HADStress screen for posttraumatic stress: Replication in Ethiopian refugees

Ashley Gulden, Joseph Westermeyer, Rebecca Lien, Marline Spring, David Johnson, James Butcher, James Jaranson

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


Purpose was to assess whether a 4-symptom somatic screen, shown to correlate with current post-traumatic stress symptoms in 1 refugee group, could function as a screening instrument in another group of refugees. Sample consisted of 512 community-dwelling refugees from Ethiopia. Data collection included demography, types of torture and nontorture trauma experienced a decade earlier in Africa, and current posttraumatic stress symptoms. Somatic symptoms included headaches (H), appetite change (A), dizziness and faintness (D), and sleep problems (S), added with equal weighting into the HADStress Screen, ranging from 0 to 4. Results showed that age, gender, torture, and other trauma experiences from a decade ago, and current posttraumatic stress symptoms predicted current somatic symptoms on univariate analyses. On a negative binomial regression model, current posttraumatic stress symptoms, male gender, and number of torture types predicted a high HADStress score. Post hoc tests supported cut-off levels at 3 and at 4 symptoms. Conclusion is that the HADStress Screen can serve as an efficient, nonthreatening screen for posttraumatic stress symptoms among refugees.

Original languageEnglish (US)
Pages (from-to)762-767
Number of pages6
JournalJournal of Nervous and Mental Disease
Issue number10
StatePublished - Oct 2010


  • Refugee
  • posttraumatic stress
  • screening
  • somatization
  • torture


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