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Specific Trauma Subtypes Improve the Predictive Validity of the
Harvard Trauma Questionnaire in Iraqi Refugees
Bengt B. Arnetz
1,2
, Carissa L. Broadbridge
1,3
, Hikmet Jamil
1
, Mark A. Lumley
3
, Nnamdi
Pole
4
, Evone Barkho
1
, Monty Fakhouri
1
, Yousif Rofa Talia
1
, and Judith E. Arnetz
1,2
1
Wayne State University, Department of Family Medicine and Public Health Sciences, Detroit,
Michigan
2
Uppsala University, Department of Public Health and Caring Sciences, Uppsala, Sweden
3
Wayne State University, Department of Psychology, Detroit, Michigan
4
Smith College, Department of Psychology, Northampton, Massachusetts
Abstract
Background—Trauma exposure contributes to poor mental health among refugees, and
exposure often is measured using a cumulative index of items from the Harvard Trauma
Questionnaire (HTQ). Few studies, however, have asked whether trauma subtypes derived from
the HTQ could be superior to this cumulative index in predicting mental health outcomes.
Methods—A community sample of recently arrived Iraqi refugees (N = 298) completed the HTQ
and measures of posttraumatic stress disorder (PTSD) and depression symptoms.
Results—Principal components analysis of HTQ items revealed a 5-component subtype model
of trauma that accounted for more item variance than a 1-component solution. These trauma
subtypes also accounted for more variance in PTSD and depression symptoms (12% and 10%,
respectively) than did the cumulative trauma index (7% and 3%, respectively).
Discussion—Trauma subtypes provided more information than cumulative trauma in the
prediction of negative mental health outcomes. Therefore, use of these subtypes may enhance the
utility of the HTQ when assessing at-risk populations.
Keywords
refugees; posttraumatic stress disorder; depression; trauma
Author for correspondence: Carissa L. Broadbridge, Department of Family Medicine and Public Health Sciences, Division of
Occupational and Environmental Health, Wayne State University School of Medicine, 3939 Woodward Ave, Detroit, MI 48201,
Telephone: 248-339-6858, Fax: 313-577-3070, [email protected].
The content of this paper is the sole responsibility of the authors and does not necessarily represent the views of NIMH.
Portions of this paper were presented at the 24
th
Annual Convention of the Association for Psychological Science (May 24–27, 2012)
in Chicago, IL.
NIH Public Access
Author Manuscript
J Immigr Minor Health
. Author manuscript; available in PMC 2015 December 01.
Published in final edited form as:
J Immigr Minor Health
. 2014 December ; 16(6): 1055–1061. doi:10.1007/s10903-014-9995-9.
NIH-PA Author Manuscript NIH-PA Author Manuscript NIH-PA Author Manuscript
BACKGROUND
In recent years, there has been an influx of Iraqi refugees in the U.S. (approximately 28,000
in fiscal years 2008 & 2009 and 40,000 in 2010–2012; 1–2). Given the large number of
refugees immigrating to the U.S. it is important that we understand the difficulties these
individuals face. Many of these individuals have experienced a number of potentially
traumatic events as a result of residing in Iraq during multiple wars (i.e., the Iran-Iraq War,
the Gulf War, and the Iraq War). These potentially traumatic events range from
discrimination and persecution to physical and psychological torture, among others (3).
Research suggests that Iraqi refugees are at an increased risk of anxiety and mood disorders
(4–10). These disorders are exacerbated by exposure to pre-migration trauma (7, 10), which
is frequently experienced in high volume for these individuals (3, 5).
Such research, however, typically relies on a cumulative index measure, indexed by a
summation of all potentially traumatic events that an individual has endorsed (11–12) on
measures such as the
Harvard Trauma Questionnaire
(HTQ; 13). The lack of detailed
information on the association between specific traumatic events and mental health status
has left the field with an incomplete understanding of refugee mental health. For example,
knowledge of the specific trauma subtypes that are most strongly associated with
psychopathology could allow for earlier identification of at-risk populations and facilitate
targeted medical and psychological interventions.
The use of cumulative trauma scores in mental health research assumes that the quantity of
trauma is what matters. However, there are qualitative differences in people’s experience of,
and emotional reactions to, different types of trauma, such as sexual assault, physical
assault, transportation accident, and illness (14). Different trauma types might therefore
contribute differently to psychopathology in a way that would be masked by a cumulative
trauma index. Indeed, research in non-refugee populations has shown differences in
pathology across subtypes of trauma exposure (15). Specifically, traumas involving betrayal
have been associated with greater pathology than similar traumas that do not involve
betrayal (e.g., seeing a family member attacked by another family member vs. attacked by a
stranger; 15).
