Aboriginal and Torres Strait Islander Complex Trauma and Strengths Questionnaire: psychometric evaluation

Area of Science:

• Psychiatry and Mental Health
• Indigenous Health
• Psychometrics

Background:

• Complex post-traumatic stress disorder (complex trauma) results from prolonged inescapable threats.
• Aboriginal and Torres Strait Islander peoples face compounding trauma due to colonization, including historical trauma and socio-economic deprivation.
• Culturally appropriate tools for assessing complex trauma in Indigenous Australians are lacking.

Purpose of the Study:

• To psychometrically evaluate a preliminary version of the Aboriginal and Torres Strait Islander Complex Trauma and Strengths Questionnaire (ACTSQ).
• To develop a culturally appropriate instrument for assessing complex trauma and strengths in Aboriginal and Torres Strait Islander peoples.

Main Methods:

• Aboriginal-led co-design was employed over two years.
• Participants included Aboriginal (n=109) and Torres Strait Islander (n=1) parents aged >16 years, recruited from South Australia, Victoria, and Northern Territory.
• Exploratory factor analysis, expert review, McDonald's Omega, and Intraclass Correlation Coefficient (ICC) were used for psychometric evaluation.

Main Results:

• A 44-item questionnaire with five factors was retained: complex trauma symptoms, grief/loss/disconnection, support/relationships, sense of self/strengths, and cultural connections/resources.
• Reliability (Omega >0.75) and inter-rater reliability (ICC 0.5-0.7) were found to be fair to good for all factors.
• Moderate correlations were observed between factors, with an exception for factor 5.

Conclusions:

• The ACTSQ demonstrates initial evidence of cultural validity for assessing complex trauma and strengths in Aboriginal and Torres Strait Islander peoples.
• Further research with larger samples is needed to replicate and enhance the psychometric evaluation of the ACTSQ.