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Harvard Trauma Questionnaire (HTQ)

The Harvard Trauma Questionnaire (HTQ) is a checklist written by HPRT, similar in design to the HSCL-25. It inquires about a variety of trauma events, as well as the emotional symptoms considered to be uniquely associated with trauma.

Currently there are six versions of this questionnaire. The Vietnamese, Cambodian, and Laotian versions of the HTQ were written for use with Southeast Asian refugees. The Japanese version was written for survivors of the 1995 Kobe earthquake. The Croatian Veterans’ Version was written for soldiers who survived the wars in the Balkans, while the Bosnian version was written for civilian survivors of that conflict.

All six versions of the questionnaire, and four manuals for its use, including English translations are available by ordering the Measuring Trauma, Measuring Torture manual.

The early versions of the HTQ (Vietnamese, Laotian, and Cambodian) consist of four sections. Part I asks about 17 traumatic life events determined to have affected Southeast Asian refugees. There are four possible responses for each event: “Experienced,” “Witnessed,” “Heard about it,” or “No.” Respondents are asked to check all that apply. Part II is an open-ended question that asks respondents for a subjective description of the most traumatic event(s) they experienced. Part III asks about events that may have led to head injury. Part IV includes 30 trauma symptoms. The first 16 items were derived from the DSM-IIIR/DSM-IV criteria for posttraumatic stress disorder (PTSD). The other 14 items were developed by HPRT to describe symptoms related to specifically refugee trauma. The scale for each question in Part IV includes four categories of response: “Not at all,” “A little,” “Quite a bit,” “Extremely,” rated 1 to 4, respectively.

In later versions of the HTQ, Part I was expanded to include 46 to 82 traumatic events, and the Experienced/Witnessed/Heard About/No scale was replaced with a simple Yes/No response to each question. The events listed were changed to better reflect the experiences of military and civilian survivors of the wars in the former Yugoslavia, and the survivors of the Kobe earthquake. Part II, the open-ended description of the most traumatic events, was unchanged. Part III, head injury, was expanded slightly in the Bosnian and Croatian versions of the HTQ and omitted in the Japanese version.

The first 16 trauma symptom items, derived from the DSM-IV PTSD criteria, are the same in every version of the HTQ. In the Japanese version, all 30 trauma symptoms from the early versions of the HTQ are used, and 7 more culture-specific questions that deal with trauma symptoms in the Japanese idiom are added. In the most recent versions of HTQ, the Bosnian and Croatian Veterans versions, Section IV includes the 16 DSM-IV PTSD questions and 24 additional symptom items that focus on the impact of trauma on an individual’s perception of his/her ability to function in everyday life. In HPRT’s experience, these symptoms are extremely important because traumatized people are usually more concerned about social functioning than about emotional distress.

Screening instruments should be administered by health care workers under the supervision and support of a psychiatrist, medical doctor, and/or psychiatric nurse. They were not designed to be used as a self-report; no checklist can replace the role of a mental health professional.