The extant literature on trauma in displaced populations also supports a subtype approach.
One study, examining the effects of four specific types of torture on PTSD and somatic
symptoms in Palestinian prisoners, found that only physical torture and psychological
torture were significant predictors of PTSD; deprivation and beatings were not (16).
Similarly, research examining Tamil refugees and asylum seekers found that various
subtypes of trauma (e.g., detention and abuse, traumatic loss, persecution, and violent death)
have differential impacts on outcomes, particularly PTSD symptoms (11, 17).
In light of evidence from the current trauma literature indicating that trauma subtypes may
be more clinically useful than cumulative trauma indexes, this study sought to examine
trauma subtypes in Iraqi refugees. To date, subtypes of trauma items from the HTQ have
been examined in non-Iraqi samples, but not in Iraqi samples. Differences in the items
included in the HTQ across culturally distinct versions of the measure prevent the use of
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subtypes established in non-Iraqi samples when examining Iraqi refugees (18). This paper
presents data on cumulative and specific trauma from the trauma event section of the HTQ
for a large sample of newly-arrived Iraqi refugees. The study’s primary aim was to examine
the factor structure of the trauma events section of the HTQ and compare the predictive
power of the extracted trauma factors to that of a single index of cumulative trauma. A
secondary aim was to examine associations of the trauma subtypes to PTSD symptoms,
depression symptoms, and language skills in order to assess convergent and divergent
validities of these subtypes. We hypothesized that: (a) specific trauma factors would explain
more variance in trauma exposure items at the measurement level than a single cumulative
trauma factor; (b) trauma subtypes would be related to PTSD and depression symptoms
(convergent validity test), but would be unrelated to language abilities (divergent validity
test); and (c) trauma subtypes would contribute more to the prediction of PTSD and
depression symptoms than cumulative trauma due to qualitative differences between
traumatic events (e.g., being taken hostage may be more traumatic than being present while
someone searches your home).
METHODS
Participants and Data Collection
Newly arrived Iraqi refugees were recruited through multiple community organizations in
Southeast Michigan. Those who initially showed an interest in participation were placed into
a pool of potential participants and a computer randomly selected 35% for recruitment into
this study. Of those who were selected, 98% were willing to participate and were
subsequently interviewed in their homes or at community organizations by trained Arabic-
speaking research assistants. All participants were interviewed within 6 months of arrival in
the U.S. Interviews lasted approximately two hours and were conducted using the measures
described below. The final sample consisted of 298 participants (54% male) ranging in age
from 18 to 69 years (
M
= 33.41,
SD
= 11.29) who had been in the U.S. for only a short
period of time (
M
= 1.00 month,
SD
= 1.08). All procedures and materials were approved by
the Institutional Review Board (IRB) at Wayne State University (Protocol#: 025509B3F).
Measures
With the exception of the HTQ, which was already available in Arabic (18), each of the
measures below was translated into Arabic by a native, bilingual speaker and then back
translated by a second bilingual individual. Participants were asked to report their age,
gender, marital status, level of education, and employment status. Participants provided the
dates when they left Iraq and arrived in the U.S., and these dates were used to compute
transition time, which was defined as the number of months that the individual was
displaced outside of their country of origin before arriving in the U.S.
The trauma events section of the Iraqi version of the HTQ (18) was used to assess pre-
migration trauma exposure. Participants indicated whether they had experienced each of 39
traumatic events before coming to the U.S. Response options were “yes” and “no.”
Cumulative and specific trauma exposure scores were calculated by a count of “yes”
responses to all items (cumulative trauma) or items in specific domains (specific trauma).
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PTSD symptoms were assessed with the civilian version of the PTSD Checklist (PCL-C),
which includes 17 self-report items asking the participant to indicate the degree to which
they were distressed by each of the symptoms of PTSD listed in the fourth edition of the
Diagnostic and Statistical Manual of Mental Disorders
, text revision (
DSM-IV-TR
; 19).
Each item was rated on a scale from 1 (not at all) to 5 (extremely), and total PTSD symptom
severity scores were calculated by summing these ratings. The PCL has been shown to have
good test-retest reliability (
r
= .87) as well as convergent validity with the Davidson Trauma
Scale (
r
= .74; 20). Internal consistency was high for this sample (
α
= .91). During data
collection, one item was missing from the PCL-C for 88 participants. These missing data
were imputed using regression.
