Validity of PTSD in a sample of refugee children: can a separate diagnostic entity be justified?

The objective of this study was to examine the construct validity of PTSD in a sample of refugee children from the Middle East-- more specifically, to assess whether associations between traumatic events and specific PTSD symptoms were more outspoken than (1) the associations of PTSD symptoms with non-traumatic exposures, and (2) the associations of violent exposures with symptoms other than PTSD-symptoms. Parents of 311 refugee children from the Middle East were interviewed concerning their children's traumatic experiences and mental health symptoms. The specific PTSD symptoms did not cluster in a factor analysis. The PTSD symptom complex was significantly predicted not only by violent exposures (mother tortured, OR 8.2, p < 0.005; father disappeared OR 3.2, p < 0.05) but also by indicators of family interaction and parents' occupational situation. The two identified violent exposures had significant independent associations with a series of symptoms including symptoms other than those of PTSD (r(s) ranging from 0.25 to 0.44, p < 0.001). Thus it does not seem sufficient to focus solely on PTSD symptomatology when assessing the mental health needs of refugee children.