed. Results revealed that training experiences are limited, with the majority of information participants received relevant to working with refugee torture survivors coming from non-empirical articles (67% of participants). Attitudes towards torture varied considerably with a sizable proportion of participants endorsing torture in some circumstances (32.4%) and reporting uncertainty about the morality of psychologists' professional involvement in torture (12.3%). Recommendations for future research and implications of study findings for training are discussed. / Committee in charge: Krista Chronister, Co-Chair; Benedict McWhirter, Co-Chair; Paul Yovanoff, Member; Jennifer Freyd, Outside Member

Thesis (Ph.D. in Nursing) -- University of Colorado at Denver and Health Sciences Center, 2005. / Typescript. Includes bibliographical references (leaves 165-174). Free to UCDHSC affiliates. Online version available via ProQuest Digital Dissertations;

Torture survivors find difficulty navigating through an unfamiliar healthcare and social service system. Many survivors who already face Post Traumatic Stress Disorder (PTSD), anxiety, and depression also endure a secondary threat which leads to re-traumatization through the struggles of acculturation. The aim of this study is to determine: 1. Identify differences and assumptions between service providers’ and clients’ definitions of self-sufficiency; 2. Examine prominent barriers to self-sufficiency that survivors encounter; 3. Pinpoint the survival strategies that survivors use in order to cope with life in DFW; 4. Determine what resources CST staff, area service providers, and survivors feel need to be improved for CST and the DFW metroplex.

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