Symptoms of depression were assessed with the 7-item depression subscale of the Hospital
Anxiety and Depression Scale (HADS; 21). The internal consistency of the scale was high
for this sample (
α
= .93). Items were rated on a scale from 0 to 3, with higher total
(summed) scores indicating greater depression symptoms.
Participants were asked the following two questions regarding their English language
abilities: “How well do you speak English?” and “How well do you write in English?” Both
questions were answered on a 4-point scale ranging from 1 (not at all) to 4 (very well).
Other studies have successfully measured language abilities using single-item measures
similar to the items used here (22, 23). These questions were asked post-migration; however,
the surveys were administered very soon (0 – 6 months) after arrival in the U.S.
Analyses
Principal components analysis (PCA) with oblique rotation (δ = 0) was then conducted on
the items of the HTQ to identify subtypes (or factors) of specific traumatic events. Oblique
rotation was used because the trauma subtypes were expected to correlate moderately with
one another, and we did not want to force the factors to be independent (24). Items with
primary loadings greater than 0.30 on the same factor were then summed to create factor
scores for subsequent analyses (24). The variance accounted for in trauma items for the
multi-factor model was compared to the variance in trauma items accounted for by a model
in which the items were forced into a single factor, representative of how the HTQ has
previously been used in a cumulative fashion (7,12). The sample size in this study (N = 298)
was adequate for a stable solution using PCA; samples of 200 – 300 participants are
suggested to ensure stability (24).
Convergent and divergent validity were examined by calculating Pearson product moment
correlation coefficients between each of the identified trauma subtypes and the following
variables: spoken language skills, written language skills, PTSD symptoms, and depressive
symptoms.
Two hierarchical regression analyses were conducted to predict PTSD symptoms and
depressive symptoms from the new trauma subtypes, after controlling for age, gender,
education, transition time, and time in the U.S. Control variables were entered in the first
step of each regression analysis, and trauma variables were entered in the second step using
simultaneous forced entry for each set of variables. Two similar regression analyses were
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conducted predicting PTSD and depression symptoms with trauma exposure assessed as a
single cumulative score. Alpha was set to a two-tailed value of .05 for these regressions.
RESULTS
Data were first analyzed to determine which potentially traumatic events were extremely
rare (experienced by less than 5% of the sample; 13 items) and which were extremely
common (experienced by more than 95% of the sample; 2 items). The frequency of
occurrence in these items is problematic because they do not contribute enough information
to maintain a meaningful factor structure (25). The uncommon events involved religious
persecution, witnessing harm to others, sexual violence, and being forced to harm someone
else in some way, while the common events involved witnessing combat and being confined
to one’s home. Two additional items (hearing about events happening to others and having
one’s property looted) were deleted due to dual loadings on multiple factors. This resulted in
22 items that were suitable for the PCA, described next.
The rotated solution of the PCA revealed five trauma components, which together accounted
for 50% of the variance in the items. Every item loaded greater than 0.30 on at least one
factor and no item loaded greater than 0.30 on a secondary factor (Table I; only loadings > .
30 are shown). By comparison, the model in which all the HTQ items were forced into a
single component explained only 14% of the item variance, and 9 of the 22 items had factor
loadings less than 0.30 (Table I). Based on the item content for each of the five components,
the following names were assigned to the trauma subtypes: (a) physical trauma to others, (b)
physical trauma to the self, (c) lack of necessities, (d) abduction of family or friend, and (e)
persecution/coercion. Descriptive statistics for these components and other key variables are
summarized in Table II.
All of the trauma subtypes were significantly correlated with at least one mental health
outcome, with the exception of Persecution/Coercion. Four trauma subtypes, Physical
Trauma to the Self, Lack of Necessities, Physical Trauma to Others, and Abduction of a
Family Member or Friend, predicted higher PTSD symptoms (
r
= .27,
p
< .001;
r
= .17,
p
< .
01;
r
= .15,
p
< .01;
r
= .13,
p
< .05; respectively). In addition, two trauma subtypes
(Physical Trauma to the Self and Lack of Necessities) predicted higher depression
symptoms (
r
= .18,
p
< .01;
r
= .27,
p
< .001; respectively). On the other hand, there were no
significant correlations between trauma and self-rated language abilities, that is neither
speaking English nor writing English was significantly related to any trauma subtype.
The results of the hierarchical regression analyses predicting PTSD and depression
symptoms are reported in Table III. For both PTSD and depression symptoms, higher levels
of physical trauma to the self and lack of necessities were significant predictors of higher
symptom levels, after controlling for age, gender, education, transition time, and time in the
U.S. More cumulative trauma was a significant predictor of both higher PTSD symptoms
(
ΔR
2
= .07,
F
(1,268) = 20.23,
p
< .001; power = .94) and higher depression symptoms (
ΔR
2
= .03,
F
(1,268) = 8.41,
p
= .004; power = .56); however, the five trauma subtypes jointly
accounted for 5% more variance in PTSD symptoms (
ΔR
2
= .12,
F
(5,264) = 7.73,
p
< .001;
power = .99) and 7% more variance in depression symptoms (
ΔR
2
= .10,
F
(5,264) = 6.63,
p
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< .001; power = .98) than did cumulative trauma. The trauma subtype models also
accounted for more variance in PTSD symptoms (
ΔR
2
adjusted
= .11) and depression
symptoms (
ΔR
2
adjusted
= .09) than the cumulative trauma models (
ΔR
2
adjusted
= .07,
ΔR
2
adjusted
= .02; respectively) when accounting for differences in degrees of freedom.
Although these results show the overall results of the full models, the effects of specific
predictors are of interest as well. Cumulative trauma uniquely accounted for 7% of the
variance in PTSD symptoms, whereas physical trauma to the self accounted for 8% of the
variance in PTSD symptoms. Similar results can be seen in the models predicting depression
symptoms. Cumulative trauma uniquely accounted for 3% of the variance in depression
symptoms, whereas physical trauma to the self uniquely accounted for 3% and lack of
necessities uniquely accounted for 6% of the variance in depression symptoms. This
suggests that some specific trauma subtypes independently accounted for more variance in
symptoms than did cumulative trauma.
DISCUSSION
This study classified specific trauma events into subtypes of trauma using factor analytic
techniques in a large sample of recently arrived Iraqi refugees. This study also assessed the
validity of using trauma subtypes as a measure of various trauma exposures by examining
the correlations of trauma subtypes with PTSD symptoms, depression symptoms, and
language abilities. Finally, this study assessed the usefulness of these subtypes of trauma
compared to a measure of cumulative trauma in three ways: (a) by comparing how well each
method summarized the trauma exposure data, (b) by analyzing the convergent and
divergent validity of the subtypes, and (c) by comparing how well each method predicted
mental health outcomes. Analyses supported a 5-component model of trauma exposure as
assessed by the HTQ. As predicted, the specific trauma components (i.e., physical trauma to
others, physical trauma to the self, lack of necessities, abduction of family or friend, and
persecution/coercion) explained more variance in trauma exposure items at the measurement
level than did the single measure of cumulative trauma. Furthermore, these subtypes appear
to be a valid way of assessing trauma exposure in recently arrived refugees, in that they
demonstrated convergent and divergent validity in accordance with our predictions. Finally,
trauma subtypes revealed better predictive strength for PTSD and depression symptoms than
did cumulative trauma, even though symptom levels were somewhat low in this sample.
Thus, all three study hypotheses were supported.
The results of the PCAs reported here suggest that trauma exposure is better conceptualized
using specific subtypes of traumatic events than using a single, cumulative trauma index.
Subtypes provide additional information that could increase our understanding of the
mechanisms contributing to observed differences in mental health outcomes. Regression
analyses further supported the usefulness of specific trauma subtypes, which demonstrated
increased predictive power over that of cumulative trauma when predicting both PTSD and
depression symptoms. This is in line with prior research on refugees and asylum seekers,
which suggests that cumulative trauma has a relatively low predictive power, accounting for
only about 20% of the variance in PTSD and depression symptoms (26).
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Two trauma subtypes were important in predicting both PTSD and depression symptoms,
physical trauma to the self and lack of necessities; however, the strength of the associations
differed for the two outcomes. Physical trauma to the self was a stronger predictor of PTSD
symptoms than lack of necessities, and lack of necessities was a stronger predictor of
depression symptoms than physical trauma to the self. Although personally experienced
events are typically more closely associated with poor mental health than are events that are
only experienced vicariously, these results suggest that the nature of those personally
experienced events is important as well. It may be that the threat or danger of physical
trauma precipitates the anxious hypervigilance, intrusions, and avoidance of PTSD. In
contrast, deprivation of things needed for survival (i.e., food, shelter, and medical care) may
cause the helplessness or defeat that is associated with depression. Note that such
explanatory power is lost when assessing trauma exposure with only a cumulative score. Not
only does the cumulative model explain less of the variance in PTSD and depression
symptoms, but it provides no information regarding which specific events actually influence
those outcomes. Therefore, both predictive power and descriptive power are lost by the use
of a cumulative trauma exposure score.
Prior research suggests that ongoing exposure to a war environment can induce negative
mental health outcomes (27–28); however, people in the present study showed rather low
rates of mental health problems even though they came from an environment in which they
had substantial exposure to war-related events. Our data suggest that it was not the events
directly related to the war that were associated with poor mental health outcomes, but rather
the events directly impacting the individuals. Prior studies have used somewhat broad or
nonspecific definitions of the war environment by including a wide range of events such as
exposure to landmines, exposure to a combat situation, abduction of friends or family,
personal assault, lack of food or shelter, and detention (17,27). The results of the present
study suggest that such events form separate domains with differential effects on mental
health. Our data also suggest that experiencing more personal events, such as physical harm
or lacking necessities, increases the risk of negative mental health outcomes, and these
effects are different than the effect of simply being in the war environment.
This study has many strengths. First, it is one of few studies examining specific subtypes of
trauma and how those trauma subtypes improve the prediction of mental health outcomes.
Second, the present study examined a large number of refugees sampled from a wide variety
of community organizations. Third, this study assessed refugees who had recently arrived in
the U.S., whereas prior research on refugee populations used convenience samples of
refugees who had been in the U.S. for an average of four years (10). By examining refugees
who have very recently arrived in the U.S., the present study is better able to attribute mental
health outcomes to the specific trauma subtypes examined, because post-migration factors,
such as social and economic challenges in the host country, have had very limited time to
exert their influence.
This study also has some limitations. First, this study examined only refugees, and only from
the country of Iraq; it is possible that the specific trauma subtypes could be different for
non-refugees and those from other countries. Additionally, the HTQ is somewhat culture-
specific, which limits comparisons to other cultural groups on these specific scales. Second,
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the present study measured trauma using the trauma events section of the HTQ, but did not
use the HTQ to measure trauma symptoms. Although this may be a limitation, the use of the
PCL allowed for a more specific assessment of PTSD. Unlike the trauma symptoms section
of the HTQ which asks about a variety of symptoms that could result from trauma, the PCL
focuses specifically on symptoms of PTSD as defined in the
DSM-IV-TR
. Third, the
analyses used in this study were somewhat exploratory, and replication is indicated. Finally,
symptom levels in this sample were particularly low, which could be a result of the speed at
which they were tested after arriving in the U.S. This is in line with research examining
soldiers, which suggests that low symptom levels are common in the months immediately
following return from deployment (29–30). Nonetheless, the relatively low scores on the
symptom measures likely limit the magnitude of the correlations we obtained with the
trauma measures.
Overall, these results suggest that information on specific trauma exposures should be taken
into account when assessing the mental health of at-risk populations in order to potentially
optimize diagnosis, treatment, and prevention programs. This study suggests that it may be
beneficial to use trauma subtypes rather than cumulative trauma scores to better describe
trauma experiences and predict mental health outcomes. Future research should examine the
effect of these specific trauma variables over time, which would provide insight as to the
time-course of mental health outcomes, and how that time-course is influenced by
differential trauma exposure. Also, the mechanisms through which such traumas influence
mental health should be examined. Such examinations could aid in distinguishing the effects
of various influences, such as culture, environmental factors, and one’s interpretation of
events, on mental health outcomes.
Further examination of trauma subtypes could advance the understanding of the role of
trauma in mental health, thereby allowing for earlier identification of at-risk individuals.
Understanding the mechanisms through which observed group differences occur may also
facilitate appropriate diagnosis and treatment of mental health disorders. Such information is
needed given the large number of refugees immigrating to the U.S. (1). More accurate
identification of individuals who are at-risk for poor mental health could allow incoming
refugees to be better served by the social and health programs that are currently in place,
thereby increasing the cost efficiency of those programs.
Acknowledgments
The authors thank Mrs. Raja Yaldo for her assistance in data entry. We also thank the following organizations for
assisting with recruitment: Lutheran Social Services of Michigan, the Arab Community Center for Economic and
Social Services/Arab Community for Health and Research, Kurdish Human Rights Watch, The Chaldean
Federation of America, U.S. Committee for Refugees and Immigrants, and Catholic Services of Macomb County.
All authors were partly supported by grant number R01MH085793 from the National Institute of Mental Health
(NIMH, B. Arnetz, Principal Investigator).
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TABLE I
Item Loadings for Single Component (Cumulative) vs. Multiple Component (Specific) Trauma Models
Item CT PTO PTS LN AFF P/C
Witnessed physical harm of others .50 .71
Witnessed murder .55 .70
Witnessed execution of civilians .40 .64
Witnessed rotting corpses .58 .63
Searched arbitrarily .46 .39
Witnessed shelling, burning or razing .31 .38
Present during a search of your home .39 .31
Taken as a hostage .35 .91
Kidnapped .28 .91
Physically harmed or beaten .43 .78
Lack of food/clean water .18 .78
Had no access to medical care .22 .74
Lacked shelter .20 .71
Family or friend taken hostage .46 .97
Family or friend kidnapped .51 .96
Disappearance of family or friend .41 .37
Violent death of family member .28 .36
Forced to flee .23 .75
Forced to settle .27 .62
Oppressed .04 .52
Someone informed on you .30 .46
Witnessed desecration .26 .35
Note:
Components are as follows (CT) Cumulative Trauma, (PTO) Physical Trauma to Others, (PTS) Physical Trauma to the Self, (LN) Lacked Necessities, (AFF) Abduction of Family member or Friend,
and (P/C) Persecution/Coercion. No secondary loadings exceeded .30.
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TABLE II
Descriptive Statistics for Study Variables
Range
M SD
Age 18–69 33.27 11.10
Months in US 0–4.50 1.00 1.09
Transition Time (months) 0–237 28.85 28.44
Physical Trauma to Others 0–7 2.65 1.72
Physical Trauma to Self 0–3 0.33 0.81
Lack of Necessities 0–3 0.42 0.78
Abduction of Family/Friend 0–4 1.99 1.40
Persecution/Coercion 0–5 3.71 1.13
Cumulative Trauma 0–22 9.16 3.25
PTSD Symptoms 17–85 19.44 5.40
Depression Symptoms 0–21 1.91 3.50
Note:
Range indicates the possible range on a given scale, not the actual range in the sample. Exceptions to this are Age, Months in the US, and
Transition Time. The range indicated for these variables is the range in the sample.
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TABLE III
Prediction of Mental Health Disorder Symptoms via Specific vs. Cumulative Trauma
Trauma Predictor
PTSD Symptoms Depressive Symptoms
β
t p r
2
β
t p r
2
Specific
N
= 275
Gender (Female = 0) −.11 −1.83 .07 .01 −.09 −1.41 .16 .006
Education (≤HS = 0) −.04 −0.75 .46 .002 −.15 −2.71 .007 .02
Age .15 2.59 .01 .02 .24 4.12 <.001 .05
Months between Home and US −.03 −0.42 .68 .001 −.10 −1.59 .11 .008
Months in US <.001 0.00 1.00 <.001 −.04 0.72 .47 .002
Physical Trauma to Others .11 1.73 .09 .01 .03 0.52 .61 <.001
Physical Trauma to Self .29 4.85 <.001 .08 .20 3.38 .001 .03
Lack of Necessities .13 2.17 .03 .02 .25 4.27 <.001 .06
Abduction of Family/Friend .09 1.54 .13 .008 .04 0.60 .55 .001
Persecution/Coercion −.01 −0.17 .87 <.001 −.05 −0.79 .43 .002
Cumulative
N
= 275
Gender (Female = 0) −.09 −1.43 .15 .007 −.07 −1.23 .22 .005
Education (≤HS = 0) −.06 −0.96 .34 .003 −.18 −3.00 .003 .03
Age .16 2.67 .008 .02 .25 4.30 <.001 .06
Months between Home and US .04 0.69 .49 .002 −.01 −0.15 .88 <.001
Months in US −.01 −0.12 .91 <.001 .06 −0.98 .33 .003
Cumulative Trauma .28 4.50 <.001 .07 .18 2.90 .004 .03
Note:
Reference categories for nominal variables are indicated in parentheses following the variable for which the category is a reference. When no reference category is indicated continuous measures were
used.
r
2
indicates the squared semi-partial correlation which tells us the unique variance in depression symptoms accounted for by that predictor (16).
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